Serious allergic reactions in cancer patients call for expert nursing intervention

ANAHEIM, CALIFORNIA Studies show that up to 35 percent of cancer patients are at risk for an allergic reaction to their cancer therapy. Yet, the same drug causing the reaction could be the drug that best helps to control the disease. This is a delicate time for treatment decisions when the physician collaborates with the expert nurse in managing the patient's treatment. Clinical nurse specialist Jeanne Held-Warmkessel, MSN, RN, APRN, BC, AOCN, of Fox Chase Cancer Center in Philadelphia, Pa., leads an expert panel of oncology nurses as they examine complicated decision making and provides her expertise on the controversial issue of retreating a patient after an anaphylactic or anaphylactoid reaction to their medication at the 29th Annual Oncology Nursing Society Congress.

"Unfortunately, patients are experiencing anaphylactic or anaphylactoid reactions to potentially life prolonging agents," explained Held-Warmkessel. "Oncology nurses are the first to respond and are the patients' best resource at such a difficult time."

An anaphylactoid reaction may develop in a patient without prior exposure to the agent, whereas an anaphylactic reaction develops in the patient that has been previously exposed. "The severity of the reaction will play a major part in whether the same medications should be used again - in a re-challenge or desensitization procedure - or a new agent prescribed," said Held-Warmkessel.

Considerations for a re-challenge include evaluating the effectiveness of the alternate agents, assessing the loss of or delay in potentially curative therapy, analyzing the likelihood of reaction recurrence and allaying the patient's anxiety. "Many patients receiving medications that may cause an allergic reaction will be successfully re-challenged," said Held-Warmkessel.

Held-Warmkessel says it's critical to closely monitor all patients receiving therapy, before, during and after treatment. Successful management of the pat

Contact: Colleen Kirsch
Fox Chase Cancer Center

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