Patient Education and Treatment of Leukemia

I would ask Mrs. Lupe if she understood what leukemia was and how it was treated. I would focus on helping her understand that leukemia was a type of cancer of the blood and required a lot of therapy. I would make sure she understood which medicines were prescribed to her and explain the side effects. I would communicate what the signs of infection are and help her understand when she needed to get treatment for new symptoms, such as renal failure and bleeding so that she may increase her quality of life.

I could teach Mrs. Lupe about the medications she would take at home and the medications, if any, she would receive through an intravenous drip. I would advise her that her treatment is long term, and that she might experience some difficulty as she started treatment, but that she was not getting sicker. I would inform her of her common side effects, including nausea, fatigue, possible pain in joints or different parts of the body such as the jaw, trouble sleeping, and hair loss.

Mrs. Lupe could be treated with a combination of several classification or types or drugs. Among them include the following major types: kinase inhibtors and cytotoxic drugs. Kinase inhibitors limit the size of tumor growth. Cytotoxic drugs are drugs that are used to treat cancer. Additionally, Mrs. Lupe could also be treated with a corticosteroid as well as an antimetabolite drug. Corticosteroids are anti-inflammatories, meaning they reduce swelling and inflammation in the body. Antimetabolites interfere with the metabolism of cells, which is useful for combating quickly reproducing cells such as leukemia.

Two kinase inhibitors available for Mrs. Lupe include Imatinib (Gleevec) and Dasatinib (Sprycel). Dosing parameters include 300–800 mg daily, with the 800 mg dose being broken up into two 400 mg doses twice a day. Long-term therapy side effects include cardiac toxicity and abnormal bone health. Many cytotoxic drugs are available for leukemia, including Vincristine and Pegaspargase. Dosing parameters include 1.4 mg/m2 IV over one minute, once weekly for Vincristine and 2500 international units/m2 IV or IM no more frequently than every 14 days for Pegaspargase. Corticosteroids include Deltasone and Orasone. Dosing ranges between 5 and 60 mg daily, depending on the condition being treated, and drug interaction. Long term usage effects include osteoporosis and issues with the body producing cortisol. Antimetabolites include Rheumatrex and Trexall. The oral dose is 7.5 to 20 mg once weekly. Some rare but serious long-term side effects include issues with lung function and bone marrow development. Other drugs would used in a complimentary or side basis and would have their own set of dosage requirements and short-term and long-term side effects.

Nutritional challenges include emaciation from the chemotherapy and constipation, which can affect diet. Mrs. Lupe will need to make sure she is getting enough Vitamin D and will need to avoid undercooked or raw foods so as not to stress her immune system.

In caring for the cancer patient, referrals for community resources should be made. Community resources Mrs. Lupe could tap into include cancer and leukemia support groups at hospitals or elsewhere. There is also a lot of reading she can do, both online and at the library. I would advise her and her husband to read more about the disease and to speak with the doctor for advice on receiving treatment. Because of the risk of depression or the possible risk of refusing treatment, I would impress upon Mrs. Lupe that being tired was a symptom of the disease and it could become worse without treatment and understanding.