Module 11 - IPCRC.NET
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Transcript Module 11 - IPCRC.NET
The
EPEC-O
TM
Education in Palliative and End-of-life Care - Oncology
Project
The EPEC-O Curriculum is produced by the EPECTM Project with major funding
provided by NCI, with supplemental funding provided by the Lance Armstrong
Foundation.
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EPEC – Oncology
Education in Palliative and End-of-life Care – Oncology
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Module 3o
Symptoms – Mucositis
Mucositis . . .
Definition: mucosal barrier injury
It may affect the entire GI tract
. . . Mucositis
Epidemiology. . .
Impact:
Oral erythema, ulceration, pain,
infection
Diarrhea (if it affects entire GI tract)
Decreased oral intake
Raises 100-day mortality
. . . Mucositis
. . . Epidemiology
Prevalence:
40 % of patients on chemotherapy
100 % if with stem cell transplant
Prognosis:
Usually self-limiting
Key points
1. Pathophysiology
2. Assessment
3. Management
Pathophysiology
Direct injury
Secondary infection
Graft versus host disease
Plevova P. Oral Oncol, 1999.
Usual course
Starts 5 - 7 days after chemotherapy
Generalized desquamation
days 11 - 14
Resolution
2 days to 2 – 3 weeks
6 weeks after radiation
Wilkes JD. Semin Oncol, 1998.
Assessment
History
Pain and its effect on the patient
Eating and drinking
Physical examination
Orthostatic blood pressure and pulse
Weight
Evaluate affected oral mucosa
Management . . .
Potential for prevention
1. Diminish mucosal delivery,
eg, oral cryotherapy
2. Modify epithelial proliferation,
eg, growth factors
3. Reduce infections, inflammatory
complications
4. Reduce, inhibit pro-inflammatory
cytokines
. . . Management
Oral hygiene
Diet (minimize contact with food)
Local anesthetics
Systemic analgesics
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Summary
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Use comprehensive
assessment and
pathophysiology-based therapy
to treat the cause and improve
the cancer experience