SUPPORTIVE CARE DURING CANCER

TREATMENT
REPORTER: ANGUPA, DEBORAH P. (YL II)
MODERATOR: DR MARY GAY BULIYAT
OBJECTIVES

TO PRESENT CASES ABOUT CHEMOTHERAPEUTIC DRUG SIDE EFFECTS AND

MANAGEMENT

TO DISCUSS SUPPORTIVE CARE DURING CANCER TREATMENT

SUPPORTIVE CARE DURING CANCER TREATMENT

NAUSEA AND
MYELOSUPPRESION DIARRHEA
VOMITING

GONADAL
MUCOSITIS ALOPECIA
DYSFUNCYION
CASE 1
POST CHEMOTERAPY
DAY 14

HOME MEDICATIONS CBC

1. METOCLOPRAMIDE HGB 107
10MG/TAB 1 TAB 3 X A DAY HCT 0.31
30 MINS BEFORE MEALS
TF, 47F MANAGED AS A FOR 3 DAYS, THEN AS WBC 0.66 (ANC 39)
CASE OF INVASIVE NEEDED FOR N6
CARCINOMA, LEFT BREAST NAUSEA/VOMITING
STAGE IIIC (PT2N3M0) ER + L 59
PR + HER2 EQUIVOCAL S/P 2. OMEPRAZOLE PLT 78
MRM, LEFT (03-16-23) WHO 40MG/CAPSULE, 1 CAPSULE
UNDERWENT CYCLE 4 TCB ONCE A DAY 30 MINUTES
DOCETAXEL – CISPLATIN BEFORE BREAKFAST FOR 5
DAYS
3. DIPHENHYDRAMINE
50MG/CAPSULE, 1 CAPSULE
ONCE A DAY AT BEDTIME
FOR 5 DAYS.
4. FILGRASTIM/GCSF
CASE 2
LABORATORY RESULT
REVEALED ELEVATED
CREATININE LEVEL OF
1.4MG/DL WITH EGFR OF 55.
ON INTERIM, PATIENT HAD
REDNESS, SWELLING AND
BLISTERING ON THE PALMS
OF THE HANDS AND LOOSE
MD 67M, KNOWN CASE OF BOWEL MOVEMENT,
RECTOSIGMOID WATERY, NONBLOODY,
ADENOCARCINOMA STAGE HENCE CONSULT.
IV( LUNGS), SP
COLONOSCOPY WITH
BIOPSY (3/31/22); SP
LAPAROSCOPIC
TRANSVERSE LOOP
COLOSTOMY (5/9/2022)
CURRENTLY ADMITTED
FOR CHEMOTHERAPY
(CAPEOX REGIMEN)
MYELOSUPRESSION

PMNs PLATELETS RBCs

6-8 hours 5-7 days 120 days

FEBRILE NEUTROPENIA (ANC <1500 PMNs / uL

•colony-stimulating factors (CSFs)
MYELOSUPPRESSION
MYELOSUPRESSION

THROMBOCYTOPENIA
•Platelet transfusion for platelet <10,000 / uL (<20,000 /
uL with Leukemia)
MYELOSUPRESSION

ANEMIA
•PRBC transfusion for Hgb <80g / L (<90g/L with
underlying condition)
NAUSEA AND VOMITING

EMETOGENIC
DRUGS

LOW
HIGH (>90%) MODERATE (30-90%) MINIMAL (<10%)
(10-30%)
NAUSEA AND VOMITING

NEUROKININ 1
SEROTONIN
RECEPTOR
ANTAGONISTS
ANTAGONISTS

ATYPICAL
ANTIDOPAMINERGIC
ANTIPSYCHOTIC
DIARRHEA

ELECTROLYTE
HYDRATION
REPLETION

SOMATOSTATIN
ANTIMOTOLITY
ANALOGUE
MUCOSITIS

BARRIER
ANESTHETICS CREATING
PREPARATIONS
ALOPECIA

COSMETIC
PSYCHOLOGICAL RESOURCES
SUPPORT
“ CHEMO CAPS”
GONADAL DYSFUNCTION AND PREGNANCY

AVOIDANCE OF
COUNSELING
TERATOGENS
CASE 1
POST CHEMOTERAPY
DAY 14

HOME MEDICATIONS CBC

1. METOCLOPRAMIDE HGB 107
10MG/TAB 1 TAB 3 X A DAY HCT 0.31
30 MINS BEFORE MEALS
TF, 47F MANAGED AS A FOR 3 DAYS, THEN AS WBC 0.66 (ANC 39)
CASE OF INVASIVE NEEDED FOR N6
CARCINOMA, LEFT BREAST NAUSEA/VOMITING
STAGE IIIC (PT2N3M0) ER + L 59
PR + HER2 EQUIVOCAL S/P 2. OMEPRAZOLE PLT 78
MRM, LEFT (03-16-23) WHO 40MG/CAPSULE, 1 CAPSULE
UNDERWENT CYCLE 4 TCB ONCE A DAY 30 MINUTES
DOCETAXEL – CISPLATIN BEFORE BREAKFAST FOR 5
DAYS Daily CBC monitoring
3. DIPHENHYDRAMINE GCSF 300mcg subcutaneous 2x a day
50MG/CAPSULE, 1 CAPSULE Prophylactic antibiotic: Levofloxacin
ONCE A DAY AT BEDTIME 750mg 1 tablet once a day
FOR 5 DAYS.
4. FILGRASTIM/GCSF
CASE 2 Advised to increase hydration.
Loperamide (4 mg at the first occurrence of
diarrhea, with 2 mg repeated every 2 h until
12 h without loose stools, not to exceed a total
LABORATORY RESULT
daily dose of 16 mg. REVEALED ELEVATED
CREATININE LEVEL OF
1.4MG/DL WITH EGFR OF 55.
HandON
and INTERIM, PATIENT HAD
foot erythrodysesthesia is most
REDNESS,
common adverseSWELLING ANDuse
effect, thus may
BLISTERING
moisturizers ON THE
to minimize PALMS
blistering Creatinine monitoring and
OF THE HANDS AND LOOSE
Advised patient not to hold the tablets follow up after 1 week.
MD 67M, KNOWN CASE OF BOWEL MOVEMENT, Monitor daily urine output.
directly and may use plastic gloves in
RECTOSIGMOID WATERY, NONBLOODY,
ADENOCARCINOMA STAGE handling the tablets.
HENCE CONSULT.
IV( LUNGS), SP
COLONOSCOPY WITH
BIOPSY (3/31/22); SP
LAPAROSCOPIC
TRANSVERSE LOOP
COLOSTOMY (5/9/2022)
CURRENTLY ADMITTED
FOR CHEMOTHERAPY
(CAPEOX REGIMEN)
THANK YOU 