Reference — Oncology
Common Cancer Treatments
Cancer treatment uses multiple modalities — often in combination — to achieve curative, life-extending, or palliative goals. This reference outlines the six major treatment categories: surgery, chemotherapy, radiation, immunotherapy, targeted therapy, and hormonal therapy.
Educational use only. Treatment selection is individualized based on cancer type, stage, molecular markers, patient fitness, and patient goals. This content is intended for nursing students and exam preparation. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Surgery
Purposes / Uses
- ✦Curative: complete tumor removal with negative margins (R0 resection)
- ✦Debulking/cytoreductive: reduces tumor burden to improve effectiveness of adjuvant therapy (ovarian cancer)
- ✦Staging: lymph node sampling/dissection to determine stage
- ✦Palliative: relieve obstruction, bleeding, or pain without curative intent
- ✦Preventive/prophylactic: remove high-risk tissue (prophylactic mastectomy for BRCA mutation)
Nursing Considerations
- ✦Preoperative education: expected recovery, drains, activity restrictions, wound care
- ✦Postoperative: standard surgical nursing (airway, circulation, pain, wound, ambulation)
- ✦Lymph node dissection: lymphedema risk — educate patient for lifelong arm/leg protection
- ✦Ostomy: stoma assessment, education on pouching, body image, and support groups
- ✦Reconstruct / implant awareness: TRAM flap, expanders, implants for breast reconstruction
NCLEX Note
Sentinel lymph node biopsy (SLNB) identifies the first draining node — if negative, full axillary dissection may be avoided, reducing lymphedema risk.
Chemotherapy
Purposes / Uses
- ✦Curative: used alone or with radiation for certain hematologic malignancies and some solid tumors
- ✦Neoadjuvant: given BEFORE surgery to shrink tumor, improve resectability, test tumor response
- ✦Adjuvant: given AFTER surgery to eliminate micrometastatic disease
- ✦Palliative: control disease, extend life, improve quality of life
Nursing Considerations
- ✦Monitor blood counts — nadir 7–14 days post-treatment; neutropenia, anemia, thrombocytopenia
- ✦Hazardous drug handling: PPE, institutional protocols required for all staff
- ✦Antiemetic premedication: ondansetron, dexamethasone, NK1 antagonists
- ✦Vesicant extravasation: stop infusion immediately, leave IV in place, apply antidote per protocol
- ✦Patient education: fever reporting, bleeding precautions, mucositis mouth care, fatigue management
NCLEX Note
Febrile neutropenia (fever + ANC <500) = oncologic emergency. Broad-spectrum IV antibiotics must be given within 60 minutes.
Radiation Therapy
Purposes / Uses
- ✦Curative: definitive primary treatment or post-surgical adjuvant (e.g., breast, prostate, head/neck cancers)
- ✦Concurrent with chemotherapy (chemoradiation): sensitizes tumor cells to radiation
- ✦Palliative: bone metastasis pain, brain metastasis, spinal cord compression, airway obstruction
Nursing Considerations
- ✦External beam: patient is NOT radioactive — no isolation required
- ✦Brachytherapy (sealed source): patient IS radioactive — time, distance, shielding principles
- ✦Skin care: gentle washing, avoid heat/cold/sun to field, no alcohol-based products
- ✦Do not remove radiation field markings
- ✦Manage site-specific effects: mucositis (head/neck), diarrhea/cystitis (pelvis), esophagitis (chest)
NCLEX Note
Key contrast: external beam = no patient radioactivity. Brachytherapy with sealed source in place = patient radioactive. Systemic I-131 = body fluid precautions required.
Immunotherapy
Purposes / Uses
- ✦Checkpoint inhibitors (PD-1, PD-L1, CTLA-4 blockers): unleash T-cells to attack cancer cells
- ✦CAR-T cell therapy: genetically engineered patient's own T-cells — hematologic malignancies
- ✦Monoclonal antibodies: target specific antigens on tumor cells (rituximab for CD20, trastuzumab for HER2)
- ✦Cancer vaccines: sipuleucel-T (prostate cancer) — patient's immune cells trained to target cancer antigen
- ✦Cytokines: IL-2, interferons — non-specific immune activation
Nursing Considerations
- ✦Immune-related adverse events (irAEs) — checkpoint inhibitors cause autoimmune inflammation in any organ
- ✦Most common irAEs: colitis (diarrhea), pneumonitis (dyspnea, cough), hepatitis (LFT elevation), dermatitis, endocrinopathies (thyroiditis, adrenal insufficiency, hypophysitis)
- ✦Teach patient to report any new symptoms — irAEs can occur months after last dose
- ✦Management: hold immunotherapy, corticosteroids, specialist consult
- ✦CAR-T: cytokine release syndrome (CRS) — high fever, hypotension, tachycardia — monitor closely after infusion
NCLEX Note
Immune checkpoint inhibitors can cause irAEs in any organ system — colitis is the most common GI irAE. Management = steroids (high-dose). Distinguish from infectious diarrhea.
Targeted Therapy
Purposes / Uses
- ✦Target specific molecular pathways or mutations driving cancer growth
- ✦Require biomarker testing to identify eligible patients (e.g., EGFR mutation for lung cancer, HER2 amplification for breast cancer, BRAF V600E for melanoma)
- ✦Types: tyrosine kinase inhibitors (TKIs), monoclonal antibodies, PARP inhibitors, CDK4/6 inhibitors
Nursing Considerations
- ✦Oral agents (many TKIs): medication adherence education, drug-drug interactions, food interactions
- ✦HER2 inhibitors (trastuzumab, pertuzumab): cardiac monitoring — ECHO before and during treatment
- ✦EGFR inhibitors (erlotinib, gefitinib): acneiform rash — do not treat with standard acne medications; maintain moisturization
- ✦BCR-ABL inhibitors (imatinib for CML): N/V, edema, bone pain — usually well-tolerated
- ✦BRAF/MEK inhibitors (vemurafenib, dabrafenib): photosensitivity, QT prolongation, fever
NCLEX Note
Targeted therapy requires biomarker/mutation testing first — not all patients qualify. Trastuzumab (HER2): cardiotoxicity risk — baseline ECHO required.
Hormonal Therapy
Purposes / Uses
- ✦Targets hormone-sensitive tumors that grow in response to estrogen or testosterone
- ✦Breast cancer: tamoxifen (SERM — blocks estrogen receptor), aromatase inhibitors (anastrozole, letrozole — block estrogen synthesis in postmenopausal women), fulvestrant (estrogen receptor degrader)
- ✦Prostate cancer: androgen deprivation therapy (ADT) — LHRH agonists (leuprolide), LHRH antagonists (degarelix), antiandrogens (bicalutamide, enzalutamide), bilateral orchiectomy
- ✦Endometrial cancer: progestins for early-stage hormone-sensitive tumors
Nursing Considerations
- ✦Tamoxifen: increased risk of DVT/PE and endometrial cancer — report vaginal bleeding, leg pain, dyspnea
- ✦Aromatase inhibitors: joint pain/stiffness (arthralgias), bone loss/osteoporosis — DEXA scan, calcium/vitamin D
- ✦ADT for prostate cancer: hot flashes, loss of libido, erectile dysfunction, gynecomastia, metabolic syndrome, osteoporosis, depression
- ✦Medication adherence: oral hormonal therapy requires years of consistent use — education is essential
- ✦Body image and sexuality: hormonal changes profoundly affect body image, libido, and relationships — psychosocial support important
NCLEX Note
Tamoxifen: SERM — blocks estrogen in breast but partially stimulates uterus → endometrial cancer risk + DVT/PE risk. Aromatase inhibitors: only for postmenopausal women (still-ovulating women can compensate through ovarian aromatase).
Combined Modality & Sequencing
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with Oncology Nursing Society (ONS) · National Comprehensive Cancer Network (NCCN) · American Society of Clinical Oncology (ASCO). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →