Innovations in antineoplastic therapy.

Cancer is a complex group of diseases. Many of the current treatment modalities available provide limited effectiveness and significant side effects. This circumstance creates a challenge for health care providers. There is great need for the development of innovative therapies that increase efficacy and decrease morbidity. In general, chemotherapeutic agents are unable to distinguish cancer cells from normal cells. As a result of therapy, patients may develop significant myelosuppression. Patients who are undergoing chemotherapy need to be observed for signs of hematologic and nonhematologic toxicities. Patients should be advised that periodic blood tests are indicated to monitor for anemia, neutropenia, and thrombocytopenia. If myelosuppression develops, measures to prevent complications such as bleeding and infection are indicated. Strategies to combat fatigue should also be discussed. Understanding of the biology of cancer has increased significantly in recent years. As knowledge of the science grows, new therapies are developed and clinical trials are initiated to investigate feasibility and efficacy of agents. Many of these trials involve agents that target specific biologic processes of cancer. While the complexities of cancer treatment are prolonging the life expectancy of patients who have the disease, patients are presenting with increasing numbers and types of morbidities. Nurses need to be aware of the rationale for treatment, mechanism of action of the agents administered, and expected toxicities of therapies. With this knowledge, symptoms can be identified earlier, life-threatening sequela can possibly be averted, and patients and families can be educated about what to expect and how to make knowledgeable decisions about treatment options. Enhancing patients' knowledge base may also increase their adherence to challenging therapies.