[The team medical support in out-patient chemotherapy: a role of nurses]

The number of cancer patients and families desiring home-based care and out-patient chemotherapy has been increasing. Hence, a support system for home-based care is urgently needed for a patient with recurrent and/or advanced unresectable cancer who recieved cancer chemotherapy. The cancer therapy especially in patients with colorectal cancer could have expected an improvement of the prognosis utilizing FOLFOX/FOLFIRI, a standard therapy established in Europe and America. Thereby, it was well recognized that the department of out-patient chemotherapy is very important for continuous venous infusion using a central venous port. Since May 2005, we started an out-patient department for patients receiving cancer chemotherapy and a risk management in order to establish a patient care team. The important thing we should recognize about the out-patient treatment is that there are many cases of cancer patients who are in the state of poor nourishment caused by plural factors such as protein-calorie malnutrition (PCM) by an intake disturbance, and the poor absorption in glucose, protein and fat which are necessary for a good metabolism. The poor nutritional status causes a deterioration of immune function and complications such as infectious diseases. Thereby, a good management of nourishment to the patient who received cancer chemotherapy is an important supportive therapy. It appears that a good management of nourishment prevented and/or alleviated the complication that caused by the treatment of cancer chemotherapy. Because of the out-patient treatment is to treat a patient in a short period of time without thorough evaluation about the same for in hospitalized patient, a team medical support, a prudent policy of chemotherapy by the medical team members consisting of nurses, pharmacists, dietitian, chemotherapist and the self-care guidance of the patient are strongly required.