Appendix III. Hormonal And Chemotherapeutic Agents
Description
This section is from the book "Cancer Manual For Public Health Nurses", by National Cancer Institute. Also available from Amazon: Cancer Nursing: A Manual For Public Health Nurses.
Appendix III. Hormonal And Chemotherapeutic Agents
Neoplastic Diseases Responding to Specific Chemotherapeutic Agents
Diagnoses | Specific Agents | Principal route of administration | Acute toxic signs | Major late toxic manifestations | Results of treatment |
Leukemia acute | 6-MP | Oral | None | Therapeutic doses usually well tolerated; excessive doses cause bone marrow depression. | In children, 50% live one year or longer. |
Amethopterin (Methotrexate®) | Oral | None | Oral and digestive tract ulceration, bone marrow depression with leukopenia, thrombocytopenia, and bleeding. | In adults, 15-25% are improved for several months or longer. | |
Adrenal cortical compounds. | Oral | None | Fluid retention, hypertension, diabetes, increased susceptibility to infection. | ||
Leukemia Chronic | Myleran® HN2 | Oral I.V. | None Nausea and vomiting | Therapeutic doses moderately depress peripheral blood cell count; excessive doses cause severe bone marrow depression with leukopenia, thrombocytopenia, and bleeding. Maximum toxicity may occur two or three weeks after last dose. Dosage must be carefully controlled. | |
Chlorambucil TEM | Oral I.V. Oral | None Occasional nausea and vomiting | Patients maintained in good condition |
Diagnoses | Specific Agents | Principal route of administration | Acute toxic signs | Major late toxic manifestations | Results of treatment |
6-MP | Oral | None | Therapeutic doses usually well tolerated ; excessive doses cause marrow depression. | during major portion of disease; life occasionally prolonged. | |
Adrenal Cortical Compounds | Oral Oral I.V. I.M. | None None | Bone marrow depression. Fluid retention, hypertension, diabetes, increased susceptibility to infection. | ||
Demecolcin | Oral | None | Alopecia, bone marrow depression. | ||
Urethane | Oral | Nausea and vomiting | Bone marrow depression. | ||
Fowler's Solution | Oral | None | Diarrhea, vomiting, skin eruptions. | ||
Lymphosarcoma | Chlorambucil HN2 TEM | Oral I.V. I.V. Oral | None Nausea and vomiting Occasional nausea and vomiting | Therapeutic doses moderately depress peripheral blood cell count; excessive doses cause severe bone marrow depression with leukopenia, thrombocytopenia, and bleeding. Maximum toxicity may occur two or three weeks after last dose. Dosage must be carefully controlled. | Occasional favorable response, but no definite prolongation of life. |
Adrenal Cortical Compounds. | Oral | None | Fluid retention, hypertension, diabetes, increased susceptibility to infection. |
Diagnoses | Specific Agents | Principal route of administration | Acute toxic signs | Major late toxic manifestations | Results of treatment |
Carcinoma of Lung | HN2 | I.V. | Nausea and vomiting | Therapeutic doses moderately depress peripheral blood cell count; excessive doses cause severe bone marrow depression with leukopenia, thrombocytopenia, and bleeding. Maximum toxicity may occur 2 or 3 weeks after last dose. Dosage must be carefully controlled. | Brief improvement in about 50% of cases. |
TEM | I.V. Oral | Occasional nausea and vomiting | |||
Carcinoma of Thyroid | I131 | Oral I.V. | None | Myxedema, bone marrow depression, renal damage. | Frequently marked improvement in properly selected cases. |
Carcinoma of Breast | TEM | I.V. Oral | Occasional nausea and vomiting | Therapeutic doses moderately depress peripheral blood cell count; excessive doses cause severe bone marrow depression with leukopenia, thrombocytopenia, and bleeding. Maximum toxicity may occur two or three weeks after last dose. Dosage must be carefully controlled. | 20-50% improved by hormonal therapy; life may be prolonged in some cases. |
I.V. | Nausea and vomiting | ||||
Estrogens | Oral | Nausea and vomiting | Fluid retention, feminization, uterine bleeding. | ||
Androgens | I.M. Oral | None | Fluid retention, masculinization. | ||
Adrenal Cortical Compounds. | Oral | None | Fluid retention, hypertension, diabetes, increased susceptibility to infection. |
Diagnoses | Specific Agents | Principal route of administration | Acute toxic signs | Major late toxic manifestations | Results of treatment |
Carcinoma of Prostate | Estrogens | Oral | Occasional nausea and vomiting | Fluid retention, feminization. | 80% of cases respond to hormonal therapy; definite prolongation of life. |
HN, | I.V. | Nausea and vomiting | Therapeutic doses moderately depress peripheral blood cell count; excessive doses cause severe bone marrow depression with leukopenia, thrombocytopenia, and bleeding. Maximum toxicity may occur two or three weeks after last dose. Dosage must be carefully controlled. | Temporary regression with 30% pulmonary metastases. | |
Actinomycin D | I.V. | Nausea and vomiting | Stomatitis, G.I. disturbances, alopecia, bone marrow depression. | ||
Pleural pericardial, and abdominal effusions. | HN, (local installation into appropriate cavity) | I.V. | Nausea and vomiting | Therapeutic doses moderately depress peripheral blood cell count; excessive doses cause severe bone marrow depression with leukopenia, thrombocytopenia and bleeding. Maximum toxicity may occur 2 or 3 weeks after last dose. Dosage must be carefully controlled. | About 25 to 50% of patients respond. |
Au198 (local installation of drug into appropriate cavity) | Intrapleural Intraabdominal | None | Bone marrow depression. |
Diagnoses | Specific Agents | Principal route of administration | Acute toxic signs | Major late toxic manifestations | Results of treatment |
Carcinoma of Testes | Actinomycin D | I.V. | Nausea and vomiting | Stomatitis, G.I. disturbances, alopecia, bone marrow depression. | 35% show favorable and sometimes prolonged response. |
Chlorambucil | Oral | None | Therapeutic doses moderately depress peripheral blood cell count; excessive doses cause severe bone marrow depression with leukopenia, thrombocytopenia, and bleeding. Maximum toxicity may occur two or three weeks after last dose. Dosage must be carefully controlled. | ||
Amethopterin (Methotrexate) | Oral | None | Oral and digestive tract ulceration, bone marrow depression with leukopenia, thrombocytopenia, and bleeding. | ||
Choriocarcinoma Female | HN2 | IV. | Nausea and vomiting | Therapeutic doses moderately depress peripheral blood cell count; excessive doses cause severe bone marrow depression with leukopenia, thrombocytopenia, and bleeding. Maximum toxicity may occur two or three weeks after last dose. Dosage must be carefully controlled. | 80% respond 30% show "permanent" regression. |
Amethopterin (Methotrexate) | Oral | None | Oral and digestive tract ulceration, bone marrow depression with leukopenia, thrombocytopenia, and bleeding. |
Appendix IV. Sources Of Educational Materials
PAMPHLETS, BULLETINS, AND FILMS ON CANCER MAY BE OBTAINED FROM:
State Departments of Health
State and Local Chapters of American Cancer Society
U.S. Public Health Service, National Cancer Institute, Bethesda, Md.
U.S. Public Health Service, Cancer Control Program, Washington 25, D.C.
Atomic Energy Commission, Germantown, Md.
Public Affairs Pamphlets, New York 16, N.Y.
Memorial Center, Nursing Division, New York 21, N.Y.
Drug Companies
Commercial Companies (prostheses and equipment)
Clubs for Cancer Patients }Lost Cord Club. Cured Cancer Club
State and Local Chapters of American Heart Association-information on sodium restricted diets
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