- the major diffeierence in clinical manifestation is that with radiaton (a local therapy) only bone marrow twithin the treatment field is affected. BUT with chemotherapy (a systemic therapy), bone marrow funtion throughtout the body is affected. hterefore effects are more profound with chemo when the two therapies are combined
- -onsert of bone marrow suppression is related to the life span of the type of blood cells. WBC affected most acute (1-2 weeks), plt in 2-3 weeks, and RBCS (4 months)-Nadir occurs 7-10 days after initation of treatment
-Neutropenia more common chemo than radiation
-Thrombocytopenia: <50 K of plt count.
-Radiaton skin changes:
erythema within day followed by dry desquamalates with weeping of serous fluid. Most evident in skin folds or pressure--goal: prevent infection. No heating pads, ice packs, water, constrictive garments, deodorants. Lubricate dry skin w/ nonirritating lotion emolient (no alcohol or perfume) Keep tissues clean with NS and vaseline petrolatum gauze. Expose area to air, avoid sun, clean with soap and water, use an electric shaver.
-Chemo skin changes:
mild erythema, hyperpigmentation alopecia (har doesn't grow back for a month after therapy is complete
-Anemia:for both radiation and chemo (RBC growth factors -Procrit/Epoetin)
-Fatigue: caused by anemia, accumulation of toxic substance left in blody after cells killed, need for extra energy to repair and heal body, lack of sleep.
-GI tract most sensitive due to relase of seotonin -> stimulates chemoreceptor trigger zone and vommitting center in brain, and cell death
-Diarrhea: pelvic readiation, recommend diet LOW in fiber and residue, avoid milk (radiation causes temp lactose intolerance)
-Mucositis: irritation, inflammation and or/ulceration of mucosa. Xerostoma.Dysgeusia (taste loss) Dyspagea (difficulty swallowing)