Glossary
of Terms and Procedures
Alopecia:
cells responsible for hair growth have high mitotic and metabolic
rates; 85%-90% of follicles on the scalp are in the anagen (growth)
phase of the hair cycle –most chemotherapy drugs are associated
with some degree of alopecia –the degree of alopecia depends
upon drug dose, serum half-life, the use of prolonged infusions,
and the use of combination therapy.
Anemia:
caused by bone marrow suppression of the stem cell or interference
with cell proliferation by chemotherapy agents; includes erythrocyte-proliferation
pathways.
Blood
Transfusion:
A transfusion is the infusion of blood or a component through tubing
connected to a needle that is inserted into a vein, usually in the
arm. The amount and type of blood component transfused depends on
the need of the patient. Patients usually get transfusions as outpatients
at their local hospitals.
Bone
Marrow Biopsy:
The bone marrow is a soft tissue inside larger bones. It makes red
blood cells, white blood cells, and platelets. A bone marrow biopsy
is a procedure done by a doctor or physician assistant to obtain
a sample of the bone marrow. It is an important test used to diagnose
many disorders. The doctor or PA injects Lidocaine at the biopsy
site (usually the hip bone) to numb the area. Once the site is numb,
a hollow needle will be inserted into the bone. Then blood will
be withdrawn through the hollow needle. Next, the doctor or PA will
push and turn the needle to obtain a bone marrow sample. A piece
of bone marrow will stay inside the needle as it is pulled out.
Slides will be prepared and sent to a pathologist at a local hospital
for evaluation under a microscope. Mild discomfort at the biopsy
site is often treated with Tylenol and usually lasts 24 hours.
Bone
Scan:
This test helps show if a cancer has spread to the bones. A short-lived
radioactive substance is injected and collects in diseased bone
cells throughout the body. These areas are known as "hot spots."
But arthritis, infection, or other bone diseases can also cause
hot spots.
Cancer:
a large group of diseases characterized by abnormal cell structure,
uncontrolled growth, ability to spread, ability to invade normal
tissue.
Cancer
Chemotherapy:
the treatment of choice for malignancies of the hematopoietic system
and for solid tumors that have metastasized regionally or distally.
Cardiac
Toxicity:
1.as caused by DNA intercalators- decreased contractility of heart
leading to increased workload and hypertrophy related to direct
insult of myofibrils 2. As caused by high-dose fluorouracil- coronary
artery spasm leading to ischemia, possibly associated with myocardial
infarction 3.high-dose cyclophosphamide- endothelial damage leading
to myocardial necrosis.
CT
Scan (Computed Tomography Scan):
The CT scan is an X-ray procedure that produces detailed cross-sectional
images of the body. Instead of taking one picture, as does a conventional
x-ray, a CT scanner takes many pictures as it rotates around the
patient. A computer then combines these pictures into an image of
a slice of the body. The machine will take pictures of multiple
slices of the part of the body that is being studied.
Doppler
Ultrasound:
Special ultrasound machines, known as Doppler flow machines, are
able to show how blood is flowing through the vessels. This is important
because blood flows differently through tumors than it does through
normal tissue. Some of these machines make color images to increase
the amount of information it contains. Unlike other forms of blood
vessel imaging, color Doppler studies do not need to use contrast
agents. Doppler Ultrasound is generally used to diagnose blood clots.
Extravasation:
leakage or infiltration of a vesicant chemotherapy agent into local
tissue.
Fatigue:
energy deficit related to disease, treatment, activity, rest, symptom
perception, and functional status.
Flare
reaction:
venous inflammatory response with subsequent histamine release that
may result in flare reaction; incidence is usually about 3% and
duration usually less than 45 minutes.
MRI
(Magnetic Resonance Imaging Scan):
Like computed tomography, MRI displays a cross-section of the body,
but in more detail. MRI uses powerful magnetic fields instead of
radiation. MRI scans take longer than CT scan – about an hour.
This may be too long for some people to be still, so sedation is
sometimes used.
Mucositis:
the epithelial cells of the oral mucosa are destroyed, causing an
inflammatory response and denudation of the oral mucosa by the following
mechanisms (1) cytotoxic effects of chemotherapy drugs on the rapidly
dividing epithelial cells of oral mucosa (2) indirectly by bone
marrow suppression.
MUGA
Scan:
Before some chemotherapy drugs are started, a doctor may check a
patient’s heart function to make sure that there are no major
problems. During the treatments, the heart function may be checked
to ensure that no changes have occurred. A MUGA Scan is done to
check for any changes in heart function. With a MUGA scan, patients
receive a short-lived radioactive substance that is then traced
through the heart with a special scanner.
Nadir:
the lowest point in the white blood cell count reached after chemotherapy.
It most commonly occurs 7-14 days following administration, depending
on the specific drugs and dosages.
PET
Scan (Positron Emission Tomography Scan):
For a PET scan, a form of sugar (glucose) that has a slightly radioactive
atom is injected into a vein. Cancer cells absorb high amounts of
the sugar. A special camera can spot the places where the sugar
collects. A PET scan can be useful because it looks for cancer throughout
the body. It also may also tell if enlarged or normally sized lymph
nodes contain cancer.
Port-A-Cath
Placement:
To ease administration of chemotherapy infusions, a physician may
prescribe the insertion of a port or port-a-cath. The port is made
of plastic, stainless steel, or titanium with a silicone septum
and catheter, which is surgically placed under the skin of the chest
or arm in a large or central vein. The procedure is usually done
by the patient’s surgeon or by a radiologist. An overnight
hospital stay is not needed. The port is accessed by a needle to
give chemotherapy.
Therapeutic
Phlebotomy:
A medical procedure, used for treatment of very specific underlying
medical conditions, where one half to one full unit of blood is
carefully withdrawn from a patient. (This is similar to donating
a unit of blood.) There are usually two reasons for therapeutic
phlebotomy: 1.) in order to withdraw excess red blood cells in a
patient suffering from a condition, such as polycythemia vera, or;
2.) remove excess iron from a patient with a condition, such as
hemochromatosis. Usually after initial diagnosis, therapeutic phlebotomy
is performed at weekly intervals to rapidly reduce levels of red
blood cells or iron to normal, or reasonably normal levels. Once
normal levels are achieved, therapeutic phlebotomy is performed
less frequently to maintain as normal a level as possible.
Thrombocytopenia:
bone marrow suppression decreases platelet production, circulating
platelets are diminished gradually because the platelet life span
is about 10 days –chemotherapy drugs accelerate platelet destruction.
Vesicant:
any agent that has the potential to cause blistering or tissue necrosis.
Irritant: any agent that causes a local inflammatory reaction but
does not cause tissue necrosis.
References:
Cancer Chemotherapy Guidelines and Recommendations for Practice
2nd Addition Oncology Nursing Society –Maryanne Fishman, RN,
MS and Mary Mrozeck-Orlowski, RN, MSN, AOCN, Copyright 1999 by the
Oncology Nursing Printing Press, Inc. Second Printing.
Core
Curriculum for Oncology Nursing 2nd Addition Oncology Nursing Society
–Jane C. Clark and Rose F. McGee, Copyright 1992 by W. B. Saunders
Company.
Some
content is provided by the American Cancer Society.
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