Chemotherapy and Its Impact on Function
Presented by Nicole L. Stout
Chemotherapy is prevalent in cancer care and involves the systemic delivery of toxic agents to reduce the viability of cancer cells in the body. The effects of chemotherapy are therefore broadly systemic, inciting negative impact across multiple body systems during cancer treatment, but can also lead to long-term, late effects that contribute to chronic functional limitations and disability. Due to the late effects of treatment, the functional impact is sometimes delayed for years following treatment and warrants consideration by rehabilitation providers planning care for individuals with even a long-term history of cancer treatment. This course will review commonly used chemotherapeutic agents, their short- and long-term side effects. It will also provide specific insight on the adverse effects across body systems, including: neurotoxcity, cardiotoxicity, cognitive changes, and cancer-related fatigue. Strategies for screening and assessment, as well as rehabilitation interventions, will be reviewed.
Meet your instructor
Nicole L. Stout
Dr. Nicole L. Stout is a research assistant professor in the School of Medicine, Department of Hematology/Oncology at West Virginia University Cancer Institute and with the School of Public Health, Department of Health Policy, Management, and Leadership. She also serves as the associate director of the WVU Cancer Institute’s…
Chapters & learning objectives
1. Chemotherapy Drug Delivery and Mechanisms of Action
Chemotherapy drug delivery routes, timing, and recovery is discussed. Overall mechanisms of action across chemotherapeutic drug classes are reviewed to provide insight on how cancer care is conducted.
2. Chemotherapeutic Drug Classes
Chemotherapeutic agents have different impacts on different cell functions, and various classes of agents target these functions to optimize effectiveness. A combination of agents is typically used with each drug, carrying multiple side effects with functional impact across multiple systems.
3. Chemotherapy-Related Neurotoxicity: Screening, Assessment, and Management
Some of the most commonly used chemotherapy agents result in nerve conduction dysfunction. Chemotherapeutic-induced peripheral n feuropathy and ototoxicity are common side effects that occur during cancer treatment and frequently have persistent impact on sensory and motor function. Validated tools for screening and assessment exist to expedite identification of neurotoxicity and evidence-based strategies support rehabilitation care plan development.
4. Chemotherapy-Related Cardiotoxicity: Screening, Assessment, and Management
Some of the most commonly used chemotherapy agents result in cardiac dysfunction. Cardiac compromise occurs during cancer treatment and, in some individuals, is not only persistent but progressive over time, impacting long-term function. Exercise interventions during chemotherapy administration are strongly evidence based and promote improvement in cardiac function.
5. Cancer-Related Fatigue: Screening, Assessment, and Management
Fatigue is a prevalent symptom across all cancer treatments and is debilitating in both the short- and long-term for a majority of individuals receiving chemotherapy. Validated tools and clinical practice guidelines for screening and assessment exist to expedite identification and management of cancer-related fatigue and evidence-based strategies to support rehabilitation and exercise interventions.
6. Chemotherapy-Related Cognitive Changes: Screening, Assessment, and Management
Cognitive changes occur commonly with chemotherapy and can impact short-term memory and problem-solving, contributing to fatigue. Validated tools and clinical practice guidelines for screening and assessment exist to expedite identification and management of chemotherapy-related cognitive changes and evidence-based strategies to support rehabilitation interventions.
7. Safety Considerations for Rehabilitation Care Planning
Chemotherapy has significant immunosuppressant impact on the body. Bone marrow is negatively impacted, leading to abnormal blood counts. Furthermore, chemotherapy affects hydration, metabolic and endocrine function, and causes severe adverse effects that warrant consideration by the rehabilitation provider to ensure a safe plan of care.
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