Post on 14-Dec-2015
Statistics
American Cancer Society estimates for 2014In US 1,665,540 new cases In US 585,720 deathsIn Ohio 67,000 new cases Cancer is the 2nd most common cause of
death in the US, responsible for 1 in 4 deaths
Statistics
By 2030 expect 2.3 million new cases annually in US
By 2030 cancer will be leading cause of deathPeople living at least 5 years after cancer
diagnosis 1970s 50% Currently 66%
Cancer treatments
Modes of treatmentSurgeryRadiationChemotherapyTreatment with single mode or multiple modesExample of multi-modal: Breast cancer
(radiation to reduce tumor prior to surgery, chemotherapy after surgery)
Chemotherapy
Usually given in outpatient setting Prevents cancer cells from metastasizingSystemic therapy
Given intravenouslyDestroys good and bad cellsTreatments on set schedule
Radiation therapy
Local treatment directed at specific areaTreatments scheduled daily, but treatment
extends for weeks
Oral chemotherapy
Increasing number of patients receiving oral chemotherapy
PRECAUTIONS NEEDED: Handled with proper protection including chemo
gloves Keep away from others in secure area
Side effects of cancer treatment
Fatigue Most common side effect Due to decreased red blood cells leading to lower
oxygen levels Inability to perform basic tasks No over-exertion, conserve energy Accommodations
Frequent rest periods Nutritious foods, plenty liquids
Side effects of therapy
Nausea Anti-nausea medications can prevent vomiting Nausea triggers
Perfumes and odors Fried foods, spicy foods, fatty foods, overly sweet foods Dehydration
Increased risk of nausea Women Younger patients Women with history of morning sickness
Helping people avoid nausea
Provide small frequent meals (nausea occurs on an empty stomach)
Avoid strong odorsAssure availability of anti-nausea medication,
encourage to take as prescribedProvide dry crackers/dry toastAvoid spicy, greasy, fatty foods
Helping people with diarrhea
ImodiumBRAT diet – bananas, rice, applesauce, dry
toastAvoid high fiber, high fat, greasy, spicy foodsAvoid caffeine, milk, alcoholIncrease fluids
People with fever
Due to low blood counts, usually 7 to 10 days after chemo
Observe for temperature increase First sign of infection
If fever of 100.4°F or 38°C (have thermometer available) To ER or call oncologist on duty
Infection precautions
Chemotherapy patients can reside in general population shelter, but away from ill people Dependent on instructions from physician Provide isolation if necessary
Skin problems
Especially for people receiving radiation therapy Redness of skin Provide Eucerin, Aquaphor
Other side effects
Less frequent side effects related to attack on the “good cells”Alopecia
May use head covering, even at nightNumbness in fingers
Difficulty feeling, holding thingsStomatitis
Questions to ask
If a shelter resident identifies as a person being treated for cancer, ask about Pain medicine Anti-nausea medicine Oral chemotherapy Personal supplies: ostomy bags, etc. Time and place of next treatment
Have available
Rest areaNutritious foodsFluids (water, juice, Gatorade, popsicles, Jell-
O)ImodiumThermometer
End of life concerns
Understanding prognosis patients continue to "hope" - requesting more
treatmentsAsk person (and listen to the answers) what
care or treatment will be needed in the shelter and how best to provide the care Ask if caregiver is with person Ask about others providing care Ask about advanced directives
End of life concerns – symptom control
Pain – adequate pain controlSecretions – control and/or managing
secretionsConstipation – adequate hydration, stool
softenersAnxiety – medication, comforting
environment, caregiversDyspnea (difficulty breathing) – positioning,
oxygen
POD related information
Per CDC – no live vaccines Herpes Zoster (shingles) Flu mist (nasal spray) Measles, mumps and rubella (MMR) Smallpox Yellow fever Chicken pox