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Childhood Cancer and Treatment PowerPoint Presentation

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On : Feb 24, 2014

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  • Slide 1 - CANCER IN THE CLASSROOM: PROVIDING A SAFE ENVIRONMENT Lisa Bashore, PhD, RN, CPNP, CPON Life After Cancer Program
  • Slide 2 - OBJECTIVES Review the various treatment modalities given to children and adolescents with cancer Discuss how cancer treatment influences attendance and / or re entry into school Evaluate how safe the school environment is for children and adolescents with cancer
  • Slide 3 - CHILDHOOD CANCER Incidence by Diagnosis
  • Slide 4 - Treatment Surgery Radiation Chemotherapy Biotherapy Stem Cell Transplant Alternative therapy
  • Slide 5 - Chemotherapy Affects rapidly dividing cells Hair GI tract Mucous membranes Bone marrow Anemia Thrombocytopenia Neutropenia
  • Slide 6 - CHEMOTHERAPY Halts the growth of cancer cells Affects normal cells as well Inability to differentiate between normal/cancer cells
  • Slide 7 - CHEMOTHERAPY Given in different routes May dictate the extent of acute effects Orally Intravenously Intrathecally Intraosseous Intramuscularly
  • Slide 8 - RADIATION Delivery of high energy beams Damage both cancer cells and normal cells Thankfully only in area radiated are normal cells affected Given alone or in combination with chemotherapy
  • Slide 9 - RADIATION Given by different methods Types: 3-dimensional conformal Intensity modulated Proton beam Stereotactic radiosurgery
  • Slide 10 - BIOTHERAPY Immunotherapy Very targeted and used body’s immune system Like Targeted minimizes damage to healthy cells
  • Slide 11 - ALTERNATIVE THERAPY Many can interfere with efficacy of treatment Unsafe in general Reduce blood counts Have bacteria or fungi Unacceptable side effects
  • Slide 12 - Massage Probiotics Contains bacteria Could colonize the GI tract St John’s Wort Bleeding potential Interaction with immunosuppressant's
  • Slide 13 - COMPLEMENTARY Yoga Imagery Art and Music Therapy Meditation Massage Aromatherapy (??)
  • Slide 14 - PALLIATIVE CARE Provides symptom management throughout the continuum of care Comprehensive, holistic care Physical, emotional, spiritual, social aspects of living with cancer
  • Slide 15 - IMMEDIATE EFFECTS OF CANCER THERAPY
  • Slide 16 - TREATMENT EFFECTS Due to damage to normal cells/blood cells Marrow All blood lines impacted Skin Mouth or whole GI tract Immune system
  • Slide 17 - SIGNS, SYMPTOMS, AFFECTS Fever (INFECTION) Fatigue Paleness Easy bruising Bone/joint pain
  • Slide 18 - PANCYTOPENIA Neutropenia: A White cell count < 1,000 with an Absolute Neutrophil Count (ANC) low Associated with infections
  • Slide 19 - Thrombocytopenia Low platelets and risk for bleeding Normal: 150,000-450,000 High threshold in oncology
  • Slide 20 - Anemia Hemoglobin: Responsible for Oxygen transport to cells Normal is 12-16 g/dl depending on age High threshold Symptom dependent
  • Slide 21 - GASTROINTESTINAL EFFECTS Nausea & Vomiting Diarrhea Dehydration Constipation
  • Slide 22 - OTHER Stomatitis Esophagitis
  • Slide 23 - IMPACT ON THE CHILD Short to extended hospitalizations Administration of therapy Infection management Recovery in-between
  • Slide 24 - EMOTIONAL RESPONSE TO CANCER Feelings of: Guilt Anger Sadness and loneliness Age / Developmental responses to cancer
  • Slide 25 - Responses 1. Dependency 2. Regression of development 3. Inability to cope at all
  • Slide 26 - DEALING WITH RESPONSES School-Age Children
  • Slide 27 - Teens
  • Slide 28 - ATTENDING SCHOOL Children on cancer treatment can/do attend school Important for social development…NORMALCY Good communication is KEY to safe and successful school environment
  • Slide 29 - INFECTION PREVENTION Germs exist…exposure happens Good Hygiene Hand washing (frequently) Hand sanitizer Keep hands as clean as possible
  • Slide 30 - VACCINES Children with cancer CANNOT receive live vaccines No specific recommendations for exposure to others Best they are NOT exposed to others having just received live vaccines
  • Slide 31 - INFECTION PREVENTION NOT share pens, cups, utensils, etc…with the patient NOT be near or in contact with the infected person Education of parents of classmates
  • Slide 32 - INFECTION PREVENTION May be asked to avoid large crowds Classmates can visit but not all together (1-2 at a time) Child may be asked to eat restricted diet
  • Slide 33 - RE-ENTERING SCHOOL Notify parent if contagious diseases present Offer rest times Hand Hygiene Offer gentle play options
  • Slide 34 - SCHOOL INFECTION CONTROL POLICY Classmates with: Fever Runny nose, cough Diarrhea Rash NOT play with child with cancer
  • Slide 35 - Cont. Wash hands after using bathroom Have wipes handy for door knobs
  • Slide 36 - HEALTHY SCHOOL ENVIRONMENT Have emergency contacts handy When to call: Fevers > 101 F Exposure to chicken pox Bleeding (active) Central line problems Not drinking or voiding sufficiently
  • Slide 37 - Central Lines & Nursing Responsibility
  • Slide 38 - IDENTIFYING CVL INFECTION INSPECT SITE LOOK FOR: REDNESS SWELLING DRAINAGE INCREASED PAIN/TENDERNESS
  • Slide 39 - CLASSMATE RULE Wash hands or use hand gel Gentle play Avoid close interaction if they don’t feel well Treat the child like they always have
  • Slide 40 - SUPPORTING THE CHILD Encourage relaxed environment Wear a hat Take naps (leave class) Drink fluids Trips to rest room Snacks Indoors all times Changes rooms alone
  • Slide 41 - SCHOOL AND EMOTIONS May be hard to return Body changes and appearance Visits from staff can reduce fears May need special care Education support
  • Slide 42 - EMOTIONAL SUPPORT Children need to have a normal routine Feel hopeful and good about future Talk to classmates Changes in the child with cancer Myths about cancer
  • Slide 43 - Encourage talking and provide support They may need an emotional break Treat them like others….NORMAL
  • Slide 44 - SUMMARY Children and adolescents with cancer are at risk for serious acute effects…including emotional turmoil Children and adolescents with cancer may attend school when feeling well and physician approved They need normalcy in a safe and healthy environment
  • Slide 45 - QUESTIONS
  • Slide 46 - Resources www.curesearch.org www.lls.org www.beyondthecure.org www.pbtfus.org
  • Slide 47 - References Association of Pediatric Hematology/Oncology Nurses. (2003). Foundations of Pediatric Hematology/Oncology Nursing: A Comprehensive Orientation and Review Course. Association of Pediatric Hematology/Oncology Nurses. (2005). APON/PBMTC’s Foundations of Pediatric Blood and Marrow Transplantation: A Core Curriculum. Kupst, M. J. (2009, October). Cancer Impact on the Child: Putting the Experience into Perspective. Presented at the Association of Pediatric Hematology/Oncology Nurses, Wisconsin. www.childrensoncologygroup.org. Family Handbook for Children with Cancer
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