leads to DNA strand breakage and cell death. This drug produces severe nausea and
vomiting and requires extensive premedication to prevent these. Vincristine is a plant
alkaloid that binds to tubulin within the cancer cell and causes cell death (Solal-Celigny,
P.et al., 1998), and this is also potentially emetogenic.
Tom presented with an 18-month history of weight loss, sense of general malaise,
decreased appetite, and a lump in the side of the neck and was diagnosed to be
having NHL. Tom was diagnosed to be HIV positive. A whole body computerized
tomographic (CT) scan revealed presence of disease both above and below the
diaphragm. Tom had involvement of lungs with bilateral upper lobe cavitations and
centrilobular nodules and involvement of liver indicated by multiple metastatic
hypointense lesions in the liver. Tom appeared to be suffering a lot. He had
weight loss, anorexia, diarrhoea, and malaise. The initial blood tests indicated his fitness
to undergo chemotherapy.
I was present as an observer when Tom attended the day unit for his pre
chemotherapy assessment; my ward sister went through the details of Tom's intended
treatment with him and discussed the possible side effects. It was at this point Tom
disclosed his main fear, which was nausea as a result of chemotherapy; he was
concerned about the effect of chemotherapy over the baseline anorexia induced by the
antiviral drugs for HIV disease. All the drugs that have been prescribed to him, except
vincristine can potentially lead to nausea, specially cyclophosphamide can generate
nausea from 18 to 24 hours following the administration. Prednisolone also leads to
bloating symptoms and nausea. On the baseline, he was...
American Journal Of Clinical Oncology; 17(6): pp. 522-526.
Coates, A., Abraham, S., Kaye, S.B. et al., (1983). On the Receiving End- Patient Perception on the Side Effects of Cancer Chemotherapy, European Journal of Cancer and Clinical Oncology; 19: pp. 203-208.
de Boer-Dennert M., de Wit R., and Schmitz, P.I., et al., (1997). Patient perceptions of the side-effects of chemotherapy: the influence of 5HT3 antagonists. British Journal of Cancer 1997;76: pp.1055-1061
Little, R.F., Yarchoan, R ., and Wilson, W.H., (2000). Systemic Chemotherapy For HIV-Associated Lymphoma In The Era Of Highly Active Antiretroviral Therapy, Current Opinions On Oncology; 12(5): pp. 438-444.
Molassiotis, A., Yung, H.P., Yam, B.M., Chan, F.Y. and Mok, T.S. (2002). The Effectiveness Of Progressive Muscle Relaxation Training In Managing Chemotherapy-Induced Nausea And Vomiting In Chinese Breast Cancer Patients: A Randomised Controlled Trial. Support Care Cancer; 10(3): pp. 237-246.
Morrow, G.R.(1984). Methodology in behavioral and psychosocial cancer research: the assessment of nausea and vomiting: past problems,current issues, and suggestions for future research.Cancer;53(suppl 10):pp. 2267-2280.
Portlock, C. S., Qin, J., Schaindlin, P., Roistacher, N., Myers, J., Filippa, D. , Louie, D., Zelenetz, A. D., O'Brien, J. P., Moskowitz, C. , Norton, L., Yahalom, J. , Straus, D. J., and Bertino, J. R., (2004).