A patient who has undergone surgical removal of a solid tumor has just begun chemotherapy. The patient experiences severe nausea and vomiting as well as alopecia. The nurse will expect the provider to:
a. continue the chemotherapeutic agent at the same dose.
b. decrease the dose of chemotherapy to mi-nimize side effects.
c. order lab tests to evaluate for the presence of residual cancer cells.
d. stop the chemotherapy because the tumor has been removed.
A
Cure of cancer requires 100% cell kill. Solid tumors, which often respond poorly to chemothe-rapeutic agents, can be "debulked" with surgery and then treated with cytotoxic drugs, because the remaining cells often re-enter the cell cycle and become sensitive to the drugs. Chemothera-peutic drugs must be given at the same dose throughout therapy because of the kinetics of drug-induced cell kill. Because chemotherapy has just begun, it is still necessary; moreover, cell counts of fewer than 1 billion cells are no longer detectable and treatment must continue until all cells are eradicated, so lab tests will not yield useful information. Stopping the chemotherapy right after surgery is not indicated.
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