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Oncology Pharmacists: Valuable Patient Resource

Posted on June 27, 2022 in Blog

This blog was written using content provided by Kasey Smith, Pharm D, Clinical Pharmacy Specialist

Patients can easily become overwhelmed as they try to make sense of a cancer diagnosis. The feeling of being overwhelmed can intensify as they try to understand the necessary lab tests, imaging scans, and biopsies they may need, on top of learning about their oncologist’s recommended treatment plans. At Thompson Oncology we understand this and provide additional support for our patients throughout their journey. One important resource for our patients is our team of highly educated and experienced oncology pharmacists.

 

The oncology pharmacists at each Thompson infusion site are available to help patients better understand how a medication works, how and when it will be given, and what side effects are possible from the medication. In the following paragraphs, we share some insights our oncology pharmacists offer when they counsel patients.

 

Pre-medications

The treatment day for most patients begins with what is known as “pre-medications”, commonly abbreviated as pre-meds.  These are medications given prior to chemotherapy and targeted therapies to help prevent a reaction to the medication as well as prevent nausea and vomiting. The pre-meds given to each patient are specific to their treatment. A patient may need zero pre-meds or may need as many as six or more different pre-meds to prepare for treatment. At Thompson Oncology, the NCCN (National Comprehensive Cancer Network) guidelines along with the patient’s medical history are used to determine which pre-medications are needed for each individual patient.

Chemotherapy

Chemotherapy is a term that describes a group of multiple different medicines that work by killing fast-growing cells, also known as rapidly dividing cells. Cancer is just that – a group of cancerous cells that grow and multiply much more quickly than most healthy cells in the body. Therefore, chemotherapy works well in treating many different cancers.

The drawback of chemotherapy drugs is that they cannot distinguish between cancerous cells that rapidly divide and healthy, normal cells that rapidly divide. Because of this, chemotherapy medicines target both. This is what causes most of the common side effects known from these medications. Examples of normal, healthy cells that rapidly divide are as listed in Table 1 along with the side effects that are caused by chemotherapy attacking these cells.

 

Table 1

Location of Rapidly Dividing Cells

Side effects

Hair cells

Hair loss (alopecia)  

Mucosal lining of the mouth

Mouth sores (stomatitis)

Stomach & Intestines

Nausea, Vomiting, Diarrhea, Constipation

Bone Marrow

Decreased immune system

Skin on the palms of hands and soles of feet

Hand & Foot syndrome

These side effects do not encompass all of the possible effects associated with these medicines, and some of the drugs have more potential for causing them than others. While a provider cannot prevent or eliminate all of the potential unintended effects of the chemotherapy, he or she can usually prescribe medications to make them more tolerable. Therefore it is imperative to make your provider aware if you begin experiencing any new symptoms or side effects.

Targeted Therapy

Targeted therapy is a type of cancer treatment that targets proteins that control how cancer cells grow, divide, and spread. As researchers learn more about the DNA changes and proteins that drive cancer, they are better able to design treatments that target these proteins.

The most common type of targeted therapy is known as monoclonal antibodies. This is a therapeutic antibody, designed in a lab, which is made to attach to specific targets found on cancer cells. The monoclonal antibodies directly stop cancer cells from growing or cause them to self-destruct.

In order for these drugs to be used, biomarker testing typically has to be completed on the patient’s tumor. The test identifies whether the patients’ cancer cells have the “target” that the medicine is looking for. The results of the testing let the oncologist know if the targeted therapy will be effective for the patient’s cancer.

Side effects associated with targeted therapies are specific to the medicine. Some commonly known potential side effects are diarrhea, wound healing issues, high blood pressure, mouth sores, fatigue, rash, dry skin, etc. The medical oncologist and oncology pharmacist will explain the common side effects associated with the targeted therapy that is chosen for a patient. They continue to monitor the patient for these symptoms throughout his or her treatment.

Immunotherapy

Immunotherapy is a term used to describe a class of medications that work by boosting a person’s immune system so that it can work harder and smarter to find and attack cancer cells. It helps the body identify cancer cells as “foreign” which allows the immune system to fight cancer cells while typically leaving normal cells alone.  In the last few decades immunotherapy has become an important part of treating different types of cancer.

Immunotherapy works better for some types of cancer than for others. It can be used by itself or in conjunction with chemotherapy depending on the indication to treat the specific cancer type. Side effects associated with these medicines are typically caused by an overreaction of the immune system. This means that the immune system is so stimulated that it begins to attack other parts of the body.

Organs that are known to be affected by this overreaction are the lungs, intestines, liver, hormone-making glands, and kidneys. Most of these effects will be monitored by lab values from blood tests that will be drawn before each treatment. These labs will be evaluated by the provider and oncology pharmacist to ensure it is safe to proceed with treatment before a patient receives an immunotherapy medication. Some of the side effects cannot be monitored through labs, therefore it is essential that patients make their providers aware of any diarrhea, respiratory issues, or any other problems that occur after beginning immunotherapy.

Empowering Patients with Resources

These days, there are many types of treatment options used for cancer and new treatments are approved all the time. At Thompson Oncology you can be assured that the medical oncologists are choosing the appropriate medication for each patient’s specific needs. Oncology pharmacists will be available throughout a patient’s treatment to help them better understand what class of medication is used to treat their cancer, how it works, what to expect in terms of side effects, and how they can successfully manage them.

To learn more about Thompson’s Oncology Pharmacy team, visit our webpage: https://www.thompsoncancer.com/oncology-pharmacy/

Click here and discover 5 Ways Oncology Pharmacists Keep You Safe

 

References:

American Cancer Society –  cancer.org 

National Comprehensive Cancer Network – nccn.org

HOPA – Hematology Oncology Pharmacy Association –  hoparx.org    

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