Chemotherapy for optic and hypothalamic gliomasCChemotherapy for optic and hypothalamic gliomasChemotherapy for optic and hypothalamic gliomasEnglishNeurology;OncologyChild (0-12 years);Teen (13-18 years)BrainNervous systemDrug treatment;Non-drug treatmentAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCUte Bartels, MD8.0000000000000061.00000000000002871.00000000000Flat ContentHealth A-Z<p>An in-depth description of the use of chemotherapy to treat optic and hypothalamic brain tumors.<br></p><p>Chemotherapy is the use of drugs to destroy tumour cells. These drugs are also called anticancer drugs or chemotherapeutic agents. Generally, children tolerate chemotherapy better than adults. They can usually carry on their normal activities.</p><h2>Key points</h2> <ul><li>Chemotherapy lasts for one to one and a half years and is given on an outpatient basis.</li> <li>Each course of treatment involves a treatment period followed by a recovery period, which is then repeated.</li> <li>Side effects of chemotherapy can include: nausea and vomiting; allergic reaction; fatigue; low blood counts;digestive issues; hair loss; and behaviour changes.</li> <li>Drugs can be prescribed to improve the side effects of chemotherapy.</li></ul>
Chimiothérapie pour les gliomes optiques et hypothalamiquesCChimiothérapie pour les gliomes optiques et hypothalamiquesChemotherapy for optic and hypothalamic gliomasFrenchNeurology;OncologyChild (0-12 years);Teen (13-18 years)BrainNervous systemDrug treatment;Non-drug treatmentAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCUte Bartels, MD8.0000000000000061.00000000000002871.00000000000Flat ContentHealth A-Z<p>Description approfondie de l’utilisation de la chimiothérapie pour traiter les tumeurs cérébrales optiques et hypothalamiques.<br></p><p>La chimiothérapie s'entend de l'utilisation de médicaments afin de détruire les cellules tumorales. On appelle aussi ces médicaments des anticancéreux ou des agents chimiothérapeutiques. En règle générale, les enfants tolèrent mieux la chimiothérapie que les adultes. Ils peuvent habituellement poursuivre leurs activités normales.</p><h2>À retenir</h2> <ul><li>La chimiothérapie dure entre un an et un an et demi et elle est administrée aux patients externes.</li> <li>Chaque série de traitement comporte une période de traitement et une période de récupération. Ce cycle se répète ensuite.</li> <li>Les effets indésirables de la chimiothérapie peuvent comprendre : des nausées et des vomissements, une réaction allergique, de la fatigue, une faible numération globulaire, des troubles digestifs, la perte des cheveux et des changements de comportements.</li> <li>Des médicaments peuvent être prescrits afin d’atténuer les effets indésirables de la chimiothérapie.</li></ul>

 

 

Chemotherapy for optic and hypothalamic gliomas1359.00000000000Chemotherapy for optic and hypothalamic gliomasChemotherapy for optic and hypothalamic gliomasCEnglishNeurology;OncologyChild (0-12 years);Teen (13-18 years)BrainNervous systemDrug treatment;Non-drug treatmentAdult (19+)NA2009-07-10T04:00:00ZEric Bouffet, MD, FRCPCUte Bartels, MD8.0000000000000061.00000000000002871.00000000000Flat ContentHealth A-Z<p>An in-depth description of the use of chemotherapy to treat optic and hypothalamic brain tumors.<br></p><p>Chemotherapy is the use of drugs to destroy tumour cells. These drugs are also called anticancer drugs or chemotherapeutic agents. Generally, children tolerate chemotherapy better than adults. They can usually carry on their normal activities.</p><h2>Key points</h2> <ul><li>Chemotherapy lasts for one to one and a half years and is given on an outpatient basis.</li> <li>Each course of treatment involves a treatment period followed by a recovery period, which is then repeated.</li> <li>Side effects of chemotherapy can include: nausea and vomiting; allergic reaction; fatigue; low blood counts;digestive issues; hair loss; and behaviour changes.</li> <li>Drugs can be prescribed to improve the side effects of chemotherapy.</li></ul><h2>Why does my child need chemotherapy?</h2><p>Chemotherapy will help treat your child’s brain tumour. The treatment team is led by a doctor called a neuro-oncologist. They take the responsibility for your child’s care during chemotherapy, and make the decisions about your child’s treatment plan. </p><p>Chemotherapy lasts one to one and a half years. It is given on an outpatient basis, and is generally not intensive. The side effects are mild to moderate, and life can go on quite normally. The most widely used combination of chemotherapy drugs is <a href="/Article?contentid=262&language=English">vincristine​</a> and <a href="/Article?contentid=91&language=English">carboplatin​</a>. </p><h2>How is chemotherapy given?</h2><p>Chemotherapy treatment is delivered in a set schedule or protocol that is based on your child’s specific condition. There are different protocols used to treat optic and hypothalamic gliomas. Usually each course of treatment involves a treatment period, and then a recovery period. Then this is repeated. Within the treatment period, the drugs are usually given intravenously on a weekly basis. In intravenous treatment, the drugs are delivered through a needle directly into a vein. A port or central line may be used. Some chemotherapeutic regimens are given orally, where a pill or capsule is swallowed by mouth. </p><h2>How do chemotherapy drugs work?</h2><p>Tumour cells grow very quickly. Chemotherapy drugs damage tumour cells as they are dividing and making new cells. The drugs are carried in the blood to all parts of the body. </p><p>Some types of normal cells also grow quickly, and they may also be damaged. This includes cells in the mouth, stomach, hair, and bone marrow, where blood cells are made. This can cause side effects. However, side effects are usually mild with this type of chemotherapy. </p><h2>What is involved in intravenous chemotherapy?</h2><p>Chemotherapy drugs are injected into a vein. These drugs may be given many times over many months. This can be difficult for children, both physically and emotionally. One key problem is that children’s veins are small. Chemotherapy can damage veins after many injections. To avoid this problem, a thin tube may be inserted into a larger vein to give the drugs. This tube is called a central venous catheter or central line. Once it is inserted, it will safely stay in your child during the entire treatment period. With a central line, your child won’t have as many injections. There will be less damage to his veins. </p><h3>The central line</h3><p>A central line is a special type of tube. It is placed in one of the large veins leading to the heart. Your child may have a central line for one or more of the following reasons: </p><ul><li> to receive chemotherapy, antibiotics, or other medicines </li><li> to receive total parenteral nutrition (TPN); this is a type of intravenous nutrition needed when your child cannot eat or absorb nutrients </li><li> to receive blood or blood products</li><li> to provide blood samples</li><li> to receive IV fluids when your child cannot drink </li><li> to receive treatments such as haemodialysis or plasmapheris</li></ul><p>There are different types of central lines:</p><ul><li> external catheters that can be seen outside the body</li><li> subcutaneous (SC) ports that are covered by the skin on the upper chest </li><li> peripheral access ports (PAP) or peripherally inserted central catheters (PICC) that are covered by the skin on the arm</li></ul><h3>What is a subcutaneous port?</h3><p>This is also known as a Port-a-Cath or just a port. It consists of a small box and a soft tube. The tube connects the port to the large vein in the neck. The port is located in the upper chest and is completely under the skin. It is used to deliver medicines. </p><h3>What is involved in getting a central line?</h3><p>The central line is put in the body during surgery. Your child will be under anaesthesia during this operation. </p><h2>Using antibiotics</h2><p>During chemotherapy, your child may need to take antibiotics to prevent a lung infection called <em>Pneumocystis carinii</em> pneumonia (PCP). The antibiotic is a combination of two medicines called trimethoprim and sulfamethoxazole. It is called Cotrimoxazole, and is commonly known as Septra or Bactrim, its brand names. </p><h3>Why does my child need to take antibiotics?</h3><p>PCP is believed to be caused by bacteria that is probably present in most healthy children’s lungs. When your child’s immune system is weakened during chemotherapy, his body loses the ability to cope with infections. As a result your child may be at higher risk of developing this type of pneumonia. </p><p>Taking antibiotics is effective at preventing PCP from developing. This is called preventive or prophylactic use of antibiotics. </p><p>The antibiotics are usually given by mouth in a tablet or liquid form. They are taken once or twice a day, three days a week throughout treatment, and for three to six months after treatment. </p><h2>Mouth care before and during treatment</h2><p>Radiation therapy and chemotherapy drugs can affect the teeth and mouth. Some of the side effects are a sore mouth or throat, and a dry mouth. There may be a higher risk of your child developing cavities. If possible, arrange a checkup with your child’s dentist before treatment begins. During treatment, regular brushing may not be possible. If this is the case, the treatment team will provide you with alternate options for mouth care. </p><h2>Monitoring during chemotherapy</h2><p>While your child is getting chemotherapy, they will have regular checkups. It is important to tell the treatment team about all of the changes or symptoms they have while at home. The treatment team will ask about their appetite, daily activities, pain, bowel movements, weakness in their fingers or toes, headaches, and vision problems. There will also be a physical exam. A complete blood count will be checked. If they are getting certain medicines, they will be sent for a hearing test. Your child may be given other medicines also, such as antibiotics to prevent pneumonia, pain medicines, and others. </p><h2>Side effects of chemotherapy</h2><p>Some medicines have unwanted effects on the body. These are called side effects.</p><p>The side effects from chemotherapy drugs depend on the type of drugs, the dose of drug, and your child’s reaction. Some children may not have any side effects. </p><h3>Within 30 minutes to a day</h3><ul><li> nausea </li><li> vomiting</li><li> allergic reaction</li></ul><h3>Within two or three weeks</h3><ul><li> fatigue </li><li> low blood counts (myelosuppression): There are three main types of blood cells. All three types can be affected. </li><li> low number of white blood cells (neutropenia) </li><li> low number of platelets (thrombocytopenia)</li><li> low number of red blood cells (anaemia)</li><li> loss of appetite</li><li> sore mouth or throat</li><li> diarrhea</li><li> constipation </li><li> taste changes</li><li> pain and damage to the ends of nerves in hands, feet, or jaw (neuropathy) </li><li> hearing loss</li><li> hair loss</li><li> possible changes in mood or behaviour</li></ul><h2>How will chemotherapy lower your child’s blood counts?</h2><p>Chemotherapy may damage your child’s normal cells that are quickly multiplying. One type of cell that is affected is bone marrow. This is the soft fatty material in the middle of bones where new blood cells are being made. Chemotherapy damages the new blood cells that are made in the bone marrow, but not the older blood cells that are already in the rest of the body. </p><h2>How long does it take to lower your child’s blood counts?</h2><p>It takes one to two weeks after your child starts chemotherapy to lower the blood counts. That is how long it takes for the older blood cells to die and the newer blood cells to be made. </p><p>Usually, your child's blood counts will return to normal within three to four weeks after starting chemotherapy.</p><h2>Understanding your child’s blood</h2><p>Your child’s blood is made up of billions of tiny cells that you cannot see.</p><p>The three main types of blood cells are red blood cells, white blood cells, and platelets.</p><p>Red blood cells are the part of the blood that carries oxygen to the rest of your child’s body. The part of the red blood cell that carries the oxygen is called haemoglobin. Red blood cells give your child energy and make her skin a healthy colour. </p><p>White blood cells protect your child from infection. They find and kill the germs called bacteria in your child’s blood. There are many types of white blood cells. The type you will hear about most is the neutrophil. The number of neutrophils in your child’s blood is called the poly count. </p><p>Platelets are the small round flat cells in the blood. They look like plates. Platelets help the blood clump, or clot.</p><h2>What is a complete blood count?</h2><p>When your child is having chemotherapy, the treatment team will check each type of blood cell in your child to see how they are being affected. To do this, they will take blood from your child. Then they will do a complete blood count, also called a CBC, to look at these four blood counts: </p><ol><li> a white blood cell count</li><li> a neutrophil count, also called a poly count</li><li> a red blood cell count and a hemoglobin count </li><li> a platelet count </li></ol><h2>What can be done to deal with the side effects of chemotherapy?</h2><p>The doctor may recommend several drugs to improve the side effects. Some of these drugs are used specially for chemotherapy. If you notice side effects or changes in mood or behaviour, let your treatment team know. </p><p>For more information, see the page entitled "<a href="/article?contentid=1379&language=English">Side Effects of Chemotherapy</a>"<br></p><h2>What is informed choice or informed consent?</h2><p>Informed choice is the option a person has to allow or not allow something to happen, like diagnostic procedures or treatment, after they have been informed of the benefits and risks of the options involved. If the person agrees, they give informed consent. Informed consent is required before beginning chemotherapy. </p>Chemotherapy for optic and hypothalamic gliomas

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