Medical Oncology

Cancer is the disordered growth of cells. When it reproduces in an organ different from the one that originates it is known as metastasis.


Many people are now cured of cancer after receiving treatment. The choice of one or more treatments depends on several reasons: the type of tumor, the site of the tumor, its size and whether or not it has invaded other organs.


Your doctor will tell you about the treatments that have been chosen in your particular case.

 

There are three major specialties for the treatment of cancer:

1. Oncology Surgery Is the removal of all or part of the malignant tissue. It is used as a diagnosis by biopsy or as a treatment.
2. Medical Oncology and Hematology: Treat cancer with medications.
3. Radiotherapy: Is the treatment of tumors with radiation.

Chemotherapy is a type of cancer treatment, which uses drugs or drugs to kill cancer cells. These drugs can be given as follows:
Oral: tablets or capsules to take.
Intramuscular: injected directly into a muscle, usually in the gluteus.
Intravenous: Is injected into the vein by means of serum.
Intrathecal: injected into the space where the cerebrospinal fluid is, usually in the lower back.
Subcutaneus: it is injected into the subcutaneous cellular tissue.

The chemotherapy will be formulated by our Oncologists and Hematologists, who will tell you if it will be given as: Ambulatory, Hospitable and / or you can take it at home.

Yes, but it is always best to consult with your doctor or nurse who will advise you to use them, because some medicines do not interact well with chemotherapy.

Cancer cells grow and divide rapidly, chemotherapy stops or slows the growth of these cells.
Depending on the type of cancer you have and how much you have grown or spread, chemotherapy may:
Cure cancer: Chemotherapy destroys so many cancer cells that your doctor can no longer detect them in the body.
Controlling cancer: Chemotherapy can prevent the cancer from spreading or make it grow more slowly.
Improve cancer symptoms , also known as palliative care. Chemotherapy reduces the size of tumors that are causing pain or pressure.

Before treatment, you will be asked to sign a form with your consent, authorizing you to administer chemotherapy and perform the necessary tests with your treatment plan. By signing the consent you are declaring that you have received this information, that you have understood it and that you are ready to receive the treatment.

Before signing consent, be sure to understand the following:

• Your diagnosis.
• The type of chemotherapy (outpatient / hospital)
• Other treatment options. • How the treatment will be administered and how long it will last. • Objective and potential benefits of treatment. • Possible side effects, including when and for how long they usually show up. • Possible consequences if you refuse treatment.

Cancer is a disease that needs to be treated from different perspectives. To do this, a medical team of various disciplines, will decide on the most appropriate treatment for you. In this way we guarantee a personalized treatment of your illness.
If you are treated with chemotherapy, a specialist doctor from the Oncology and Hematology group will be responsible for that treatment. In addition, a specialized nursing team will assist you in managing appointments to schedule chemotherapy, will be responsible for administration and follow-up and Will instruct on care during and after treatment.

You and your doctor will make the decision about your type of care. Nursing counseling will provide you with all kinds of instructions you need to understand this process.

Treatment Effects

Each day, new blood cells are formed, replacing those that die. These form in the bone marrow and the effect of chemotherapy can alter this formation. These cells are:

Red blood cells:
They carry the oxygen through our body, which is necessary to produce energy in each of the cells of our organism. If the red blood cells are low, you may feel more tired than normal, dizzy or weak.

White Blood Cells:
Prevent infectious diseases; If they are diminished, it will be difficult for your body to fight infections. Some signs that should alarm you if they occur during chemotherapy are:
• Fever (temperature greater than 38 degrees Celsius)
• Chill
• Pain or burning when you urinate or defecate
• Cough with phlegm production
• Redness, swelling or discomfort, especially around a wound, a sore, grain (clay), the site of the intravenous route or the vascular access device.
Platelets:
They help our blood coagulate in the presence of some wound, preventing bleeding. Some signs that may indicate that platelets have decreased are: • Bruising or bruising
• Small red dots called petechiae
• Wounds that bleed longer than usual
• Bleeding from the gums
• Bleeding from the nose
• Bleeding from the urine, stool and / or vomiting

It is the most common symptom among patients. Does not have an exact cause is due to illness, to treatments, chemotherapy, radiotherapy or surgery; Poor appetite, lack of sleep, pain and other factors.

Fatigue appears suddenly and patients describe it as lack of energy; Although not all patients experience it with the same intensity.

May be useful:
• Plan the day with time to rest.
• Conserve energy for activities of real importance.
• Do short walks or do soft exercises. • Eating the best you can and maintaining adequate fluid intake.
• Inform your doctor or nurse of any changes in your energy level.
• Schedule an exercise routine.

The digestive tract extends from the mouth to the rectum; Includes the throat, stomach and intestine.

May be useful:
• Eat lightly cold foods at room temperature like yogurt, ice cream, jellies. • Fraction the three basic meals to five meals. • Choose foods that are more pleasant to you.
• Tail drinks often help lessen nausea. If you are hungry, ingest toast or soda crackers. • Drinking liquids permanently.
• Vomiting medication formulated by your doctor may be available. Be strict in the hours of use. • Try to avoid strong odors
• Avoid sweet, fatty or fried foods if you find that you do not tolerate them.

Also known as lack of appetite and may occur from the day after the chemotherapy has been applied.

May be useful:
• Eat when you feel the need and are willing. • Preferably, consume foods to your liking. • Finding time and pleasant atmosphere at lunch.
• Avoid doing other activities when eating, such as reading, watching TV, etc.

It is the difficulty to make bowel movements in the normal way. Some of the medications used for chemotherapy and some others used to relieve pain may cause it.

May be useful:
• Eating foods rich in fiber: cereal, bran, fruits and vegetables. • Drink plenty of fluids. • Perform a normal level of activity, taking into account rest periods. • Tell your doctor and / or nurse who will tell you if laxative use is necessary.

Chemotherapy can cause bowel movements to be altered by producing soft or fluid bowel movements more often.

May be useful:
• Eating low-fiber foods. • Avoid whole milk and milk products, you can consume milk and dairy products. • Drink plenty of fluids, replacing lost fluids. • Eat in a small amount, frequently and chew food very well.

Some medications can affect the hair follicles where hair is born and grows. Hence you may lose some or all of the hair while you are undergoing treatment. Your skin or the puncture site may become pigmented or dry.

Your nails may also turn dark, yellow, brittle or cracked. Although many of these manifestations are not serious, it is important to inform them.

Hair loss
May be useful:
• Use a mild shampoo. • Dry hair naturally.
• Use separate brush or bristle brush. • Shorten your hair if possible before starting treatment, as long as your doctor tells you that the treatment will cause hair loss. • Make use of scarves, turbans, caps, etc. Pretending comfort.
• Always share your fears or concerns with the nursing staff.

Skin reactions
Only some medications can produce this type of side effect. If this is the case, you will be informed.

The acne-like skin reaction is eye-catching but manageable. It is usually accompanied by dryness and peeling. Your treating physician and the nursing team will be attentive to that process to provide you with the care you need. This reaction begins in the first week of treatment and in the 3rd or 4th week begins to decrease. It may be more intense, if combined with chemotherapy and radiation therapy.

May be useful:
• Wash face and neck daily with warm water and mild soap that does not contain deodorants or alcohol. Maintain throughout the treatment, except for skin ulcers.
• Use body moisturizer or oatmeal creams to prevent and improve dryness. Use neutral pH creams. Especially in areas where it is going to be treated with radiotherapy. • Use electric razor, or take precautions to reduce the risk of cutting.
• Avoid scraping and friction in the area. Wear cotton clothes. • Do not take the sun directly protect yourself with blocker and proper clothing.

Chemotherapy can cause certain changes in the sex organs, both female and male, that depend on the general condition of the person, their age and the type of drug being applied. In women
Menstrual cycles may be irregular or may go away completely while you are on chemotherapy, check with your doctor. Hormonal changes produce menopausal symptoms such as hot and cold and irritations and dryness in the vaginal mucosa. Your doctor may suggest some action to relieve this discomfort. Infertility can occur and can be temporary or permanent. However, you may become pregnant during treatment. This situation should be avoided because drugs to treat cancer could cause fetal malformations. For this reason it is important that you discuss with your doctor what may be the best method of contraception and follow it during the course of treatment. In men
Infertility can occur because some chemotherapy drugs can reduce the number of sperm or their mobility. It is important to talk to the doctor about this and the possibility of keeping sperm in a semen bank, in case you want to have children in the future.

It is not advisable because some medications can cause birth defects. Doctors advise using methods for birth control throughout the duration of your treatment.

If you and your partner are considering pregnancy after completing chemotherapy, talk to your doctor about this subject, taking into account the type of tumor and its prognosis.

Ulceration and inflammation of the mouth (stomatitis) may occur one to two weeks after treatment restarts. The oral mucosa may become red and painful or small white blisters may appear.

Some medications can damage the salivary glands and cause them to make too little saliva. This complication is more common in patients who combine chemotherapy with radiation therapy in the neck area. The symptoms of dry mouth can be: thick saliva, increased thirst, "stinging" tongue, difficulty using dental prostheses, dry and cracked lips, changes in the sense of taste. May be useful:
• Have good and frequent oral hygiene.
• Commercial mouthwashes are not recommended because their chemical components can injure more. Replace it as follows: a teaspoon of baking soda is added to a glass of water. Perform mouthwash every 4 hours.
• Perform a daily self-examination of the mouth, taking into account: color, pain and condition of mucous membranes, tongue and gums.
• Use a soft bristle brush and the right dental brushing technique.
• Extreme care in the case of dentures or braces.
• Consume liquids permanently.
• If you have pain, eat soft, soft foods.
• Avoiding extreme temperatures at meals, are not well tolerated.
• Sometimes you will require medications, which should only be prescribed by your treating doctor.

Nausea and vomiting may begin after treatment or may occur within 24-48 hours and may last for a few days. Your doctor will formulate medication to prevent and control these symptoms.

May be useful:
• Eat in a pleasant and ventilated place.
• Try to have a quiet atmosphere at lunch time.
• Eat slow. Chew well.
• Eat light meals and avoid heavy meals. It is preferable to make 5 shots of small quantity.
• Do not force yourself to eat, choose foods that appeal to you.
• It is preferable to take advantage of times when you are hungry. Lack of appetite is common the days after treatment. Do not worry, in a few days you will regain your appetite for food.
• Take liquids one hour before meals, by sips, and do not mix with food to have a lower filling sensation.
• Avoid fatty, fried or very sweet foods.
• Foods are more tolerable at room temperature.
• If it has a metallic and tasteless taste, you can spice it up to improve the sensations.
• After eating do not lie down immediately, sit in the chair for two (2) hours.
• Wear loose clothing, not tight.
• If nausea occurs in the morning, eat before lifting any dry food such as biscuit, toast or bread.
• If you vomit, brush your teeth and rinse your mouth with water. If in spite of these recommendations and medication, vomiting is not controlled, go to the nursing staff and / or the emergency department.

Both the disease itself and its treatment produce a series of physical, psychological and social changes. Role and body image changes affect sexual self-image and there are feelings of doubt that arise in physical contact with the partner and in intimate relationships.

General concerns about diagnosis, uncertainty, family, economic situation, as well as physical fatigue, fatigue or weakness, produce anxiety that can affect the desire and the sexual act. However, if your pre-disease and treatment sexual relations have been successful, they will most likely remain pleasurable during treatment. When you feel fears and doubts, discuss them with your partner and if necessary, consult your treating doctor.

These effects are less frequent, but may occur with certain medications, and should be evaluated by your doctor constantly.

Although rare, at the time of chemotherapy, symptoms such as nervousness, generalized itching, red staining, chills, cramps, abdominal pain, respiratory distress may occur. The nursing team in charge of the administration of chemotherapy, will be attentive to any eventuality that happens to him. If you notice any unusual feeling during the administration, talk to the nurse from the beginning.

Symptoms such as tingling, numbness, or a feeling of needles and pins in your feet and hands may spread to the legs and arms after the administration of chemotherapy. Inability to feel hot or cold, like feeling a hot stove. Inability to feel pain, like the pain of a cut or wound in one foot.

May be useful:
• Protect hands and feet from extreme temperatures.
• Protect your mouth and nose from cold with a scarf, especially in the face of sudden temperature changes.
• Do not eat cold foods or drinks.
• Do not drink ice in drinks.
• Do not use too hot or too cold water.
• Wear wide clothing and comfortable shoes.
• Be careful when picking up objects that in any way represent danger, sharp objects, sharp objects, hot objects, etc.
• If your balance or strength is diminished, avoid being exposed to falls by using rugs in the shower, supporting handrails or having a companion on stairs and long journeys.
• Wear comfortable and safe shoes.
• If your doctor recommends medications for symptom management, be strict in your use.

Some medicines can irritate the bladder, cause urine to change color or affect the kidneys. Your doctor will order tests to check your kidney function.

May be useful:
• Drink plenty of fluids.
• Evacuate the bladder at least every two hours.
• Identify signs and symptoms: pain, burning, urinary urgency, inability to urinate.
• Be alert to the appearance of blood in the urine, if it is very concentrated or presents sediment.
• Always perform good hygiene after each disposal.

The disease itself or some of the side effects can cause mucositis pains, headache, etc. These can be avoided and it is important for your doctor to be aware of these symptoms.

May be useful:
• Make a record of location, intensity and frequency.
• Take the drug prescribed for pain according to the precise indications.
• Consult strictly with your treating physician.
• Do not wait until the pain gets worse, use all the resources necessary to prevent it.

It is very important that you feed well while you are on treatment; Good nutrition helps your body recover faster and fight better against infections.

Chemotherapy does not require a special diet; Consume what you are accustomed to. Their feeding under the chemotherapy does not require additional vitamins, nor suspend any food.

Chemotherapy can bring major changes to your life. It can affect your general health, threaten your sense of well-being, interrupt your daily routine and impose a burden on your relationships with others. It is normal and understandable that you and your family members feel sadness, anxiety, anger or depression. It is therefore not surprising that some people become very sensitive, crying, anxious, angry or depressed.

These reactions are perfectly normal but disturbing if they can not assimilate.

There are ways to fight these emotional "side effects" as well as ways to cope with the physical side effects of chemotherapy. You can get support from various sources. Here are some of the most important ones:

May be useful:
• Ask your doctor to refer you to the Oncology Support Professionals Group where you will find qualified professionals in Palliative Care, Psychology, Physiotherapy, Social Work and Support Groups to help you manage the symptoms.
• The goal of palliative care is to prevent and alleviate suffering and provide the best possible quality of life for patients and their families, regardless of the stage of the disease.
• Goals include improving the quality of life for the patient and family, helping them make decisions and providing opportunities for personal growth.
This team is to provide specialized care:
• Managing pain
• Controlling physical symptoms
• Coping with cancer stress
• Talk to your family
• Determine what is most important to you
• Preparing for the future
• Advance Healthcare Directives
• Living Will
• Deciding When is the Right Time for Home Care
• Encourage the best possible quality of life

Friends and family can often comfort and reassure you as no one else can. However, you may have to take the first step in communicating. Many people do not understand what cancer is and move away because they are afraid of the disease. Others are worried that you will bother about some improper comment.

You can help to dispel these fears by openly talking about your illness, your treatment, your needs and your feelings, correcting the wrong ideas in this way. You can also let people know that there is nothing that is "right" to say. Once people know that they can talk to you sincerely, they may feel more willing to express themselves openly.

Here are some suggestions to help you during your chemotherapy treatment:

Try to think about the goals of your treatment. This will help you maintain a positive attitude in the days when things become difficult.

Remember that eating right is very important. Your body needs food to rebuild tissues and regain strength.

Do not be too picky about yourself. You may not have the same energy as always, so try to rest as much as you can. Leave the small details aside and do only what is most important to you.

Try new hobbies and learn new skills. If your doctor approves, exercise if you can. By using your body you can feel better about yourself, and it helps you to free yourself from tension or anger and increase your appetite. You fight a disease that requires treatment. We understand that sometimes you will not feel well after the administration of chemotherapy; However, remember that giving up treatment is abandoning yourself.

• Wash hands frequently during the day, especially before eating and after going to the bathroom.
• Bathe every day.
• Use electric razor, or take precautions to reduce the risk of cutting.
• Use the dental brushing technique correctly, prefer a soft bristle brush. Avoid flossing. Use a nonalcoholic mouthwash.
• Avoid being in places where there are many people.
• Avoid carrying out activities that involve risks such as sudden play, blows or the handling of sharps.
• Avoid contact with people who are suffering from a contagious disease.

• Avoid drug use that is not prescribed by the doctor.
• Eat well-cooked foods during treatment.
• Do not get vaccinated without first asking your treating doctor.
• Gently, but very well, clean the rectal area after each bowel movement and wash your hands.
• Use lotion or oil to soften and heal your skin if it becomes dry or cracked.
• Clean cuts and scrapes immediately with warm water and soap. Apply an antibiotic cream or ointment and cover with a bandage.
• Even if you are extremely careful, your body may not be able to fight infections when your white blood cell count goes down. Pay attention and examine your body regularly to identify signs and symptoms of a possible infection.