Chemotherapy
Chemotherapy is a treatment using medicines chemical known drug of anti-cancer, the elimination of cancer cells and destroy them, and come the main advantage of this treatment of his ability to deal with tumors of mobile and deployed, while limited to radiation therapy or surgery to address the oncology administration, confined placements specific, and return its effectiveness Special to the fact that cancer cells somehow more sensitive to chemicals than normal cells, and may be used as a treatment for some individual cases, or part of an integrated treatment program consists of several treatments in common, and the decision is made by using this treatment balance between effectiveness and side effects and complications between the future and the seriousness of cancer, and of course Vamadaafath and its acceptable compared to the same disease, in addition to the positive therapeutic yield is very large.
And expressions of medical used to describe chemotherapy term treatment for the growth of abnormal (antineoplastic), and the expression of toxins cellular (cytotoxic) any drugs lethal to cells, and is sometimes prescribed treatment is systemic (systemic) of any that include all the physical constitution, where transmitted drug chemical through the blood circulation to all Members and tissues of the body, and can eliminate cancer cells, where reported, and may be used before surgery when the solid tumors in preparation to it and in order to facilitate Bhzareth and shrink the tumor, what is known as chemotherapy Initial Assistant (Neoadjuvant) may also used after the surgery and remove the tumor in order to eliminate any tumor cells may be a residual, and to help avoid the return of tumor growth, including chemotherapy known additive
(Adjuvant), which may be received also without finding traces of the cancer cells, but there are certain factors may lead to predict the possibility of return (such as the transmission of secondary tumor to the lymph nodes).
Doses and treatment plans
Doses and scheduling of each drug a chemical specific, typically when most of the cases of tumors, and most physicians follow her treatment with a standard differences marginal, and in turn had followed the doctors plan treatment different in some cases, made up of different drugs and schedule a different time to deal with tumors of certain stages particular, and of course there are factors and considerations on the order of light treatment plan and determine the drugs used, and these factors include the type of tumor and degree (similar to the cells with normal cells), and the classification phase (ie places like and how its spread), and age the patient and his general health, in addition to the problems associated with serious health ailments such as liver and kidneys, and tumor types of treatments received in the past, if any, and of course, uses regular medical doctors Balnscherat, which describe the plans in place and effective treatment when similar cases.
Doses
The margin of use of most drugs the normal is not restricted, especially medicines that could be addressed without a prescription, in the sense that different doses of which may serve the purpose therapeutic effectiveness and safety, for example, may indicate the posters mailbox aspirin to the possibility of take two tablets a day for headaches moderate, while just simply eating one disk may be effective, in turn a different matter altogether when dealing with drugs, chemicals, where the margin of safe use and effective restricted and specifically, addressed the amount of very few will not be effective in the treatment of cancer, and eating large amounts may cause serious side effects, is therefore necessary always calculated doses accurately.
And is Almelligram unit of measurement usual doses and approved, and the calculated dose at each patient in two ways, either based on body weight or based on surface area, for example, may reach the dose standard for a drug 10 mg per kg or 10 mg / kg, thus Valjrah when a child weighs 30 kg of 300 mg, and the surface area of the body (body surface area BSA) are calculated per square meter based on the weight and length of the body, where is equal to the square root of multiplying the length Balsntmitr weight in kilograms divided by the number 3600, for example, may reach the dose of standard drug 300 mg per square meter, or 300 mg / m 2, thus Valjrah when a child weighs 30 kg and a length of 125cc and body surface area of 1.021 square meters (ie, of one square meter approximately), to be 300 mg.
And natural that different doses in children and adults, and may be modified doses according to the factors and different considerations, such as poor nutritional status of the patient, and drugs associated with that are addressed, and how the use of radiation therapy during the session of chemotherapy, in addition to the censuses of blood and variations, and other health problems, especially liver and kidneys.
Treatment plans
Are receiving chemotherapy, usually in episodes repeated course of treatment (for a day or for several days) and then cycle recovery (several days or weeks) and so on until the end of the treatment program, and in general it is used during periods of prolonged to reduce how much the cancer cells gradually, to the extent which can in which the immune system control of any growth and throw, in addition to that space of time between doses placed to achieve the greatest effect on cancer cells and at the same time give sufficient time to allow the cells of the normal to recover, and in most cases, patients receive doses every three to four weeks during a period of four to twelve months or more in some types of tumors, especially tumors of blood, which may extend its therapeutic targeting prevention to a period of two years or more, depending on the treatment program used at each case.
And because of the types of drugs, chemicals from the effects of varying degrees on the cells and organs natural normal sound, (which leads to the emergence of effects and side effects associated with), is usually a different laboratory tests before starting sessions therapeutic, such as complete blood count and tests of kidney function and liver, in addition to periodic evaluation of the effects of drugs received on some of the vital organs, and may require the appearance of any data is normal during these tests and tests to adjust the dose, or changing certain medications or delay treatments, in addition to pre-empt some of the side effects, take Some measures such as increasing rates of perfusion to the body, and the equation of some vehicles, or taking medications for proof of these symptoms, or drugs in support of some of the vital organs of the guard.
And is usually follow several treatment plans to make the most of the toxic effects of drugs of chemical tumors, and are often configured the treatment plan of several drugs, differ in how they work and their effect on tumor cells, as different side effects usual, and in order to achieve the greatest impact on the these cells with minimal effect profile, and in this respect are selected combination treatment, as side effects of expected and to avoid the sharp ones, for example, can be given to the property known as the potential impact on the kidneys, with a drug known to the possibility of influencing the heart, instead of giving two drugs together have the possibility cause effects on the kidneys.
In view of what the cancer cells of the properties of a dynamic and configurations membership abnormal use of several drugs together, targeting the exclusion of resistance possible for one property, and interference in the initial stages of the phases of growth may prevent the development of drug-resistant chemical that has been observed in tumors bloated or transitional popup.
On the other hand, comes the need to use a combination of several drugs at once to affect cancer cells in various stages and phases of its growth, and that does not go by all these cells at one time, and where the impact of each property is limited to a certain point only, The use of combination will ensure the desired effect and undermine all phases of growth at the same time.
And in this regard it should be noted that some cancer cells, leukemia changes genes making them resistant to chemotherapy, in particular, and show these changes Bmorth known Bmorth drug resistance multiplier (multiple drug resistance MDR) which allows the cells Allokimah expulsion fast for some drugs of chemical inside the cell to the outside, which prevents from a pool of the drug inside the cell quantity necessary to eliminate them, and this gene is particularly important in the treatment of leukemia, acute myeloid, which for this reason require treatment using high doses of chemotherapy over a short period, while processed counterpart leukemia, lymphoma Acute low doses over a longer period.
The effect of chemical drugs
Most chemical drugs to destroy cancer cells by influencing the Hamadha Alrebonowi (DNA) to disrupt and disable it or the fragmentation and thus impede the sequence of the life cycle of the cell in its various stages, such as the stages of formation and division, reproduction and growth, both by interfering with the process of installation or obstruction of its functions or influence the chemical cell, in addition to undermine and disrupt the construction of nuclear proteins within cells, and each property is different in the way of his work and the stage that intervenes and affects the life cycle of the cell.
And include the major categories of chemical drugs:
Elements of alkylation (alkylating agents), and drugs that inhibit metabolism (antimetabolites), and compounds derived from alkaloids plant (plant alkaloids), and antibiotics Ddah tumors (antitumor antibiotic), in addition to other categories a variety of anti-tumor growth are indirect ways, such as Steroid hormones and enzymes, impeding the production of proteins and anti-foreign objects that support the immune system.
Elements of alkylation (alkylating agents)
Interfere with cell division and fragmentation of the structure of DNA in all stages of the life cycle of the cell, the most heavily traded species is the property Alsakulovsvamaid (Cyclophosphamide).
Metabolic inhibitors (antimetabolites)
And you are disabled and disable cell growth to intervene in some of the activities of vital metabolic processes and especially the formation of DNA and transformations, types of drugs are the most heavily traded Mercabtopaoren (6-mercaptopurine), and Alsaetharaben (Cytarabine), and Floroyurassel (5-fluorouracil 5FU) .
Antibiotics Ddah tumors
And in general the integration in the DNA mutations that frozen Rebonclaik acid that controls the manufacture of nuclear proteins, leading to cell death, of sorts: drug doxorubicin (doxorubicin / Adriamycin), and drug Almitomaysan
(Mitomycin-C) and Bleomaesen (bleomycin).
Plant alkaloids (Plant (vinca) alkaloids)
And extracted from the plant Alvinckh or periwinkle, and is based in particular to prevent cells from dividing and reproducing through cell division, of the kinds: the drug vincristine (Vincristine) and vinblastine (vinblastine).
PARP enzymes restored the DNA (DNA-repair enzyme inhibitors)
And is the fragmentation of the proteins responsible for DNA repair cancer cells, and a correction of DNA and repair Onsagah is one of the biological processes important cells, and preventing them becoming cancerous cells more susceptible to undermining and vulnerability, and lose the ability to grow, these types of brakes: Property Aitoboseid (etoposide) and Tubotikan (topotecan).
Channels to receive chemotherapy
Be dealt with chemotherapy drugs in ways and different channels, some of which are given by mouth (Oral) in the form of tablets or capsules or liquids, or topically to the skin (Topical) in the form of pastes, while most of the body is injected, the injection of different ways: injection IV (Intravenous IV), intramuscular injection (Intramuscular IM), injection into the main artery (Intraarterial), direct injection under the skin topically (Subcutaneous SQ), intravenous injection and is one of the most widely used method, and treatments can be given by injection directly into the tumor (Intralesional), or cavities within a specific target and specific (intracavitary), or injected directly into the abdominal cavity (intraperitoneal intraperitoneal), or in the chest cavity (pleural membrane within the intrapleural), or injected into the central nervous system via the cerebrospinal fluid (NA injection Intrathecal).
You may also use other methods to help injection such as catheters (catheters) and ports (ports), or pumps, usually when the patient needs a lot of treatments intravenous, and to avoid the inconvenience of inserting needles when you receive each dose of treatment, or when blood samples are installation tool catheter remain for long periods, and is used both to inject different drugs and medicines to help such as antibiotics, vehicles, and solutions support, or to withdraw blood samples for analysis throughout the treatment period, or for the delivery of medicines to private places, and is teaching the patient and family how to care for these tool and sterilized to avoid the emergence of inflammation or infection from which, and cultivated such catheters are usually in the vein of a key, (usually the chest), or his arm, and sometimes in the artery or in the abdominal cavity or pelvis, or under the scalp at the injection sheathing for the delivery of drugs cerebrospinal fluid.
Consists tool catheter simple tube Lin small diameter, are implanted surgically in the vein of a broad, usually region-Sadr is injected through it, and sometimes is a link from the outside port (port) circular form of plastic or metal, is implanted under the skin and is injection and draw through it, and sometimes may be added in the pump controls the speed of a stream of medicines within the catheter, and may be external pump remains outside the body and can be carried and movement during use, or internal reservoir containing a small drug-surgery is installed under the skin.
The following paragraphs profile of chemical drugs, and some useful suggestions:
Eating Albrchamat
Necessary when direct giving oral medications for children, starting in a good and understanding since the first day, and explore the means by which conformity with the Child-to-eat, as it was noted that when over a period of treatment to long-term turn the process of taking the drugs to the conflict between parents and child, and methods that may greatly help break Albrchamat into small pieces, or mixed with foods or beverages of choice for children, such as jam, fruit juices, as for some types of medicines, the taste is unpalatable, such as vehicles steroid dexamethasone or Prednisone, and preferably some parents to facilitate swallowing the use of capsules gel (Gel caps), different sizes suit and age of the child to put Albrchamat within them, as there are types of medicines prepared flavors especially for children, such as antibiotics Bactram or Septra, which dealt with the child for a long time, especially during periods of maintenance (maintenance) in cases of tumors of blood .
The important thing is to show flexibility, and be left to the children always take the drugs voluntarily, and choose how comfortable that suits him, and, of course, should consult a physician about the possibility of breaking up or mix Rivets drugs, chemicals, and make sure there are no precautions when children are prevented from that.
Intravenous
When most children are planting tools catheter temporary to inject drugs, and blood samples for analysis, and to avoid the pain tingling needle repeated and facilitate the injection, and Some doctors recommend not to use this method for several reasons, namely to avoid exposure to infection through, as well as it entails the need to care and permanent sterilization, which may not be able to maintain family time, and on the whole, and even when there is a tool to the child catheter will need intravenous from time to time.
And begin the process of intravenous injection (intravenous) is usually installed bronchiole or cannula injection (cannula), and by selecting a vein suitable in any position of the body, usually at the bottom of the arm or hand, and is used to bond Asb to make the vein prominent to facilitate the introduction of needle injections, which are being stuck in the appropriate place after sterilization, and is pulled to succeed the place Qusayba, and is a plastic tube small diameter, its own side outer port injection, which injects drugs through it, and prove during the injection, which can sometimes take several hours and removed after it ends, and can be kept for several days if necessary.
Here are some useful suggestions by direct intravenous injection of the child:
Try to keep the child calm, the fear makes blood vessels near the surface of the skin narrow, usually children remain calm presence of the parents, the adolescents Vitlpon privacy, and noted that the same person or the same nurse each time the start of injection to make the child more calm and relaxed.
Leave it at the disposal of the child to choose his own, especially after the injection the first time, and made him familiar with the selection of the appropriate vein.
The need for heating position, Valbrodh make veins to narrow.
Drink plenty of fluids, Lack of fluids reduces the flow of the veins.
Use a local anesthetic to the skin, such as Aimla cream (EMLA cream) to avoid inserting the needle km, which is usually placed one hour before the injection.
We point out that the treatment of children need wisdom and patience, especially when preparing to handle more of the treatment itself, and if the event (conflict) need to retreat and stop for some time, as it responds to children, usually if taken into account their point of view, and were given some discretion about issue.
NA injection (Intrathecal)
Injection can not be normal to most chemotherapy drugs to reach parts of the central nervous system (brain and spinal cord), and due to the combination of cerebral circulatory and multiple barriers, which requires the use of NA injection, in order to inject drugs directly to the cerebral spinal fluid surrounding spinal cord and brain, whether by injection between the bottom of the lumbar spine, or planting tool injection fixed and known Aomaya portfolio under the scalp, and in order to eliminate the possible presence of cancer cells, central nervous system,And the brain, or to protect them from any leaks or setbacks, and, of course, different doses and injection number during the therapeutic sessions from one patient to another, and depends on several factors such as tumor type and level of advancement and spread of a patch, in addition to the use of radiation therapy.
And portfolio consists Aomaya (Ommaya reservoir) of a small tool of plastics working Xdadh, and take the form of the dome and connected to pipe high, is surgically implanted to install them under the scalp, and is reached the tube cavity within the brain, where gather the cerebrospinal fluid, which gives an introduction is always of the liquid cord to inject drugs through it in addition to the withdrawal of samples for analysis, and is a comfortable way instead of injections repeated between lumbar back pain, where the insertion of the syringe plug wallet after shaving and sterilizing position, and then samples the spinal fluid, and injecting a slow drug without the patient feels no pain and without the need for anesthesia, and patients can engage in active normal including washing hair without caveats, and do not need the wallet for special attention, and, of course, be necessary to inform the doctor if there were some symptoms, such as swelling of the scalp position the portfolio or reddened, or the emergence of outlying areas, in addition to fever and high fever or headache, or nausea and stiff neck.
The injection process vaginalis between the bottom of the lumbar spine, is up to the patient lies on one side with the inclusion of the knees or put wrapped sitting hunched forward, and the doctor sterilized the lower back after choosing the appropriate position, and then uses local anesthesia or sedation full short term, and then enter the needle between two paragraphs of the lumbar spine where there is cerebrospinal fluid, which soon begins to flow through the needle, and are collecting a small amount of analysis, then placed syringe medication and is injected slowly, and may feel some children, especially adolescents headache after this process, and can avoid that by lying for an hour or so.
Side effects associated with chemotherapy
Once injected anti-cancer drugs circulatory even begin its work in influencing the cancer cells, which are generally active cells, fast growth and division, and heavy reproduction, and in turn includes the effect of drugs, some normal cells healthy fast-growing and heavy production and a permanent replacement, such as bone marrow cells and tissues of the digestive system, which leads to the emergence of effects and side effects associated with receiving treatments, and fortunately Most of these effects are a reflection of any to be temporary and go away often once you stop taking the treatments, and some go away even before the end .
It should be noted that the emergence of side effects or not is not evidence of the effectiveness and efficiency of the drugs used may also come to mind, they differ greatly in intensity and quality from one person to another, and of the drug to another and from the course of treatment to another even for the same person , and depend mainly on the type and dose of the drug user and the interaction of the body about it, and analysis and multiple lab tests only for the predictors of efficacy.
And it is noted that children are distinguished from adults with respect to chemotherapy, can scarcely side effects have less than adults as they recover from the effect faster, and is one of the features direct to the lack of toxic effects, in that the doctor is able to give high doses of drugs needed to eliminate tumor .
The types of normal cells heavy reproduction and fast growth, which affected usually with drugs, include the cells and tissues of the bone marrow that produce blood cells, and cells and tissues of the digestive system (mouth, esophagus, stomach, and intestine) and the hair roots, and reproductive cells, and the for some drugs, some effects on the tissues of vital organs, such as heart, lung and kidney, liver, and bladder and the nervous system, and of course drugs are given support to avoid such effects and to prevent them before and during treatment.
And natural that the medical team very close to the patient in anticipation of side effects and complications, and there are treatments for most of these effects, but most important is to seek to avoid the emergence of the sharp ones, and take preventive measures prior to prevent or alleviate it, and there are many tests, whether figurative or analytical performed to investigate the side effects and preparation of doses, and the usual battery of tests performed:
A complete blood count, which includes a census of various cells of the blood, leukocytes and erythrocytes and platelets and roe blood, and different rates of these cells, in order to investigate the sensitivity of the cells that produce blood bone marrow and lymph nodes of drug chemicals, and the possibility of further need to be addressed or reduced or modified, (please go to a page that chemotherapy and blood cell count for more details).
Periodic analysis of blood chemicals, and to measure levels of certain compounds and chemicals in blood, which describes the effect on the liver and kidneys and their effectiveness, where some of the drugs harmful effects of these two important members.
Measure the filtration rate glomeruli of the kidneys (Glomerular filtration rate GFR) to investigate the effectiveness of the kidney to perform its function, and this analysis is usually one of two ways, either by measuring the rate of Alhumainin or creatinine levels (creatinine) in urine during the specified period of time, or by imaging studies of the kidneys, and these measurements important to calculate the doses of certain types of chemical drugs.
An echocardiography (echocardiogram) to measure the energy pumping of the heart to blood, as they may affect certain types of chemical drugs on the heart.
It should be noted that it is injected fluids and solvents, and additional intravenous drugs before taking up most of the chemical, and continue to do so to varying periods of time by type of drug user after the completion of the dosage, and to increase the rates of ischemic and body equation of certain compounds in blood.
And useful in this regard, reference to the viewer, known syndrome decay tumor (Tumor lysis syndrome), the incidence of leukemia and lymphoma, and is considered as one of the side effects of chemotherapy, and produces at the rapid degradation of the cells of tumor, which, when death released waste decay, and increase the proportion of certain compounds and minerals, blood, such as uric acid (Uric acid), potassium, phosphate, and reduce the proportion of calcium, and is not taken preventive measures, there may be complications of the kidneys, heart and nervous system, and usually begins with measures before the direct treatments and includes an increase in the rate of perfusion when the patient and make sure drink plenty of fluids, and give solutions of bicarbonate to increase alkalinity of the urine, and the use of certain medications such as real estate Alleuprenol (Allopurinol), which helps in reducing the rate of uric acid, and drug Yorikosem (Uricozyme), and to help get rid of the remnants of decay, and to protect the kidneys in particular.
Types of side effects
Side effects can be classified into common and uncommon, and vessels of any quick impressions and close appear after days or weeks, in addition to late complications and long-term that appears in prolonged periods of time or years after the end of the processors.
The immediate impacts occur during the injection common and include nausea and vomiting and heartburn at the injection site when the leak medication to the skin, but is not common and rare allergies are different types (skin rash, blisters, swelling of eyelids, hands or feet, shortness of breath).
While the side effects include nearby common and that occur within days or weeks: abort the bone marrow (low blood cell count) and complications of the mouth (such as inflammation and ulceration and drought) and temporary hair loss, constipation, diarrhea and fatigue, but is not common and rare include: jaundice (yellowing of the skin swab and the eyes due to liver problems), and bladder inflammation (redness due to irritation of the urinary bladder and the emergence of some bleeding) and different changes in mental or nervous system (forgetfulness, hallucinations, dizziness, irritability, bouts of nervous or sudden phase changes, depression and anxiety).
As of late complications in the long run that may result from treatments tumors different they are linked to the overall effects on physical growth and intellectual development of a child patient in addition to the effects of a late show on some vital organs, but more importantly may have increased risk factors for any vulnerability to the development of secondary tumors is the original tumor processor, where the proportion of the risk of a secondary tumor is between 3% to 12% during the twenty years following the diagnosis and treatment of any kind of tumors of children and especially the development of some types of leukemia (please go to the page of late complications of treatments for tumors for more details), and Snodz About these effects at the end of this article.
Dealing with side effects
A lot of side effects associated with chemotherapy and if they are not dangerous but annoying and painful and stressful for the patient, and can be avoided or controlled in some of them take a series of appropriate measures, and in return is some danger and the necessary pay attention to developments and to anticipate the complications and take necessary precautions.
And in the following paragraphs we review the profile for the overall effects of these measures and management.
(And please go to supportive care to see more details on the various effects):
Frustrate the bone marrow
Of the most important effects associated with chemotherapy is a decrease of the ability of the body to produce a critical mass of blood cells, different, in what is termed frustrated bone marrow, and (bone marrow is the spongy tissue soft located inside the bone, which produces blood cells of different continuous), which in turn leads to low rates of blood cells, which may expose the patient to multiple risks: the risk of a weakened immune system due to the low level of white blood cells, leading to easy capture of infection of different, without the ability to resist, and the risk of anemia due to lack of rate of red blood cells, then the risk easy bleeding and lost the ability to repair wounds or lacerations, or boycott any position of the body as a result of low platelets.
And continue to thwart the status of the bone for some time until he recovered and returned to the normal pace of production, and as the case may be modified therapeutic doses or reduced, postponed or suspended until the return blood cell count to the appropriate level.
And in the following paragraphs an overview of low rates of blood cells and various effects.
(Please go to a page that chemotherapy and blood cell count and blood censuses Page for more details):
Low white blood cell count
Are white blood cells, key elements of the immune system, they are struggling infection and defend the body by attacking foreign objects, such as bacteria or fungi, viruses or bacteria of different or any foreign objects to the body, and kill them by various means, such as diners, or the secretion of toxins to destroy it, and according to the mechanism of the types of cells, white blood cells of different, and when the bone marrow frustrating as a result of chemotherapy, reduced ability to produce white blood cell numbers needed to replace blood cells Almkthlh, which ended the period of their life cycle vessels, which leads to lower rates in blood, and low population active cells, especially cells neutral (neutrophils) active in the fight against various infections, which the body loses its natural immunity and weakens the immune system, and patients are exposed to risk of contracting various infections easily, which can be a threat to some of his life in a short period of time.
And therefore warranted Time control cell count white blood while receiving treatments in anticipation of to decline from the normal level, and time on the lookout for symptoms of any infection, in addition to taking all precautions to prevent their occurrence, including the isolation of the sick child entirely in a protected environment as possible when the low census to maintain safety.
And of signs of infection in the patient and that need to take into account the appearance and notify your physician:
Fever and high body temperature to more than 38 degrees Celsius or severe shaking and sweating, coughing, shortness of breath or difficulty breathing, or inflammatory white or red patches or gums, mouth and gums, change the color of burning or pain when urinating or defecating, or the presence of the smell of urine redness or pain or swelling in any position in any skin ulceration wound unhealed.
And of recommendations which must be observed when low white blood cell count:
Taking into account the need to wash hands constantly sick child and for all the family and the medical team and medical use of soaps and lotions sterile and antiseptic.
The use of non-alcoholic mouthwashes and focus on oral hygiene and teeth constantly.
The use of diapers sterile and kept clean and dry their positions to prevent allergies.
Remove a child patient and the patient is infected with one of the easy spread of infectious diseases such as influenza, and reduce or prevent visits, taking into account the child not to touch the flowers that offer gifts or eating food is reliable or sterilization without shaking hands or kissing allow the child.
Remove a child from infant vaccination of live vaccines such as measles, and to avoid giving the child any vaccines or vaccines without the consent of your physician, especially live vaccines that prevent completely.
Remove a child from domestic animals and to avoid or change the decorations of the house painted during the sessions of treatment.
Remove a child from communities, markets, public transport and avoid the mass games.
Remove a child from coming under direct sunlight and avoid sun burns, and not the child's hair shaving blades and the regular use of electric shaver to avoid cuts, and avoid shaving the face adolescents.
Periodically monitor the temperature of the child close and specific periods and inform your physician immediately if the temperature reached 38 degrees Celsius.
Avoid raw foods and non-cooked, such as fruit salads and fresh vegetables or salad and raw fish, natural cheese and unpasteurized milk and raw eggs, fruit and fresh or frozen or dried, and condiments and spices, juices and those attending the cold.
Not to give suppositories or measure the temperature anally.
Low count of red blood cells
Red blood cells of the basic elements of blood and represent about half the size, and contain the protein hemoglobin which carries oxygen from the lungs to various organs and tissues of the body, and frustration when the bone after receiving chemotherapy reduced rates and blood hemoglobin level drops, leading to the emergence of what known as anemia (anemia), and becomes blood (light) by the common expression, and the child appears pale and tired and feel tired and weak, because the blood does not carry enough oxygen to the heart, lungs and muscles and various organs, and of course, is measurement periodic rates of red blood cells and hemoglobin and the fact the symptoms of anemia, which include:
Pale skin and lips leukemia feeling of weakness and physical exhaustion, ease headaches, dizziness and fainting Palace shortness of breath and gasping for the slightest effort, rapid pulse and heart and pocket ringing ears feel cold.
And when the recommendations of the emergence of anemia:
Determine the activities of the child physically exhausting and increase comfort and relaxation.
Taking into account the necessities of good nutrition and adequate, and nutrient-rich and calorie and protein intake of vegetables, especially green, and red meat, liver, and legumes.
Increased rates of ischemic and eat more of the various fluids and juices, and avoid taking stimulants such as coffee and caffeine compounds.
Lack of blood platelets
Of plates or plaques bloody great importance, in turn, its effectiveness in protecting various tissues from bleeding Bertgaha and close to the positions of cuts or cuttings in any position of the body, and that the main role in the formation of clots of blood, and low rates expose the patient to the risks of easy bleeding and blood loss to the property of clotting, so needed to anticipate and monitor the population of the low rates during the processors, and take all precautions to prevent injuries or bruises, even minor ones, which can cause bleeding difficult to stop at low rates.
And of signs of lack of blood platelets:
Rash or red granules and patches under the skin or bruising is justified in dark, minimal bruising or easy bleeding from the gums or nose, bleeding from the nose does not stop the emergence of signs of bleeding in the stool (red or black) or in the urine (pink, red , brown) or vomiting (red or dark brown).
And of the precautions taken into account to avoid bleeding:
Into account the cleanliness of the mouth, and teeth cleaning Taraute Pferashi soft and soothing creams, and avoiding mouthwashes that contain alcohol, to avoid dryness of the mouth and gums and to prevent the ease of bleeding.
Take sips of water or juice continuously to moisturize the mouth, lips and use moisturizer to prevent Thqqatha.
Recommendation of the child to blow your nose gently and do not blow your nose.
Unit to avoid coughing, consult a physician for an appropriate description of cough syrup.
When a child is recommended to avoid constipation try to defecate or strongly Alhsr, and consult a physician is required to describe the appropriate laxative.
Avoid using a thermometer to measure temperature anally, and not to give suppositories or enemas.
Avoid team sports or any activity that may cause bruising or falling and causing injury and also avoid the large weights.
Always wear sneakers to protect the foot, and wearing wide clothes.
Avoid aspirin or any of its compounds or any other non-steroid drug or antacids without the consent of your physician.
Increase perfusion to avoid constipation and to maintain the moisture of the mouth and digestive cycle.
Balbrootineyat eating rich foods, and fresh vegetables and avoid the harsh and difficult to digest.
Hair Loss
Some drugs cause chemical precipitation and have more influence than others on the hair follicles, and it is not possible to avoid this happening, and was falling hair with remarkable speed, and is common to be done gradually, and sometimes continues for several weeks and may include areas other than the hair of the head especially in adults, and may be partially or precipitation includes all of the head, as it would be temporary and the hair usually returns to normal growth after a full stop and treatments over a period of time not exceeding a few months, and may grow in color and slightly different structure.
And may be difficult on the child or the child, and even the parents because of changes in external appearance dramatically and the significance to the case of the disease, and may wish the child to wear a wig and it does not affect the return of hair growth again, and would prefer to shorten the hair a remote start treatment or throat completely, and wear a headgear appropriate to spare the scalp directly to the sun or to cold, as is always advised during the period of rainfall using washes hair palliative, and not to use hair dryers or chemicals such as dyes or electrical appliances such as Aaqsat hair and others.
Here are some suggestions on hair loss:
Parents are advised to deport their own feelings on the subject, and make it normal to be a bald.
Once treatment begins, it is preferable to use washes hair type dampening your hair weak,
And drying the hair gently, without rubbing, and discharged gently with soft brushes or combs the lashes wide.
Prepare children to accept changes its appearance, and shorten his hair the way that suits him.
Avoid using hair dryers or Aqsat or dyes or chemicals.
If you want to wear a wig, preferably chosen before starting the treatment to match the original hair.
The use of cushions of the fabric smooth to avoid friction and rubbing the scalp hair falling.
Wear hats and appropriate child chooses to leave as he wished, and head protection from exposure to the sun or cold.
Shaving the head completely that the child did not mind, it reduces the problems of dealing with hair loss.
Effects of the mouth and throat
Cells grow natural constituent parts of the intestinal tract including the mouth, and multiply at a rapid pace and is a permanent replacement, and from here, an abused quickly due to chemotherapy, and occurring oral different complications, such as inflammation of the mucous membrane and sores and dehydration, and difficulty swallowing, as well to changes in taste, (please refer to page page and complications of oral feeding problems, to view more details).
Maintaining the feed system is good and appropriate, and health care full the mouth and teeth can reduce the severity of the effects of treatments, including cleaning and disinfection good of the mouth at all times, especially after meals, and scrub brush to clean and remove plaque between the teeth, as required selection of products oral care accurately, which should avoid species that can injure sensitive tissue and mouthwashes that contain alcohol, and different flavors of toothpaste may irritate tissue and cause heartburn gum and so it is best to use the pastes it mildly, and may not be enough to remove plaque rinse Oral and Altamadamad Balgsolat, especially when the dry mouth because they are heavier and thicker, and therefore should be used brushes and sticks teeth or threads Sunni or wipers teeth (a sponge mounted on wooden skewer), which is also used to clean the palate and tongue, They should always maintain the moisture lips using lip moisturizers appropriate to prevent cracking.
The following suggestions will help to address the problems of the mouth:
Maintaining the oral mucous membrane moisture permanently, and eating more of fluids, preferably some of the children absorb the Demilitarized hard candy sugar or ice chips, or chewing gum to fruit juices, to soften and feel comfortable.
Avoid foods and drinks highly acidic, such as orange juice or grape, instead you can try apple juice or juices, sweet, and should also avoid carbonated and carbonated beverages.
Avoid spicy foods and spices, bitter and spicy and a lot of salt, or coarse foods, and try eating soft foods such as soups and mashed potato dishes, and types of Alasaúbah and gels in different meals.
Keep foods at room temperature or chilled slightly, Foods high heat increase the trouble, and refrigerated foods such as fresh fruits, especially high water content such as watermelon and cantaloupe, or ice cream.
Into account that the child uses brushes or sponge mops cotton to clean the teeth and if the child can use a very small piece of sterile gauze is Asbha around the finger is clean and smooth.
Use a combination of salt and soda mouthwashes (half a teaspoon of salt, two tablespoons of sodium bicarbonate dissolved in about a liter of water), or a solution sodium bicarbonate (one teaspoon in about a quarter liter of water) every two to three hours after meals, and entice a child to maintain that.
Required to inform the physician when there is a dark red spots or white or bright places painful mouth or gums.
Need to maintain the best level of protein and calories daily feeding system.
In the event of changes in food taste like the taste of metal harsh, it is recommended using the pots and dishes, plastic or paper, and can experience juices sour like lemonade or orange (in the absence of inflammation of the mouth) or types of pizza and potato chips, and dipping the meat in fruit juices, sweet
