Devita, Hellman, and Rosenberg's Cancer

LWBK1006-44 LWW-Govindan-Review November 24, 2011 11:30

Chapter 44•Management of Adverse Effects of Treatment 559

Echocardiograms or radionuclide imaging can directly measure left ven-

tricular ejection fraction. Other measures of cardiac dysfunction include

measuring serial diastolic pressures, serum cardiac troponin T levels, and

brain natriuretic peptide levels. Electrocardiograms have little value in

early detection of cardiac dysfunction because changes tend to occur

late.

Answer 44.20. The answer is D.

Systemic chemotherapy can cause hair loss through either thinning of the

hair shaft or inhibition of matrix proliferation. The chemotherapy drugs

most commonly associated with total alopecia include cyclophosphamide,

doxorubicin, irinotecan, docetaxel, topotecan, and bleomycin.

Answer 44.21. The answer is B.

Prolonged azoospermia is often seen with radiation to the testis, chloram-

bucil, cyclophosphamide, procarbazine, melphalan, and cisplatin. Carbo-

platin does not often cause prolonged azoospermia. Other agents (dox-

orubicin, cytosine arabinoside, vinblastine, vincristine) can be additive in

causing prolonged azoospermia when combined with other agents that

affect sperm production but cause only temporary reductions in sperm

when used alone.

Answer 44.22. The answer is D.

Several interventions have been shown to improve cancer-related fatigue.

These include supplementation with mistletoe extract, L-carnitine, and

high-dose vitamin C, as well as massage therapy, stress-reduction inter-

vention, polarity therapy, and relaxation breathing. Data are mixed for

progressive muscle relaxation, psychoeducation, virtual reality distrac-

tion, and yoga. The use of music therapy, omega-3 fatty acid supplemen-

tation, and reiki did not show an improvement in fatigue symptoms.

Answer 44.23. The answer is D.

Constipation may occur with up to a third of patients treated with

vinca alkaloids (vincristine, vinblastine, vinorelbine). Constipation usu-

ally occurs after the first dose and is most prominent between 3 and

10 days after chemotherapy, and typically resolves in a few days. Thalido-

mide also frequently causes constipation.

Answer 44.24. The answer is D.

Hand-foot syndrome is an adverse effect seen with several chemotherapy

agents including cytarabine, 5-fluorouracil, capecitabine, pegylated lipo-

somal doxorubicin, and multitargeted tyrosine kinase inhibitors such as

sorafenib and sunitinib.