Nursing care strategies for the management of side effects in patients treated for colorectal cancer.

Oncology nurses play a critical role in the detection and management of adverse effects resulting from the toxicity of colorectal cancer (CRC) treatment regimens. Standard chemotherapy for CRC involves combination 5-fluorouracil plus leucovorin, a regimen with a well-characterized toxicity profile that includes abdominal cramping and diarrhea, nausea and vomiting, skin and hypersensitivity reactions, fatigue, stomatitis, neutropenia and thrombocytopenia, and alopecia. Diarrhea is the principal dose-limiting toxicity. Trimetrexate, a nonclassical antifolate, is currently being investigated in combination with 5-fluorouracil/leucovorin in phase II/III trials. In addition to the management of side effects, the psychosocial and educational needs of CRC patients require attention. The rigorous treatment schedule presents patients with multiple obstacles in daily living, significantly impacting their quality of life. The oncology nurse is vital in managing the care of CRC patients and ensuring that their physical, psychosocial, and educational needs are met. Educating patients about adverse treatment effects empowers them to manage their symptoms and enables them to alleviate serious or life-threatening treatment complications. Three case studies are provided to illustrate and reinforce nursing management strategies for hypersensitivity reactions, fatigue, and psychosocial issues related to CRC treatment.