Side effects of chemotherapy
Oncology / / May 08, 2016
Most anticancer drugs has a toxic effect on the organs of the hematopoietic system.An exception in this respect are bleomycin and streptonigrin.The small degree affect the bone marrow and dacarbazine, adriamycin, and platinum compounds.Toxic effects on the blood forming organs usually begins to manifest 24 hours after administration of the drug.The degree of reduction in the number of blood cells and platelets is dependent on the dose, the patient's age and previous load on hematopoietic organs.Sometimes reduction of these indices preceded them temporary increase.maximum reduction of time varies for different patients when using different drugs.When administered drugs nekumuliruyuschihsya decrease in the number of white blood cells is observed on 4-5 day, then for a week should be a full recovery.However, there are medications (eg, nitrosoureas), toxic effects on organs which hematopoietic system manifested 2-3 weeks after treatment.In connection with this control pattern is needed and the blood of pati
therefore recommended to begin treatment of anticancer drugs only when the number of leucocytes is not lower than 4000 (absolute granulocyte not lower than 2000), and platelet count exceeds 100 000. If during the treatment the number of leukocytes decreased below 4000, but greater than 3,000,treatment should be continued by reducing the dose of medications in half.When white blood cells below 3000 treatment should be stopped until the restoration of baseline (usually 1-2 weeks).Particular attention should be paid to the introduction of additional drugs and avoid simultaneous administration of compounds acting on the bone marrow.
Most cytostatics cause nausea, vomiting, loss of appetite, and in the long-term treatment - Reduction of body weight of the patient.Vomiting is not only due to the irritation of the mucous membranes, but may have a central origin and facilitates the introduction of sedatives.Due to the frequent occurrence of such reactions when administered anticancer drugs inside should strive to ensure that no significant loss to their vomit.With severe lesions of the mucous membranes of the mouth (stomatitis, gingivitis, glossitis) have to meet with the administration of methotrexate, cytosine arabinoside.A frequent complication is diarrhea, especially when using methotrexate and 5-fluorouracil.Treatment with high doses of cytotoxic drugs almost always lead to such side effects, against which often develop secondary fungal and septic lesions.In the prevention and treatment of these complications are of great importance a thorough oral care and symptomatic therapy.
Treatment mainly vinblastine, cyclophosphamide, adriamycin often leads to partial or complete baldness.This patient should be warned.After 6-8 weeks after the end of treatment the hair grows back.Local skin pigmentation may cause long-term treatment Myleran and administration of bleomycin in a total dose above 300 mg sometimes leads to the development of hyperkeratosis of palms and soles.
Neurotoxicity in the form of peripheral paresis, myalgia, hyperhidrosis, rarely ileus may accompany treatment with vincristine.Heavier toxic disorders of the central nervous system (drowsiness, impaired balance, blackout) can occur when administered to embihina, procarbazine, and others. Various mental reactions are accompanied by the beginning or the end of treatment with high doses of prednisone.The introduction of platinum compounds can cause deafness development, cause renal toxicity.To prevent the latter suggest the use of mannitol.By liver toxicity can sometimes result in prolonged therapy with estrogen or 6-mercaptopurine (leupurin).
pulmonary fibrosis may develop after Myleran therapy lasted for years, after bleomycin administration in a total dose of 500 mg or higher high-dose methotrexate.Unfortunately, this process is irreversible.For typical adriamycin cardiotoxicity (conduction disturbances, myocardial ischemia).
Anticancer drugs reduce sexual function.In men, frequent azoospermia, decreased libido and potency.Women usually develop oligo- or amenorrhea.However, despite this treatment during cancer therapies and after pregnancy can occur.In such cases, the doctor and the patient face the decision a difficult task.Experience has shown that the risk of the fetus is small, but the possibility of a genetic injury is not completely ruled out.
lot written about that connection with antitumor activity are at the same time and carcinogenic.Yet the possibility of developing a second cancer in survivors for a long time and patients with small amounts of 1: 5000.Without exception, all anticancer drugs have immunosuppressive effect.This fact encourages the clinician to pay special attention to the prevention of tumor process often related diseases, and for their development - to provide timely therapy.From this point of view, even cure athlete's foot looks important, since among the causes of death of cancer patients increasing place is mycotic sepsis.
diverse and multifaceted side effects of anticancer drugs have specific requirements to the attending physician.The need for strict control and constant readiness to eliminate an expected side effect.This makes it appropriate chemotherapy only in institutions where doctors have the necessary professional experience, where the treatment has the appropriate material resources.