Mini Review
Open Access
Chemotherapeutic Toxicity And Symptom
Management In Geriatric Patients With Cancer
Nurhan Doğan* and Kenan Gümüş
Department of Nursing, Amasya University, Turkey
*Corresponding author: Dr. Nurhan Doğan, Department of Nursing, Faculty of Health Sciences, Amasya University, Turkey, Tel: +90 358
218 17 67; F ax: +90 358 218 47 60; E -mail:
@
Received: December 19, 2018; Accepted: February 16, 2018; Published: February 23, 2018
Citation: Nurhan D, Kenan G (2018) Chemotherapeutic Toxicity And Symptom Management In Geriatric Patients With Cancer. Palliat Med Care 5(1): 1-2. DOI: 10.15226/2374-8362/5/1/00153
AbstractTop
Introduction: It is very important to perform a comprehensive
geriatric assessment to prevent the development of physiological and
psychological complications that may be associated with cancer and
treatment in elderly individuals.
Method: Literature review was presented extracting from the full texts and summarized articles reached via databases such as “Pub Med, Scopus, Scince Direct, Ulakbim, Google Scholar” by using key words such as chemotherapeutic toxicity, symptom management, geriatric patients and cancer.
Results: Complications such as myelosuppression, gastrointestinal toxicity, fluid electrolyte imbalance, metabolic problems, skin reactions, ulcers, photosensitivity, organ toxicity are very common in comoterapy. In order to control these complications, which may be seen more aggressively in elderly individuals, the patient, family and health personnel should work as a whole.
Conclusion: Routinely informed about comprehensive geriatric assessment, disease status, functional capacity and general health risks, quality of life should be kept at maximum level. Whenever possible, the person performing the patient should protect their activities independently. Individual and family cancer treatment procedures and chemotherapy complications and symptom management should be trained.
Keywords: Cancer; Chemotherapeutic Toxicity; Geriatric Patients; Symptom Management
Method: Literature review was presented extracting from the full texts and summarized articles reached via databases such as “Pub Med, Scopus, Scince Direct, Ulakbim, Google Scholar” by using key words such as chemotherapeutic toxicity, symptom management, geriatric patients and cancer.
Results: Complications such as myelosuppression, gastrointestinal toxicity, fluid electrolyte imbalance, metabolic problems, skin reactions, ulcers, photosensitivity, organ toxicity are very common in comoterapy. In order to control these complications, which may be seen more aggressively in elderly individuals, the patient, family and health personnel should work as a whole.
Conclusion: Routinely informed about comprehensive geriatric assessment, disease status, functional capacity and general health risks, quality of life should be kept at maximum level. Whenever possible, the person performing the patient should protect their activities independently. Individual and family cancer treatment procedures and chemotherapy complications and symptom management should be trained.
Keywords: Cancer; Chemotherapeutic Toxicity; Geriatric Patients; Symptom Management
Introduction
Innovation in health care technology, the expansion of health
services to individuals prolonged life expectancy has increased
with the raising of awareness and the elderly population [1- 3].
Along with age progression, the incidence of cancer is increasing,
but cancer-related deaths are also increasing. According to
statistics and studies done, the incidence of cancer and the
majority of cancer deaths were seen in individuals over 65 years
of age [3- 8]. The causes of cancer-related deaths in the elderly
include inadequate anti-tumoral treatment, inability to tolerate
treatment, lack of age-specific treatment protocols, reduction in
functional capacity, psychological, social and comorbid health
problems and inadequate use of preventive methodsIt is very
important to make comprehensive geriatric assessment to
prevent the development of physiological and psychological
complications that may be associated with cancer and treatment
in elderly individuals, because in these patients the treatment gain
is minimal and the treatment toxicity is high [3, 7- 9]. The greatest
concern during the use of chemotherapeutic drugs used in cancer
treatment is toxicity. Toxicities of these drugs need to be known
and monitored [8,10]. In elderly patients, due to age-related
physiological changes, the mechanism of action of the drug, the
dosage and form of administration, the pharmacokinetics and
pharmacodynamics of the drug, the protocol of drug or drug
administration, the adequacy of the person’s liver, kidney and
bone marrow functions, co-morbidity and has been spread to
bone marrow of the disease, toxicity is determined [8; 10-13].
It is vital that geriatric cancer is vital in the development of
cancer, because individuals are able to tolerate treatment, have
correctable conditions that may affect treatment, management
of treatment symptoms, increase in patient’s quality of life, and
individual differences in the aging process [3, 8, 12, 14-16]. The
elderly individual should be treated with necessary psycho and
/ or pharmacotherapeutic approaches and caregivers should
be ensured. Many causes such as depression, functional and
cognitive disorders lead to malnutrition. Individuals should be
closely monitored for malnutrition, polypharmacy status should
be learned and drug interaction should be assessed. For renally
withdrawn drugs, dose adjustment should be done by calculating
glomerular filtration rate. Chemotherapeutic toxicities;
myelosuppression (bone marrow toxicity), gastrointestinal
toxicity (nausea-vomiting, anorexia, oral mucositis, diarrhea,
constipation), fluid-electrolyte imbalance, metabolic problems
(such as impaired glucose regulation), skin reactions (dryness,
pruritus, erythema, urticaria, ulcer, photosensitivity, alopecia),
organ toxicity (hepatotoxicity, pulmonary toxicity, cardiac toxicity,
neurotoxicity, nephrotoxicity) in terms of individuals should be
monitored closely [12, 13, 17, 18].
Method
Literature review was presented extracting from the full texts
and summarized articles reached via databases such as “Pub
Med, Scopus, Scince Direct, Ulakbim, Google Scholar” by using key
words such as chemotherapeutic toxicity, symptom management,
geriatric patients and cancer. The review was carried out on the
magazines which can only be accessed on-line in the screening
process.
Result
The recognition and reporting of side effects of chemotherapy
in geriatric patients is at least as important as the efficacy of
the treatment; but it is reported that there is not yet a standard
developed in the world in this respect, but the question of side
effects and the quality of life findings are behind the scenes. The
development of tools to measure the individual’s risk of serious
toxicity from chemotherapy and these tools are thought to be of
considerable benefit, especially for older patients [Table 1].
Table 1:Chemotherapeutic Toxicities
Chemotherapeutic Toxicities |
|
Myelosuppression |
Bone marrow toxicity (neutropenia, thrombocytopenia, anemia) |
Gastrointestinal toxicity |
Nausea-vomiting |
Anorexia |
|
Oral mucositis |
|
Diarrhea |
|
Constipation |
|
Fluid-electrolyte imbalance |
|
Metabolic problems |
İmpaired glucose regulation |
Skin reactions |
Dryness |
Pruritus |
|
Erythema |
|
Urticaria |
|
Ulcer |
|
Photosensitivity |
|
Alopecia |
|
Organ toxicity |
Hepatotoxicity |
Pulmonary toxicity |
|
Cardiac toxicity |
|
Neurotoicity |
|
Nephrotoxicity |
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