FANCONI'S ANEMIA IN PATIENTS WITH HEAD AND NECK SQUAMOUS CELL CARCINOMA: CHALLENGES FOR PATIENTS, CHALLENGES FOR TREATMENT

2.50
Hdl Handle:
http://hdl.handle.net/10755/165104
Category:
Abstract
Type:
Presentation
Title:
FANCONI'S ANEMIA IN PATIENTS WITH HEAD AND NECK SQUAMOUS CELL CARCINOMA: CHALLENGES FOR PATIENTS, CHALLENGES FOR TREATMENT
Author(s):
Richardson, Marian; Cox, Andrea
Author Details:
Marian Richardson, RN MSN AOCN, Nursing Manager: Radiation Oncology, Johns Hopkins Hospital, Baltimore, Maryland, USA, email: marian657@msn.com; Andrea Cox, RN, BSN
Abstract:
Fanconi's Anemia (FA), a rare autosomal recessive genetic disorder, is associated with chromosomal instability and abnormal DNA repair. This predisposes patients to congenital abnormalities, bone marrow failure, human papillomavirus, and development of solid tumors, especially squamous cell carcinoma of the head and neck (HNSCC), esophagus, anus, and vulva. The risk of HNSCC in FA patients is approximately 500 fold higher than the general population. Because of flawed cellular repair, standard cancer therapies need modification. Treatment considerations include the use of targeted therapies versus chemotherapy and conventional radiation treatment versus Intensity Modulated Radiation Therapy (IMRT). Nurses are crucial in identifying patients with FA and aggressively managing their treatment related toxicities. This presentation provides an overview of FanconiÆs Anemia and a description of two case studies demonstrating the challenges of managing these complex patients. Case Study I: A 31 year old woman with known FA presented status post multiple surgical procedures for oropharyngeal cancers and status post surgical excision of left retropharyngeal space for retropharyngeal recurrence. Conventional radiation treatment to 63 Gy to the left neck and supraclavicular area was administered with 2 planned treatment breaks. Nursing interventions included multidisciplinary coordination, daily assessment, management of treatment toxicities and psychological support. Case II: A 30 year old male presented with SCC of the tonsil. His treatment plan consisted of concurrent chemotherapy (Platinum and targeted therapy on protocol) and an IMRT based radiation plan. Early treatment toxicities including oral mucositis, neutropenia, and sepsis raised suspicion of a DNA fragility syndrome. Testing proved positive for FA. Treatment plan was amended to single agent Cetuximab and conventional radiation treatment. Nursing interventions included aggressive management of odynophagia, mucositis, skin reaction, cachexia and interdisciplinary coordination. A review of FA case studies initiated a nursing inservice on treatment considerations in this patient population. Oncology nurses must be aware of treatment implications for FA patients. Patients who develop early severe toxicities to treatment should be tested for DNA fragility syndromes. Treatment plans should be amended, treatment breaks considered, and prolonged recovery time anticipated. FA patients should have early and regular screening for HNSCC.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
32nd Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Las Vegas, Nevada, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleFANCONI'S ANEMIA IN PATIENTS WITH HEAD AND NECK SQUAMOUS CELL CARCINOMA: CHALLENGES FOR PATIENTS, CHALLENGES FOR TREATMENTen_GB
dc.contributor.authorRichardson, Marianen_US
dc.contributor.authorCox, Andreaen_US
dc.author.detailsMarian Richardson, RN MSN AOCN, Nursing Manager: Radiation Oncology, Johns Hopkins Hospital, Baltimore, Maryland, USA, email: marian657@msn.com; Andrea Cox, RN, BSNen_US
dc.identifier.urihttp://hdl.handle.net/10755/165104-
dc.description.abstractFanconi's Anemia (FA), a rare autosomal recessive genetic disorder, is associated with chromosomal instability and abnormal DNA repair. This predisposes patients to congenital abnormalities, bone marrow failure, human papillomavirus, and development of solid tumors, especially squamous cell carcinoma of the head and neck (HNSCC), esophagus, anus, and vulva. The risk of HNSCC in FA patients is approximately 500 fold higher than the general population. Because of flawed cellular repair, standard cancer therapies need modification. Treatment considerations include the use of targeted therapies versus chemotherapy and conventional radiation treatment versus Intensity Modulated Radiation Therapy (IMRT). Nurses are crucial in identifying patients with FA and aggressively managing their treatment related toxicities. This presentation provides an overview of FanconiÆs Anemia and a description of two case studies demonstrating the challenges of managing these complex patients. Case Study I: A 31 year old woman with known FA presented status post multiple surgical procedures for oropharyngeal cancers and status post surgical excision of left retropharyngeal space for retropharyngeal recurrence. Conventional radiation treatment to 63 Gy to the left neck and supraclavicular area was administered with 2 planned treatment breaks. Nursing interventions included multidisciplinary coordination, daily assessment, management of treatment toxicities and psychological support. Case II: A 30 year old male presented with SCC of the tonsil. His treatment plan consisted of concurrent chemotherapy (Platinum and targeted therapy on protocol) and an IMRT based radiation plan. Early treatment toxicities including oral mucositis, neutropenia, and sepsis raised suspicion of a DNA fragility syndrome. Testing proved positive for FA. Treatment plan was amended to single agent Cetuximab and conventional radiation treatment. Nursing interventions included aggressive management of odynophagia, mucositis, skin reaction, cachexia and interdisciplinary coordination. A review of FA case studies initiated a nursing inservice on treatment considerations in this patient population. Oncology nurses must be aware of treatment implications for FA patients. Patients who develop early severe toxicities to treatment should be tested for DNA fragility syndromes. Treatment plans should be amended, treatment breaks considered, and prolonged recovery time anticipated. FA patients should have early and regular screening for HNSCC.en_GB
dc.date.available2011-10-27T12:12:36Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:12:36Z-
dc.conference.date2007en_US
dc.conference.name32nd Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationLas Vegas, Nevada, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.