Immunotherapy Immunotherapy is treatment with drugs that help the immune system recognize and attack cancer cells. Active immunotherapy agents activate the patient’s immune system to fight the disease. Passive immunotherapies provide the components of the immune system to attack cancer. These passive agents (i.e., antibodies) are created outside of the body, and then given back to fight the disease. Hormone therapy Hormone therapy uses sex hormones and hormone-like drugs to impact the function or production of male or female hormones. They work differently than standard chemotherapy agents, but they can slow the growth of cancers that depend on natural sex hormones in the body (i.e., breast, uterine, and prostate cancers). Hormone therapy works by preventing the body from making certain hormones or by keeping cancer cells from using the hormones needed to grow.
Active immunotherapies include: ● Monoclonal antibody therapy (i.e., alemtuzumab, and rituximab). ● Immunomodulating drugs (i.e., thalidomide and lenalidomide). ● Non-specific immunotherapies and agents that boost the immune response (i.e., BCG, interferon-alfa, and interleukin-2). ● Cancer vaccines, an active immunotherapy, exist for certain forms of cancer. Examples of hormone therapy include: ● Aromatase inhibitors (anastrozole, letrozole, and exemestane). ● Progestins (megestrol acetate). ● Anti-estrogens (fulvestrant, toremifene, and tamoxifen). ● Anti-androgens (flutamide, nilutamide, and bicalutamide). ● Estrogens. ● Gonadotropin-releasing hormone (GnRH), also called l uteinizing hormone-releasing hormone (LHRH) .
SIDE EFFECTS FROM CANCER TREATMENTS
● Fertility issues in girls & women. ● Flu-like symptoms. ● Hair loss (alopecia). ● Immunotherapy & organ-related inflammation. ● Infection and neutropenia. ● Lymphedema. ● Memory or concentration problems. ● Mouth and throat problems. ● Nausea and vomiting. ● Nerve problems (peripheral neuropathy). ● Pain. ● Sexual health issues in men & women. ● Skin and nail changes.
Cancer treatments can be effective in attacking cancer cells, but they can also create problems that affect healthy tissues or organs. These side effects can be mild or severe and they vary from patient to patient. Common side effects can include nausea, fatigue, appetite loss, diarrhea, edema, and risk for infection. However, the type and severity of symptoms depends on factors such as the type of treatment, frequency of treatment, patient’s age, and presence of other health conditions. The National Cancer Institute posted a comprehensive list of all possible side effects: ● Anemia. ● Appetite loss. ● Bleeding and bruising (thrombocytopenia). ● Constipation.
● Sleep problems & insomnia. ● Urinary and bladder problems. (National Cancer Institute. n.d.)
● Delirium. ● Diarrhea.
● Edema. ● Fatigue. ● Fertility issues in boys & men.
The following sections will describe the side effects and complications specific to each type of cancer treatment.
Radiation therapy Fatigue is the most universal side effect from radiation therapy. It usually begins approximately three weeks into treatment, but it gradually resolves when the treatment is finished. Several other side effects can occur in the tissues that are subjected to the radiation field. They can be grouped as early side effects and late side effects. Early side effects include changes in the skin, gastrointestinal system, bone marrow, respiratory system, and central/ peripheral nervous system. Patients may report itching, dryness, erythema, or skin peeling in the treatment area. Gastrointestinal effects include diarrhea, nausea, vomiting, and anorexia. The bone marrow might decrease the production of leukocytes, erythrocytes, and thrombocytes. Patients may report thickening of sputum or develop inflammation of the walls of the alveoli Surgery Cancer surgery, as with any other surgery, has benefits, risks, and possible side effects. These depend on the type of cancer, location of the tumor, type of surgery, and other treatments received. Patients who have less invasive procedures typically recover faster and have milder side effects. Side effects after cancer surgery can include pain, fatigue, appetite loss, localized swelling, drainage, bruising, numbness, bleeding, infection, lymphedema, and possible organ dysfunction.
in the lungs (pneumonitis). Inflammation and edema can occur around the nerves in the central and peripheral nervous systems. The late side effects from radiation therapy can impact the same systems and tissues as the early side effects; however, the impact is more significant also involving the muscles and soft tissues. The skin may change color, heal slower, or become fibrotic (or even necrotic in some cases). Malabsorption, obstruction, or ulceration of the gastrointestinal tract are possible. The effect on the bone marrow can cause chronic low blood counts. Central and peripheral nervous systems may develop atrophy, plexopathy, occlusion, or infarction. Respiratory and cardiovascular risks include pulmonary fibrosis and, less frequently, cardiomyopathy or pericardial fibrosis. Bone growth may slow and osteoporosis or osteonecrosis can develop. Fibrosis is the primary effect on the muscles and soft tissues. Pain is the most common side effect from cancer surgery. The intensity and location of pain is affected by the size of the incision, amount of tissue removed, location on the body, and degree of preoperative pain. As with radiation therapy, patients often experience fatigue after surgery. It can be caused by anesthesia, loss of appetite, stress, baseline nutrition, and the healing process using energy. Appetite loss is common after most surgeries, especially when anesthesia is used. This generally resolves within a few days to a week.
Page 20
EliteLearning.com/Physical-Therapy
Powered by FlippingBook