Critically appraise the morbidity of chemotherapeutic drugs for ovarian epithelial cancers and the measures, which might be taken to minimize the side effects of therapy
- The baseline tests may influence treatment planning e.g FBC, renal function, ECG
- The possible side-effects and complications include – nausea and vomiting, bone marrow suppression, infection, leukaemia
- Of the merits of cisplatin vs carboplatin
Cisplatin has nephrotoxicity, tinnitus and hearing loss, nausea and vomiting, myelosuppression, peripheral neuropathy. Carboplatin has less neuropathy, ototoxicity and nephrotoxicity than cisplatin. More hematopoietic toxicity than cisplatin.
- Of the specific side effects of alkylating agents – Myelosuppression, cystitis, bladder fibrosis, alopecia, hepatitis, amenorrhoea
- Of the specific problems associated with paclitaxel- cardiac arrhythmias, alopecia, allergic reactions, Myelosuppression
- Toxicity can be assessed – monitor FBC and differential white cell count and platelets, renal and liver function tests
- The measures to minimize side effects are
- sedation, effective anti emetics prior to and during treatment, steroids and H2 antagonists
- fluid loading prior to treatment , overnight administration of cytotoxic agents
- limitation of treatment if no response after three pulses of therapy
- limitation of treatment to one year beyond which it is not helpful and the risk of leukaemia are increased
- Alopecia is prevented by selection of appropriate chemotherapy, cooling the scalp may have some results.
- Specialized support and treatment in a cancer centre
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