Treatment of bone metastasis is by\ \ \ \ \ \ \ ? - Chitranjjan National Cancer Institute Kolkata - 2021

Chitranjjan National Cancer Institute Kolkata - 2021

Medical & Surgical Nursing

Easy

Appeared in: Chitranjjan National Cancer Institute Kolkata - 2021

Explanation

Samarium-153 is a bone-seeking radionuclide specifically indicated for the treatment of metastatic bone disease.
It is used with the palliative intent to relieve pain from widespread osteoblastic metastases.
The agent, Samarium-153 lexidronam, concentrates in areas of high bone turnover and delivers localized beta radiation.
Its use is confirmed for pain palliation in patients with confirmed osteoblastic metastatic bone lesions that are visible on a radionuclide bone scan.

Option B: I-131 with tositumomab is a radioimmunotherapy agent used to treat non-Hodgkin lymphoma by targeting CD20-positive B-cells, not bone metastases.
Option C: Phosphorus-32 is primarily used to treat polycythemia vera, a myeloproliferative disorder, by suppressing bone marrow activity. It is not a first-line agent for bone pain palliation due to significant myelosuppression.
Option D: Yttrium-90 is typically used for localized treatment of liver tumors (radioembolization) or in combination with antibodies for treating lymphoma. It is not used for systemic treatment of diffuse bone metastases.

Clinical Relevance

Nursing practice connection: Knowing Radiopharmaceuticals in Oncology helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses caring for patients receiving Samarium-153 must follow radiation safety protocols (time, distance, shielding) as the patient will be radioactive for a period.
Key nursing interventions include monitoring for bone marrow suppression (thrombocytopenia, leukopenia), which is the primary toxicity, and managing potential 'flare' reactions (a temporary increase in bone pain shortly after administration).
Patient education is crucial, covering safety precautions to protect family members, such as using separate toilets and avoiding close contact with children or pregnant women for a specified time.

How to Approach the Question

First, identify the core concept of the question, which is the treatment for 'bone metastasis'.
Recognize that the options are all radioisotopes, indicating the question is about radiopharmaceutical therapy.
Recall or deduce the specific clinical applications for each radioisotope.
Systematically evaluate each option. Think about the primary disease each agent treats.
Select the agent known to be a 'bone-seeking' radionuclide used for palliating pain from skeletal metastases.
Eliminate the options used for other conditions like lymphoma (I-131 tositumomab, Yttrium-90) or blood disorders (P-32).

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 1 pp. 772-774, 744-746