Chemotherapy can destroy cancer cells and inhibit the growth and reproduction of cancer cells, but chemotherapy drugs will also cause adverse effects on normal cells while killing cancer cells, causing a situation of "killing a thousand enemies and self-destructing eight hundred", causing various adverse reactions.
Most antitumor chemotherapy drugs induce hepatotoxicity is usually due to a specific response, the incidence is very low, usually observed 1-4 weeks after administration. Hepatotoxicity is often manifested as drug-induced hepatitis, elevated bilirubin, elevated transaminases, etc.
Response
During chemotherapy, follow the doctor's instructions to regularly test liver function and deal with problems in a timely manner.
Hepatoprotective drugs are used before or during chemotherapy.
When patients have signs of hepatotoxicity, they should stop the drug or reduce the dose of the drug in time under the guidance of the doctor, and after the indicators return to normal, they can consider changing chemotherapy drugs or continuing to use drugs.
anaemia
The widespread use of cytotoxic drugs, especially platinum-based drugs, is an important factor in anemia in oncology patients. Clinically, it is manifested as fatigue, palpitations, shortness of breath, and poor tolerance, without obvious specificity, which is often masked by the primary disease and is easily ignored by doctors or patients!
Patients should eat more high-quality proteins rich in "hematopoietic raw materials", essential trace elements (iron), folic acid and vitamin B12 and other nutritious foods, such as animal liver, blood products, fish and shrimp, eggs, soy products, black fungus, black sesame seeds, dates and fresh vegetables and fruits.
Proper exercise, adequate sleep, and reasonable diet can not only enhance physical fitness, improve mood, but also improve immunity, and improve anemia to a certain extent.
diarrhoea
Chemotherapy-related diarrhea can lead to weakness, electrolyte abnormalities, kidney failure, volume depletion, shock, and even life-threatening, delayed treatment, increase hospitalization costs, increase the psychological burden of patients, reduce compliance, and even make treatment halfway abandoned, affecting the completion of the entire chemotherapy program.
Avoid foods or beverages that accelerate bowel movement before and after chemotherapy, such as dairy products, juices, fruits, vegetables, pepper, spicy foods, etc.
Eat foods that are high in protein, high in calories, and less residue, and avoid foods that are irritating to the gastrointestinal tract; avoid eating gas-producing foods, such as sugars, legumes, and carbonated drinks.
In severe diarrhea, the first liquid should be advanced, and after the diarrhea stops, it should be gradually changed to semi-liquid until the general diet.
Patients with severe diarrhea after chemotherapy should rest in bed and pay attention to keeping the abdomen warm. Warm compresses can be used to weaken intestinal movements, reduce the frequency of bowel movements, and help alleviate symptoms such as diarrhea and abdominal pain.
Hand-foot syndrome
Hand-foot syndrome is usually a skin toxicity caused by chemotherapy drugs, most patients have precursors of contact pain, palms and soles usually have a tingling sensation, and within a few days, erythema, protrusions, and even peeling and ulceration can occur.
The incidence and severity of hand-foot syndrome can be significantly reduced during chemotherapy by attaching ice packs to the wrist and ankle areas [1].
Avoid exposure to hot things such as sunlight and hot water, wear loose clothing and comfortable, breathable shoes and socks, and avoid unnecessary pressure on the skin.[2]
Raise your legs as high as possible when sitting or lying down.
Nephrotoxicity
The vast majority of chemotherapy drugs are excreted through renal metabolism, resulting in renal toxicity reactions mainly including serum muscles and increased urea nitrogen. It may present with frothyurine and casturia, followed by azotemia, decreased renal function, and acute renal failure and uremia in severe cases.
During the use of chemotherapy drugs, renal function should be tested regularly as directed by a doctor.
Before and after chemotherapy, it is advisable to drink more water to ensure sufficient urine output to promote drug excretion and reduce renal toxicity.
Patients with severe conditions should reduce the dose of the drug or stop the drug under the guidance of a doctor, and then resume the drug or change the chemotherapy drug after the situation has eased.
rash
As a common complication in chemotherapy patients, rashes can be life-threatening when severe. The types mainly include acne-like drug eruptions, measles-like drug eruptions, dermatitis, erythematous drug eruptions and other conditions.
Rash grading
I. degree: the patient's skin appears itchy;
Second degree: the appearance of spots on the patient's skin;
Iii. degree: the patient has a rash, inflammatory reaction to the oral mucosa;
IV. degree: the patient's skin is disabled;
V. degree: patients have various serious adverse reactions, and even death.
To avoid unconscious scratching of the skin, patients should trim their nails regularly and wear gloves before going to sleep.
Maintain the indoor temperature at about 22 °, humidity should be maintained at about 50%, avoid the use of irritating lotions, and do a good job of skin care.
Too high a water temperature will cause the rash to worsen, so bath water should avoid too high a water temperature.
Patients with skin defects should keep themselves and their surroundings clean, wipe down the items and floors in the room with disinfectant, and use clean sheets and covers.
bibliography
1、GordonKB,TajuddinA,GuitartJ,etal. Handfootsyndromeassociatedwithliposomeencapsulateddoxorubicintherapy[J]. Cancer,1995,75(8):2169-2173
2、WilkesGM,DoyleD.Palmarplantarerythrodysesthesia[J]. JOncolPharmPractice,2003,9(4):137-150.