Info
Anal cancer, SqCC, cT___N___M___, dx on ___/___/___
- Initial presentation:
- Treatment plan: definitive CCRT and longterm observation
- Explain the purpose of neoadjuvant CCRT:
- goal: decrease recurrence/metastasis as much as possible, not guarantee cure
- NOTE: regular follow up is still needed
- Explain the rationale and strategy with CCRT followed by longterm observation:
- CCRT duration: 5 weeks, with C/T during week 1 and week 5
- C/T regimen: Mitomycin-C (10mg/m2)/5-FU
- Side effects:
- GI upset (N/V, diarrhea, mucositis, anal area dermatitis)
- Hair loss
- Marrow suppression
- Infection
- RT scheduled since
___/___/___:- Arrange admission for #1 MMC (10mg/m2)/5-FU (1000mg/m2) on 00/00 and check lab, and arrange admission
- Assessments before chemotherapy:
- Vascular assessment (PICC)
- Nutritional assessment
- Pharmacist education
- GYN check for risk of cervical cancer and check HIV, explain to patient.
- Explain AEs of MMC/5FU:
- 5FU:
- diarrhea (55%)
- hand-foot syndrome (15-20%)
- nausea/vomiting
- elevations in LFT
- myelosuppression
- MMC:
- myelosuppression
- nausea/vomiting
- mucositis
- potent vesicant (extravasation can lead to tissue necrosis and chemical thrombophlebitis at the site of injection)
- anorexia
- fatigue
- HUS in rare events
- intestinal pneumonitis
- hepatoveno occlusive disease
- chemical cystitis and bladder contraction
- 5FU:
- Importance of nutritional support:
- Emphasize high protein diet during C/T period