Cancer in Children and Young People

Cancer in Children and Young People......Page 3
Contents......Page 7
Preface......Page 13
Foreword......Page 15
Contributors......Page 17
Acknowledgements......Page 19
Part 1 Chemotherapy......Page 21
Commentary: Chemotherapy......Page 23
Cell cycle......Page 27
Growth fraction......Page 28
Protocol development and clinical trials......Page 29
Considerations when planning chemotherapy treatments......Page 30
Treatment approaches......Page 31
References......Page 33
Classification of drugs......Page 35
References......Page 39
Safe handling......Page 41
Personal Protective Equipment (PPE)......Page 42
Work practices......Page 43
Setting for chemotherapy administration......Page 45
Administration of chemotherapy......Page 47
Routes of administration......Page 48
Intrathecal route......Page 51
The intramuscular and subcutaneous routes......Page 52
References......Page 53
Introduction......Page 55
Gastrointestinal tract......Page 56
Taste alteration......Page 62
Nausea and vomiting......Page 63
Pharmacological interventions......Page 66
Anorexia/weight loss......Page 68
Haematological problems......Page 75
Viral infections......Page 80
Cutaneous side effects......Page 81
References......Page 85
Septic shock......Page 93
Home care......Page 94
Disseminated intravascular coagulation (DIC)......Page 95
Acute tumour lysis syndrome (ATLS)......Page 97
Hyperuricaemia......Page 99
Hyperkalaemia......Page 100
Nursing implications of ATLS......Page 101
References......Page 102
Introduction......Page 105
Targeted approaches......Page 106
Gene therapy......Page 107
New treatments for cancer – the nurse’s role......Page 108
References......Page 109
Part 2 Haematopoietic Stem Cell Transplantation......Page 111
Commentary: Haematopoietic Stem Cell Transplantation......Page 113
History......Page 117
Types of transplant......Page 118
Diseases for which haematopoietic stem cell transplant is a treatment modality......Page 119
Tissue typing......Page 120
Adult unrelated donors......Page 122
References......Page 125
The family......Page 127
Support......Page 129
Preparation of children......Page 130
Conditioning regimens......Page 133
Preparation of a sibling donor......Page 136
Ethical use of sibling donors......Page 137
Saviour siblings......Page 141
References......Page 142
Collection of bone marrow......Page 145
Collection of peripheral blood stem cells (PBSC)......Page 146
Venous access......Page 148
Stem cell collection......Page 149
Collection of umbilical cord blood cells......Page 150
Bone marrow/stem cell infusion......Page 151
References......Page 153
Introduction......Page 155
Infection prophylaxis......Page 156
Protective isolation......Page 157
Dietary restrictions......Page 158
Mouth care......Page 159
The effects of isolation......Page 160
References......Page 161
Mucositis......Page 163
Treatment and nursing implications......Page 164
Haematological complications......Page 167
Infection......Page 170
Veno-occlusive disease......Page 174
Graft versus host disease (GVHD)......Page 176
Graft versus leukaemia (GVL)......Page 179
References......Page 180
Discharge planning......Page 183
Psychosocial effects of stem cell transplant on the family......Page 186
References......Page 188
13. Staff Support in Stem Cell Transplant Units......Page 189
Educational needs of nurses in blood and bone marrow transplant units......Page 190
References......Page 191
What is gene therapy?......Page 193
What does the gene therapy process involve for the child?......Page 194
Care of the child undergoing gene therapy for X-linked SCID......Page 196
Care of the child undergoing gene therapy for ADA-SCID or CGD......Page 197
Risks and side effects of gene therapy......Page 198
References......Page 199
Part 3 Surgery......Page 201
Continuity of care......Page 203
Pain......Page 204
Central venous access......Page 205
References......Page 206
Introduction......Page 207
The challenge of surgical care in paediatric oncology......Page 208
Surgery as a diagnostic tool......Page 209
Surgery as a treatment modality......Page 212
Preparing the child and the family for surgery......Page 218
Post-operative nursing care......Page 221
Late effects of surgical treatment......Page 226
Surgery in supportive care......Page 228
Management of infection......Page 232
Surgery to avoid the complications of radiotherapy......Page 233
References......Page 234
Commentary: Neuro-oncology......Page 239
Overview of brain tumours......Page 243
Increased intracranial pressure and hydrocephalus......Page 245
Tumour types......Page 246
Investigations into brain tumours......Page 247
Neurological assessment......Page 248
The multidisciplinary team......Page 252
Intra-operative care......Page 253
Post-operative management......Page 254
Jack’s journey through CNS tumour treatment......Page 256
Ongoing needs of a child with a brain tumour......Page 257
Adjuvant treatment: specifics of treating a child with a CNS tumour......Page 259
Late effects of CNS tumours and acute rehabilitation needs......Page 262
Discharge planning......Page 264
Palliative care......Page 265
The future of neuro-oncology......Page 266
References......Page 267
Commentary: Primary Bone Cancer in Young People......Page 271
Introduction......Page 275
Types of tumours and their presentation......Page 277
Treatment options......Page 280
Limb conservation surgery......Page 282
Amputation......Page 285
Discharge planning......Page 288
Late effects......Page 289
Future trends......Page 292
Impact of setting......Page 293
References......Page 295
Part 4 Radiotherapy......Page 299
Introduction......Page 301
The nature of radiation......Page 302
Artificial production of radiation for clinical use......Page 303
Effect of ionising radiation on human tissue......Page 304
Hazards to healthy tissue during radiotherapy......Page 305
References......Page 306
External beam therapy (teletherapy)......Page 309
Brachytherapy......Page 317
Use of unsealed sources (intravenous radioactive materials)......Page 319
Administration of alternative radiotherapy techniques......Page 322
What does the future hold for radiotherapy?......Page 324
References......Page 326
Brain tumours......Page 331
Adverse effects of radiotherapy in the treatment of brain tumours......Page 332
Acute lymphoblastic leukaemia with CNS involvement......Page 334
Retinoblastoma......Page 335
Hodgkin’s lymphoma......Page 336
Wilms’ tumour......Page 337
Pelvic irradiation......Page 338
Conclusion......Page 339
References......Page 340
Acute reactions in healthy tissue......Page 341
Skin......Page 342
Mouth......Page 348
Promotion of nutritional intake......Page 351
Pain control......Page 352
Small intestine......Page 353
Bone marrow......Page 354
Fatigue......Page 355
Brain......Page 356
Cystitis......Page 357
References......Page 358
The decision to use radiotherapy in the palliative care of children......Page 363
Radiotherapy in oncological emergencies......Page 364
Radiotherapy in end of life symptom management......Page 366
References......Page 368
Part 5 Late Effect of Cancer Therapies......Page 371
23. Overview of Long-Term Follow-Up......Page 373
The nursing role......Page 374
References......Page 375
Endocrinopathies......Page 377
Thyroid gland......Page 378
Hypothalamic pituitary axis......Page 379
Gonadal dysfunction......Page 380
Fertility......Page 383
Liver......Page 385
Neurological impairment......Page 386
Neuropsychological......Page 388
Eyes......Page 389
Craniofacial and dental......Page 390
Musculoskeletal......Page 391
Hearing......Page 393
Gastrointestinal......Page 394
Cardiac......Page 395
Renal and bladder......Page 396
Pulmonary......Page 397
Second malignancies......Page 398
References......Page 399
Assessment, planning, implementation and evaluation of programmes of care......Page 403
Liaison and education......Page 404
Provision and facilitation of alternative models of care......Page 405
Research and audit......Page 406
References......Page 407
26. Health Promotion for Long-Term Follow-Up Patients......Page 409
Smoking......Page 410
Nutrition, physical activity and achieving a healthy weight......Page 411
Sexual health......Page 413
Theoretical approaches and models......Page 414
References......Page 415
Defining quality of life in the health-care setting?......Page 417
Psychological function......Page 418
Social function......Page 419
Employment and insurance......Page 420
Conclusion......Page 421
References......Page 422
Index......Page 425