Chemotherapy has been a routine in Surgical Department in the place i work. There's many types and many regimes of chemotherapy used here. Chemotherapy when given to patient, it has many aims that works differently for each different regime.
First of all, types of chemo can be divide into 2 main group :
1. Curative -----------> i) neoadjuvant ii) adjuvant
2. Palliative
Curative chemo used with the aim to treat the cancer and to reduce the size of tumor or to be given after a surgical intervention with the aim of preventing the recurrence of the tumor. Basically to get rid of the tumor.
Palliative chemo is used just to reduce the activity or aggressiveness of the tumor without any intention to treat the cancer fully. Used when the cancer already have metastasis. Basically just to increase the life expectancy of a patient.
Neoadjuvant chemo - given before any surgery done, given with the aim to shrink the primary tumor so that when the tumor reduce in size, it can be surgically removed.
Adjuvant chemo - given after any surgery to remove the tumor is done, with the aim of reducing the % of recurrence and also to reduce any new tumor growth.
Types of chemo drugs :
i) alkylating agents
ii) antimetabolites
iii) anthracyclines
iv) alkaloids
v) topoisomerase inhibitors, etc etc.
They all function by effecting on the cell divison and DNA synthesis and function.
Types of Chemo Regime commonly used in my place :
1. For Breast CA -------------> i) FAC - Folinic acid
Adriamycin/Doxorubicin
Cyclophosphamide
ii) FEC - Folinic acid
Epirubicin
Cyclophosphamide
2. For Colorectal CA ---------> i) FOLFIRI - Folinic acid ( Leucovorin)
5-Fluorouracil
Irinotecan
ii) FOLFOX - Folinic acid
5-Fluorouracil
Oxaliplatin
iii) De Gramont - Folinic acid
5-Fluorouracil
iv) Mayo - Folinic acid
5-Fluorouracil
** Folinic Acid - i) works to increase the efficacy of the chemo drug to kill the cancel cell
ii) also works as protector of healthy cells from the chemo effect
(always give folinic acid before giving chemo drugs, especially Fluorouracil)
Complications or Side effects of Chemo Treatment -- affects on all the healthy fast dividing cells of body
Divided into local and systemic
i) Local - skin erythema, pain , dry mouth, vomitting, nausea, reduce appetite, allergic locally, alopecia
ii) Systemic - reduce immunity (neutropenia) , induce anemia ( effect on bone marrow fx)
tendency to bleed ( thrombocytopenia)
GIT effect - constipation @ diarrhea
infertility
fatigue
secondary neoplasm ( AML after chemo treatment)
Can also be cardiotoxicity, hepatotoxicity, nephrotoxicity, ototoxicity and also encephalopathy
Nama : Dhimas Widya Kusuma
ReplyDeleteN I M : A310110176
Kelas : 2D
Kutukan Perempuan
Disaat siang hari, ada permpuan yang mengacungkan golok kepada seorang laki-laki. Perempuan tersebut mengusir laki-laki itu sambil berkata, “ tak becus buat anak, minggat kau!”. Lantaran si laki-laki berlari sekencang mungkin, karena takut akan golok yang dihunuskan oleh perempuan tersebut. Meskipun laki-laki dan perempuan tersebut sudah berkeluarga selama 10 tahun, atpimereka tak juga dikaruniai seorang anak. Itu sebabnya kenapa perempuan itu sangat marah.
Karena keinginannya sangat kuat untuk memiliki anak, suatu hari perempuan itu berdiri di emperan toko dengan rok mini dan sangat ketat. Hingga akhirnya datang seorang laki-laki muda yang menawarnya. Setelah kesepakatan terjadi, melalui kedipan mata dan akhirnya mereka berdua melakukan hubungan terlarang. Selama seminggu perempuan itu menunggu, berharap tumbuh janin dirahim perempuan itu setelah ia melakukan hubungan terlarang dengan laki-laki muda tersebut. Karena perempuan itu suka tokoh-tokoh wayang, maka ia akan menamai anak-anaknya seperti tokoh wayang. Dan apabila suatu hari nanti perempuan itu memiliki anak laki-laki, akan dinamainya Werkudara dan apabila anaknya wanita, akan dinamainya Subadra.
Seminggu berlalu, dan janin yang ditunggu juga tak kunjung ada. Lalu ia berkata, “ tak ada kenikmatan untuk bajingan.” Usai kejadian itu, perempuan kembali menebar pesona. Berkali-kali ia melakukan hubungan terlarang itu. Berkali-kali juga, ia berganti pasangan. Hingga selama 5 tahun kejadian itu berlanjut, hingga perempuan itu menjadi lebih tua, dan rambutnya sudah ditumbuhi uban.
Dimalam yang hitam, akibat listrik yang padam, perempuan itu bergemeremang, “ Jika kau masih tak menggelembungkan perutku, aku selekasnya bersetubuh dengan setan”. Dan kilat dilangit menyambut sumpah perempuan itu.
Perempuan itu sering tebar pesona, kadang dia melakukan hubungan dengan siswa puber yang butuh saluran hasrat purbaninya. Tak jarang tukang becak menyutubuhinya secara bebarengan. Perempuan itu sangat benci dengan ibu-ibu yang memiliki seorang anak. Perempuan itu sangat teriris hatinya ketika mendengar tangisan bayi.
Akhirnya perutnya menggelembung juga. Selama 9 bulan ia melewatinya, dan akhirnya perempuan itu melahirkan bayi entah laki-laki atau perempuan. Hari demi hari barlalu. Tangan perempuan itu menggamit bayinya (dua ekor ular kecil), dilingkarakan 2 ekor itu dilehernya, dielus dan diusap kepala 2 ular itu dengan lembut. Entah siapa yang menyetubuhinya, laki-laki atau setan hingga perempuan itu melahirkan 2 bayi ular.
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