Journal articles on the topic 'Cancer pain Chemotherapy'
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Hancock, E. William. "Chest Pain During Cancer Chemotherapy." Hospital Practice 20, no. 7 (July 15, 1985): 93–97. http://dx.doi.org/10.1080/21548331.1985.11703097.
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Savage, L. "Chemotherapy-Induced Pain Puzzles Scientists." JNCI Journal of the National Cancer Institute 99, no. 14 (July 10, 2007): 1070–71. http://dx.doi.org/10.1093/jnci/djm072.
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Choi, Kyomin, and Jeeyoung Oh. "Peripheral Neuropathy and Pain Caused by Cancer Chemotherapy." Journal of the Korean Neurological Association 39, no. 1 (February 1, 2021): 1–9. http://dx.doi.org/10.17340/jkna.2021.1.1.
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Peripheral neuropathy and pain are common adverse effects of chemotherapy, which incidence are rising significantly commensurate with extension of survival period in cancer patients. Chemotherapy-induced peripheral neuropathy is caused by most commonly used chemotherapeutic agents including platinum compounds, taxenes, proteasome inhibitors, thalidomide, and vinca alkaloids. Management of neuropathy and pain caused by chemotherapy is still challenging due to there is no proven therapies and preventive methods. The pain and its impact are becoming a main deterioration factor in quality of life and economic burden in our society. We review the mechanism, clinical characteristics, updated evidence of possible management of neuropathy and pain caused by traditional chemotherapeutic agents for contributing to the application of clinicians in their actual medical environment.
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Yosra, Yahyaoui, Ghorbel Achref, Charfi Lamia, Gamoudi Ahmed, Gabsi Azza, and Mezlini Amel. "Low Grade Abdominal Leiomyosarcoma with Liver Metastasis: A Second Cancer Twenty Years after Treatment for Nasopharyngeal Cancer." Clinical Oncology Research and Reports 1, no. 2 (November 16, 2020): 01–03. http://dx.doi.org/10.31579/2693-4787/015.
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Background: leiomyosarcoma is one of the most frequent soft tissues and abdominal-pelvic sarcomas however intra-abdominal leiomyosarcoma with liver metastasis remain a very rare disease. Case presentation: A 61 year-old man presented in February 2019 a recent history of abdominal pain and weight loss. Imagery showed a 5 cm abdominal mass with multiples liver lesions. Biopsy of the liver lesions concluded to a metastases of a low grade leiomyosarcoma. Surgical resection was deemed not possible due to anatomical restrictions and the patient received 6 cycles of systemic mono-chemotherapy with epirubicin. A CT scan performed after the chemotherapy showed a stable disease using RECIST criteria. Conclusions: In case of an unresectable liver metastasis palliative chemotherapy can be offered although it is widely recognized that leiomyosarcoma show moderate sensitivity to chemotherapy.
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Fonte, Carlos E., and Frank Cardello. "Chest Pain in a Cancer Patient on Chemotherapy." Hospital Practice 26, no. 7 (July 15, 1991): 145–46. http://dx.doi.org/10.1080/21548331.1991.11704212.
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Banipal, R. P. S., and M. K. Mahajan. "Methotrexate Revisited—in Recurrent Head and Neck Cancer." Palliative Care: Research and Treatment 5 (January 2011): PCRT.S6107. http://dx.doi.org/10.4137/pcrt.s6107.
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Aims Response of single agent chemotherapy in improving quality of life in patients with recurrent head and neck cancers. Methods and material This is a study of the 18 patients with advanced cancers of head and neck, who had failed earlier attempts of radical treatment with Surgery, Radiotherapy ± chemotherapy and have residual or recurrent tumours, were treated with single agent Injection Methotrexate 50 mg/m2 weekly. Follow up visit complaints and clinical examination details were recorded. History regarding pain, speech and diet was collected for every visit. Severity of pain was divided with the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 pain scales. Symptom control was done with analgesics, antiemetic and infection control. Results Weekly single agent chemotherapy with injection Methotrexate has significantly improved the quality of life of patients. 38.8% of patients have shown good response with decrease in the tumour bulk by more than 50% and other 39% of patients have stable disease on Injection Methotrexate. 22.2% patients have shown disease progression on single agent chemotherapy. Overall 83.3% patients have shown improvement in Quality of life in terms of symptomatic control. After 6 weekly treatments with injection methotrexate 63% patients were pain free with 16% patients reported decrease in pain. 87.5% of patients have shown improvement in speech and diet. Improvement in symptoms has shown decrease in depression in cancer patients. Grade 3 toxicity observed was Neutropenia (11.1%), anaemia (11.1%) and Mucositis (16.6%) which was managed adequately. Median survival with good quality of life is 5.4 months. Conclusions Single agent methotrexate chemotherapy on an out-patient basis can provide good quality of life. Decrease in pain along with improvement in speech and diet has shown decrease in incidence of depression and overall positive impact on psychosocial status. Few cases have shown sustained regression of gross disease adding to maintained quality of life with better socio-economic compliance.
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Lin, Jaung-Geng, and Yi-Hung Chen. "The Role of Acupuncture in Cancer Supportive Care." American Journal of Chinese Medicine 40, no. 02 (January 2012): 219–29. http://dx.doi.org/10.1142/s0192415x12500176.
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Acupuncture has many beneficial effects during cancer therapy and has proven efficacy in the management of side effects induced by chemotherapy and radiotherapy. In this review, we discussed the benefits of acupuncture on cancer patients. In cancer pain management, acupuncture is effective for head and neck pain, waist pain, abdominal and chest pain. Many studies confirm the excellent efficacy of acupuncture against symptoms of vomiting and nausea, including those induced by chemotherapy and radiotherapy. Head and neck cancer patients receiving radiotherapy may develop xerostomia, which may be relieved by acupuncture. Acupuncture may also cause sedative and hypnotic effects in cancer patients for treating nervousness and insomnia.
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Coffeen, Ulises, Marco Antonio Sotomayor-Sobrino, Ariadna Jiménez-González, Luis Gerardo Balcazar-Ochoa, Pamela Hernández-Delgado, Ana Fresán, Ricardo Plancarte-Sánchez, Daniela Arias-Muñoz, and Abraham Ochoa-Aguilar. "Chemotherapy-induced neuropathic pain characteristics in Mexico’s National Cancer Center pain clinic." Journal of Pain Research Volume 12 (May 2019): 1331–39. http://dx.doi.org/10.2147/jpr.s186107.
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Ramaekers, Ryan C., Jon Olsen, Angela Mae Obermiller, Melhem Salim Jabbour, Mark Tharnish, Megan Schriner, Rita Hays, et al. "Efficacy and safety of half-dose pegfilgrastim in cancer patients receiving cytotoxic chemotherapy." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 9110. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.9110.
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9110 Background: Pegfilgrastim reduces neutropenia risk in patients (pts) on cytotoxic chemotherapy. A single 6 mg dose per chemotherapy cycle commonly causes bone pain and leukocytosis. While half-dose pegfilgrastim has been shown to be safe and effective in breast cancer pts, there is no data on half-dose pegfilgrastim in general oncology pts. Methods: We evaluated the efficacy and safety of half-dose pegfilgrastim in general oncology pts on cytotoxic chemotherapy at St Francis Cancer Center. Pts who received at least one dose of 6 mg pegfilgrastim and developed NCI-CTCAE grade 2 or more bone pain and/or leukocytosis (WBC>10,000/ml) were given 3 mg dose pegfilgrastim on their following chemotherapy cycles. Pt demographics, type/number of chemotherapy regimens, efficacy, side effects and complications were evaluated. McNemar’s test, logistic regression analysis and ANOVA were used for statistical analysis. Results: Twenty-six pts (3 males, 23 females, all Caucasian) with median age 55 (range 34-86) received a total of eighty-three 3 mg doses of pegfilgrastim. Cancers treated were breast (N=16), colorectal (N=7), head and neck (N=1), non-Hodgkin lymphoma (N=1) and non-small cell lung cancer (N=1). Chemotherapy received was anthracycline (N=9), taxane (N=7), 5-FU/oxaliplatin (N=7), 5-FU/cisplatin (N=1), gemcitabine/oxaliplatin (N=1), pemetrexed/carboplatin (N=1). No neutropenia or chemotherapy dose modifications occurred on half-dose pegfilgrastim. In the 26 pts we report, bone pain occurred in 23 pts at 6 mg and 14 pts at 3 mg dose. Leukocytosis occurred in 23 pts at 6 mg and only 2 pts at 3 mg dose (McNemar’s test, P<0.01). While older age and full-dose pegfilgrastim were predictive of bone pain, more than one line of chemotherapy and half-dose pegfilgrastim were predictive of lack of leukocytosis (logistic regression analysis/ANOVA, P<0.01). Conclusions: Half-dose pegfilgrastim in general oncology pts receiving cytotoxic chemotherapy seems to be safe and effective with less bone pain and leukocytosis without resultant neutropenia or need for chemo modification. Larger prospective studies of half-dose pegfilgrastim in this setting are needed to further understand the feasibility of this approach.
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Venkata Durga, Vinoothna Thelkar, Parineethi Karanam, Jyoshna Pisini Vyshnavy, Sadasiva Rao Galaba, and Srikanth Boga. "Pain Assessment in Breast Cancer Patients." Journal of Pharmaceutical Quality Assurance and Quality Control 4, no. 1 (June 29, 2022): 27–34. http://dx.doi.org/10.46610/jqaqc.2022.v04i01.006.
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Introduction: Breast cancer is the most prevalent cancer among women population. Pain during and after chemotherapy is of various types and has no background information on the mechanism and treatment. Aim: To analyse pain after chemotherapy in breast cancer patients. Materials and Methods: It was a Prospective Observational Cohort of 6 month time period at Omega Hospitals, Guntur with 76 patients. Data was collected by direct interaction either with the patient or the patient representative or by studying patient’s profile through questionnaire. Statistical Analysis: All the collected data was entered into Excel sheet (Microsoft Excel 2016 MSO (16.0.13328.20262) 32-bit: Windows 11 version). The collected data was transported to SPSS (version – 28) for analysis. Results: The intermittent pain was seen in most of the patients (40.8%) along with Continuous Pain (14.5%) & Predominantly Neuropathic Pain (3.9%). Conclusion: Inspite of robustic research on the characteristics of pain, patients complain of pain in other locations too. Also, researches should throw light on management, prevention and identification of pain by various techniques like radiation or surgery. We can certainly hope that by considering diagnosis, management, prevention we can improve clinical patient outcome with less adverse drug reactions.
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Slavik, Eugen, S. Ivanovic, and Danica Grujicic. "Cancer pain: Classification and pain syndromes)." Acta chirurgica Iugoslavica 51, no. 4 (2004): 9–14. http://dx.doi.org/10.2298/aci0404009s.
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In spite the new information's about the physiology and biochemistry of pain, it remains true that pain is only partially understood. Cancer pain is often experienced as several different types of pain, with combined somatic and neuropathic types the most frequently. If the acute cancer pain does not subside with initial therapy, patients experience pain of more constant nature, the characteristics of which vary with the cause and the involved sites. Chronic pain related to cancer can be considered as tumor-induced pain, chemotherapy-induced pain, and radiation therapy induced pain. Certain pain mechanisms are present in cancer patients. These include inflammation due to infection, such as local sepsis or the pain of herpes zoster, and pain due to the obstruction or occlusion of a hollow organ, such as that caused by large bowel in cancer of colon. Pain also is commonly due to destruction of tissue, such as is often seen with bony metastases. Bony metastases also produce pain because of periostal irritation, medullar pressure, and fractures. Pain may be produced by the growth of tumor in a closed area richly supplied with pain receptors (nociceptors). Examples are tumors growing within the capsule of an organ such as the pancreas. Chest pain occurring after tumor of the lung or the mediastinum due to invasion of the pleura. Certain tumors produce characteristic types of pain. For example, back pain is seen with multiple myeloma, and severe shoulder pain and arm pain is seen with Pancoast tumors.
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Nuriya, Galih Noor Alivian, and Agis Taufik. "Aromaterapi Sebagai Terapi Komplementer untuk Mengatasi Nyeri, Depresi, Mual dan Muntah pada Pasien Kanker: A Literature Review." Journal of Bionursing 3, no. 1 (January 29, 2021): 1–11. http://dx.doi.org/10.20884/1.bion.2021.3.1.86.
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Introduction: Cancer is an abnormal cell growth that attacks the surrounding tissue which can cause death for the sufferer. Cancer is the second leading cause of death in the world by 13% after cardiovascular disease. Cancer can cause sufferers to experience a decrease in physical conditions such as pain and psychologically such as depression. One of the pharmacological therapies that can cure cancer is chemotherapy. Chemotherapy has side effects of myelosuppression, nausea and vomiting, causing discomfort for the sufferer. One of the complementary therapies that can reduce pain, depression and the effects of chemotherapy is aromatherapy. Methods: This study used 6 steps including, formulating research questions and objectives, searching for existing literature, screening according to inclusion, assessing article quality, extracting data, and analyzing data. Articles obtained from data based on Google Scholar. Using Indonesian keywords, namely: “Aromatherapy”, “Nausea”, “Vomiting”, “Cancer”, “Pain”, there were 5 articles that met the inclusion criteria and were included in the analysis. Results: Aromatherapy has been shown to be effective in reducing pain and depression in cancer patients as well as providing comfort to reduce nausea and vomiting due to the effects of chemotherapy administered by patients. Discussion: Complementary aromatherapy interventions have good benefits for cancer patients in reducing pain and depression and reducing nausea and vomiting. The provision of this therapy should be promoted more widely to patients and health professionals to support patient comfort. Conclusion: Aromatherapy can reduce pain and depression and reduce nausea and vomiting in cancer patients undergoing chemotherapy.
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Gudaitytė, Jūratė, Dominykas Dvylys, and Indrė Šimeliūnaitė. "Anaesthetic challenges in cancer patients: current therapies and pain management." Acta medica Lituanica 24, no. 2 (July 17, 2017): 121–27. http://dx.doi.org/10.6001/actamedica.v24i2.3493.
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The objective. The aim is to present the major effects of cancer treatment (chemotherapy, radiotherapy, surgery) that the anaesthesiologist should consider preoperatively, and to review techniques of the analgesic management of the disease. Materials and Methods. To summarize the major challenges that cancer patients present for the anaesthesiologists, a literature review was conducted. Articles presenting evidence or reviewing the possible effects of anaesthetics on cancer cells were also included. Online databases of Science Direct, PubMed, and ELSEVIER, as well as reference lists of included studies were searched. Articles published from 2005 to 2016 were selected. Results. Anaesthesiologists should pay attention to patients receiving chemotherapy and its side effects on organ systems. Bleomycin causes pulmonary damage, anthracyclines are cardiotoxic, and platinum-based chemotherapy agents are nephrotoxic. A lot of chemotherapy agents lead to abnormal liver function, vomiting, diarrhoea, etc. Surgery itself is suspected to be associated with an increased risk of metastasis and recurrence of cancer. Regional anaesthesia and general anaesthesia with propofol should be used and volatile agents should be avoided to prevent cancer patients from perioperative immunosuppression that leads to increased risk of cancer recurrence. Pain management for palliative patients remains a major problem. Conclusions. To provide the best treatment for cancer patients, cooperation of anaesthesiologists with oncologists and surgeons becomes imperative. It has been established that anaesthetic techniques and drugs could minimize the perioperative inflammation. However, further research of the perioperative “onco-anaesthetic” is needed.
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Bennett, G. J. "110 PAINFUL NEUROPATHY FOLLOWING CANCER CHEMOTHERAPY." European Journal of Pain 10, S1 (September 2006): S32a—S32. http://dx.doi.org/10.1016/s1090-3801(06)60113-4.
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Galligan, Martin. "Prescribing for persistent cancer pain: focus on chemotherapy-induced peripheral neuropathy." Journal of Prescribing Practice 2, no. 4 (April 2, 2020): 176–80. http://dx.doi.org/10.12968/jprp.2020.2.4.176.
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Chemotherapy-Induced peripheral neuropathy is rapidly becoming a growing problem faced by healthcare processionals and individuals living with and beyond cancer. The incidence of cancer diagnoses is increasing and, as a result, so is the incidence of individuals living with the consequences of cancer treatment. Chemotherapy-induced peripheral neuropathy is a complex symptom, and its incidence and impact on quality of life varies across treatment modalities. This complexity continues into its assessment and management, and healthcare professionals require more support and guidance when presented with this pain state. This article will explore the current literature surrounding assessment methods and management strategies that will enable prescribers to make informed decision when encountering chemotherapy-induced peripheral neuropathy.
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Aghabati, Nahid, Eesa Mohammadi, and Zahra Pour Esmaiel. "The Effect of Therapeutic Touch on Pain and Fatigue of Cancer Patients Undergoing Chemotherapy." Evidence-Based Complementary and Alternative Medicine 7, no. 3 (2010): 375–81. http://dx.doi.org/10.1093/ecam/nen006.
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Despite major advances in pain management, cancer pain is managed poorly in 80% of the patients with cancer. Due to deleterious side effects of pharmacology therapy in these people, there is an urgent need for clinical trials of non-pharmacological interventions. To examine the effect of therapeutic touch (TT) on the pain and fatigue of the cancer patients undergoing chemotherapy, a randomized and three-groups experimental study—experimental (TT), placebo (placebo TT), and control (usual care)—was carried out. Ninety patients undergoing chemotherapy, exhibiting pain and fatigue of cancer, were randomized into one of the three groups in the Cancer Center of Imam Khomeini Hospital in Tehran, Iran. Pain and fatigue were measured and recorded by participants before and after the intervention for 5 days (once a day). The intervention consisted of 30 min TT given once a day for 5 days between 10:00 a.m. and 10:30 a.m. The Visual Analogue Scale (VAS) of pain and the Rhoten Fatigue Scale (RFS) were completed for 5 days before and after the intervention by the subjects. The TT (significant) was more effective in decreasing pain and fatigue of the cancer patients undergoing chemotherapy than the usual care group, while the placebo group indicated a decreasing trend in pain and fatigue scores compared with the usual care group.
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Vadivelu, Nalini, Maggie Schreck, Javier Lopez, Gopal Kodumudi, and Deepak Narayan. "Article Commentary: Pain after Mastectomy and Breast Reconstruction." American Surgeon 74, no. 4 (April 2008): 285–96. http://dx.doi.org/10.1177/000313480807400402.
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Breast cancer is a potentially deadly disease affecting one in eight women. With the trend toward minimally invasive therapies for breast cancer, such as breast conserving therapies, sentinel node biopsies, and early treatments of radiation and chemotherapy, life expectancy after breast cancer has increased. However, pain after breast cancer surgery is a major problem and women undergoing mastectomy and breast reconstruction experience postoperative pain syndromes in approximately one-half of all cases. Patients post mastectomy and breast reconstruction can suffer from acute nociceptive pain and chronic neuropathic pain syndromes. Several preventative measures to control acute post operative pain and chronic pain states such as post mastectomy pain and phantom pain have been tried. This review focuses on the recent research done to control acute and chronic pain in patients receiving minimally invasive therapies for breast cancer, such as breast conserving therapies of mastectomies and breast reconstruction, sentinel node biopsies, and early treatments of radiation and chemotherapy.
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Connolly, Irene, Carolyn Zaleon, and Marcos Montagnini. "Management of Severe Neuropathic Cancer Pain." American Journal of Hospice and Palliative Medicine® 30, no. 1 (April 13, 2012): 83–90. http://dx.doi.org/10.1177/1049909112443586.
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Neuropathic cancer pain is common, very disabling and difficult to treat. It can be related to tumor invasion of neural structures and neuronal damage by surgery, chemotherapy and radiation therapy. Adjuvant analgesics are often used with opioids to control neuropathic pain in cancer patients. Methadone, a synthetic opioid with multiple mechanisms of action, is gaining increasing importance as an effective agent in the treatment of cancer related neuropathic pain. This case illustrates the challenges of managing severe pain in a patient with head and neck cancer while undergoing anti-tumor treatment. A review of the adjuvant analgesics and opioids, particularly methadone, in the management of neuropathic pain is also included.
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Mohrmann, Caroline, Jane Armer, and Robert J. Hayashi. "Challenges Evaluating Chemotherapy-Induced Peripheral Neuropathy in Childhood Cancer Survivors." Journal of Pediatric Oncology Nursing 34, no. 2 (July 7, 2016): 106–14. http://dx.doi.org/10.1177/1043454216651016.
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Children treated for cancer are exposed to a variety of chemotherapeutic agents with known toxicity to the peripheral nervous system. The side effect of peripheral neuropathy can cause changes in sensation, function, and even cause pain. Although peripheral neuropathy is recognized by pediatric oncology nurses as an important and significant side effect, measuring neuropathy can be quite complex for clinical care and research efforts. With more children surviving a cancer diagnosis today, this issue is increasingly important for childhood cancer survivors. This article has reviewed existing literature examining peripheral neuropathy in childhood cancer survivors with particular interest paid to measurement tools available and needs for future research. It is important for nurses to choose appropriate measures for clinical care and research methods in order to have an impact on patients experiencing this condition.
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Amiri, Aref H., and Soleiman Jaferian. "Post-chemotherapy arthralgia and arthritis in lung cancer." South Asian Journal of Cancer 01, no. 02 (October 2012): 72–75. http://dx.doi.org/10.4103/2278-330x.103715.
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Abstract Objective: Evaluate the characteristics of arthritis, arthralgia and musculoskeletal pain after chemotherapy in patients with lung cancer. Materials and Methods: In this study, we evaluate the characteristics of 17 patients with joint symptoms following receiving chemotherapy for lung cancer. Demographic information of patients including sex, age, time of rheumatologic findings after starting of chemotherapy, time of improvement after starting of medication, and relevant laboratory findings for each patient. Results: A total of seventeen patients (six women with mean age 41.2 ± 5.2 years and 11 men with mean age 42.5 ± 8.2) that received standard chemotherapy for lung cancer according to stage of disease. Joint symptoms usually began about seven months after the first session of chemotherapy. Patients had an average of two tender joints and 1 hr of morning stiffness. Four patients were positive for anti-nuclear antibody, and none of patient was positive for rheumatoid factor. Non-steroidal anti-inflammatory drugs, disease modifying anti-rheumatic drugs (DMARD), corticosteroids, and venlafaxine were prescribed. Four patients did not show an improvement. Follow-up was available for all patients. 11 patients showed favorable responses, characterized by a significant decrease (more than 50%) in morning stiffness, pain, and tender joint counts after a mean of three months’ treatment. Two patients had complete resolution of symptoms and did not required further medications for arthritis, arthralgia or musculoskeletal pain. Conclusion: Chemotherapy-related arthropathy in lung cancer is not uncommon. Early treatment with NSAID, DMARD, and corticosteroids is effective in the majority of patients.
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Avelino, Camila Uanne Resende, Rafael Marques Cardoso, Suzana Sales de Aguiar, and Mário Jorge Sobreira da Silva. "Assessment of quality of life in patients with advanced non-small cell lung carcinoma treated with a combination of carboplatin and paclitaxel." Jornal Brasileiro de Pneumologia 41, no. 2 (April 2015): 133–42. http://dx.doi.org/10.1590/s1806-37132015000004367.
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OBJECTIVE: Non-small cell lung carcinoma (NSCLC) is the most common type of lung cancer. Most patients are diagnosed at an advanced stage, palliative chemotherapy therefore being the only treatment option. This study was aimed at evaluating the health-related quality of life (HRQoL) of advanced-stage NSCLC patients receiving palliative chemotherapy with carboplatin and paclitaxel. METHODS: This was a multiple case study of advanced-stage NSCLC outpatients receiving chemotherapy at a public hospital in Rio de Janeiro, Brazil. The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire was used in conjunction with its supplemental lung cancer-specific module in order to assess HRQoL. RESULTS: Physical and cognitive functioning scale scores differed significantly among chemotherapy cycles, indicating improved and worsened HRQoL, respectively. The differences regarding the scores for pain, loss of appetite, chest pain, and arm/shoulder pain indicated improved HRQoL. CONCLUSIONS: Chemotherapy was found to improve certain aspects of HRQoL in patients with advanced-stage NSCLC.
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Hellerstedt-Börjesson, Susanne, Karin Nordin, Marie-Louise Fjällskog, Ritva Rissanen, Magnus Peterson, and Cecilia Arving. "Colored body images reveal the perceived intensity and distribution of pain in women with breast cancer treated with adjuvant taxanes: a prospective multi-method study of pain experiences." Scandinavian Journal of Pain 18, no. 4 (October 25, 2018): 581–91. http://dx.doi.org/10.1515/sjpain-2018-0050.
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AbstractBackground and aimsBreast cancer is the most prevalent adult cancer worldwide. A broader use of screening for early detection and adjuvant systemic therapy with chemotherapy has resulted in improved survival rates. Taxane-containing chemotherapy is one of the cornerstones of the treatment. However, taxane-containing chemotherapy may result in acute chemotherapy-induced nociceptive and neuropathic pain. Since this pain may be an additional burden for the patient both during and after taxane chemotherapy, it is important to rapidly discover and treat it. There is yet no gold standard for assessing taxane-induced pain. In the clinic, applying multiple methods for collecting information on pain may better describe the patients’ pain experiences. The aim was to document the pain during and after taxane through the contribution of different methods for collecting information on taxane-induced pain. Fifty-three women scheduled for adjuvant sequential chemotherapy at doses of ≥75 mg/m2of docetaxel and epirubicin were enrolled in the study.MethodsProspective pain assessments were done on a visual analog scale (VAS) before and during each cycle of treatment for about 5 months, and using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire’s (EORTC-QLQ-C30) two pain questions at baseline, 3 months, and 12 months. Participants scoring pain on the VAS >30 and undergoing an interview also colored their pain on a body image during treatment and at 12 months.ResultsSurprisingly widespread, intense pain was detected using a multi-method approach. The colored body image showed pain being perceived on 51% of the body surface area during treatment, and on 18% 12 months after inclusion. In general, the pain started and peaked in intensity after the first cycle of taxane. After Cycle 3, most women reported an increase in pain on the VAS. Some women continued to report some pain even during the epirubicin cycles. The VAS scores dropped after the last chemotherapy cycle, but not to the baseline level. At baseline, 3 months and 12 months after inclusion, the women who estimated VAS >30 reported higher levels of pain on the pain questions of the EORTC-QLQ-C30.ConclusionsThis study contributes information on how different pain assessment tools offer different information in the assessment of pain. The colored body image brings another dimension to pain diagnostics, providing additional information on the involved body areas and the pain intensities as experienced by the women. A multi-method approach to assessing pain offers many advantages. The timing of the assessment is important to properly assess pain.ImplicationsPain relief needs to be included in the chemotherapy treatment, with individual assessment and treatment of pain, in the same way as is done in chemotherapy-triggered nausea. There is a time window whereby the risk of pain development is at its highest within 24–48 h after receiving taxane chemotherapy. Proper attention to pain evaluation and treatment should be in focus during this time window.
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Viriyasiri, Pongsaton, Phatthanan Phutthikiat, Phatthawan Phonmak, Phurinut Krutjaikla, Sittichai Ongtip, and Prapaporn Suprasert. "Symptom and Anxiety Assessment in Gynecologic Cancer Patients Receiving Chemotherapy." Asian Pacific Journal of Cancer Care 5, no. 2 (June 7, 2020): 95–100. http://dx.doi.org/10.31557/apjcc.2020.5.2.95-100.
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Background: Side effects of chemotherapy usually disturbed the daily life of patients. During chemotherapy, quality of life of patients is affected by the severity of symptoms experienced. Objective: To evaluate the side effects experienced by gynecologic cancer patients receiving chemotherapy.Methods: Gynecologic cancer patients receiving chemotherapy (at least 1 cycle with standard premedication that included antiemetic drugs) between 18 June and 25 September 2019 were invited to this study. Participants were interviewed by our team for personal data and attitudes toward their disease and treatment. In addition, the Edmonton Symptom Assessment System (ESAS-Thai version) tool, and Multinational Association for Supportive Care in Cancer (MASCC) antiemetic tool were used to assess the symptoms during chemotherapy. Results: One hundred sixty-five participants entered this study. The mean age was 53.5. The three most common type of cancer were ovarian (37.6%), cervical (37.6%) and uterine cancer (21.8%). Most common chemotherapy was carboplatin plus paclitaxel (64.8%). Two-thirds of the participants believed they could be cured. The most common severe symptom from the ESAS tool was pain (20.6%), followed by fatigue (18.8%), appetite change (16.4%) and numbness (10.3%). In addition, 10.9% of patients experienced nausea/vomiting in acute phase, while 20.6% experienced it in the delayed phase. Conclusion: Our participants revealed positive attitudes toward cancer and treatment. Some patients experienced nausea and vomiting despite using antiemetic drugs. The most frequent self-reported symptom was pain. Therefore, pain control was necessary to improve their quality of life.
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Seraphin, Michael, Peter T. Silberstein, and Gregory Cichon. "Trends in palliative care interventions for stage IV esophageal cancer: An analysis of the NCDB." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e24104-e24104. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e24104.
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e24104 Background: Palliative care (PC) addresses patient quality of life and satisfaction with care. Oncological PC can be manifested through surgery, radiation, chemotherapy, and pain management. These treatments do not cure disease but improve quality of life. The survival rate for stage IV esophageal cancer is 15-20%, making it an excellent candidate for PC. This study will analyze patterns in who received each type of PC. Methods: This study looked at 8808 patients with stage IV esophageal cancer who received PC interventions from 2004-2018 in the National Cancer Database (NCDB). The NCDB listed 4 types of PC: surgical, radiation, chemotherapy/hormone therapy, and pain management. All modalities were to “alleviate symptoms, but no attempt to diagnose, stage, or treat the primary tumor is made.” Exclusion criteria was concurrent tumors and missing data. Histology subgroups were divided into adenocarcinoma, squamous cell carcinoma, and other, based on ICD-O-3 coding. Cross tabulation analysis was performed using Pearson chi-square and ANOVA tests. Kaplan Meyer curves with log-rank analysis were used to determine survival probabilities. Results: Of PC interventions, 9.0% were surgical, 42.5% radiation, 41.1% chemotherapy, and 7.4% pain management with no other treatment. From 2004-2018 pain management increased 380% and chemotherapy increased 250%. Radiation increased 32%, and surgical decreased 39%. Surgical patients were more often male (79.9%), white (87.4%), non-Hispanic (97.3%), treated at an academic/research program (39.6%), and have a mean survival of 8.6 months. The most common surgical interventions were photodynamic therapy and esophagectomy with partial gastrectomy. Radiation patients more often male (82.3%), white (83.9%), non-Hispanic (96.5%), treated at a comprehensive community cancer center (39.7%), and have a mean survival of 9.1 months. Most common phase I radiation treatments were external beams (photons) and external beams NOS. Chemotherapy patients were more likely to be male (84.5%), white (88.2%), non-Hispanic (96.8%), treated at a comprehensive community cancer program (39.4%), and have a mean survival of 13.9 months. Chemotherapy patients most often received multiagent chemotherapy and single agent chemotherapy. Pain management patients were more often male (80.2%), white (88.0%), non-Hispanic (96.5%), treated at an academic/research program (38.8%), and have a mean survival of 4.1 months. Chemotherapy patients had average age of 62, while all other interventions had an average age of 65 (p < 0.001). Conclusions: Major differences between subtypes of PC interventions included location of treatment, average age at diagnosis, and mean survival. Chemotherapy patients were diagnosed younger and had a longer mean survival time. Pain management patients had the lowest mean survival time. This data can be utilized as PC utilization increases in the United States.
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D'Alessandro, Eduardo, Christina de Brito, Rebeca Cecatto, Maira Saul, Jose Antonio Atta, and Chin An Lin. "Evaluation of Acupuncture for Cancer Symptoms in a Cancer Institute in Brazil." Acupuncture in Medicine 31, no. 1 (March 2013): 23–26. http://dx.doi.org/10.1136/acupmed-2012-010206.
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Introduction Acupuncture has been progressively included in the practice of mainstream medicine in recent decades. The State of Sao Paulo Cancer Institute is a public hospital established in 2008 and its acupuncture service follows the experience and model of several oncology centres in the USA, aiming to optimise the treatment of symptoms such as postoperative pain, oncological pain, neuropathic pain, nausea, vomiting, xerostomia and fatigue induced by chemotherapy. This paper describes the population given acupuncture treatment and the effects of the intervention on symptom management. Methods One hundred and eighty-three patients from our service were enrolled in the study. Baseline and final symptom intensity was recorded using a visual analogue score (VAS) ranging from 0 to 10 cm, with a higher score meaning higher symptom intensity. Results Fifty-four (29.50%) were receiving active treatment with chemotherapy and/or radiotherapy, 29 (15.85%) were receiving hormone therapy and 100 (54.65%) were considered to be in remission. The main symptoms were: oncological pain in 44 (24.04%), chemotoxicity in 34 (18.6%), lumbar pain in 53 (28.96%) and chronic postoperative pain in 54 (28.4%). The mean (SD) initial symptom score was 7.04 (1.8), which was reduced to 2.56 (2.75) after treatment (p<0.001), an improvement of 63.6% in control of the symptoms. Further analysis of the data showed that the effect was similar in different indications for acupuncture treatment. Conclusions Use of acupuncture may have improved symptom control in patients enrolled in this study.
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Rosaulina, Meta, and Zuliawati Zuliawati. "HUBUNGAN TINDAKAN KEMOTERAPI DENGAN KEJADIAN NYERI OTOT PADA PASIEN KANKER PAYUDARA DI RSU SEMBIRING." Jurnal Penelitian Keperawatan Medik 5, no. 1 (November 2, 2022): 15–20. http://dx.doi.org/10.36656/jpkm.v5i1.1112.
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Breast cancer is an abnormal cell division in the breast that cannot be controlled so that it spreads quickly. Pain is a factor that contributes to the emergence of fatigue in cancer patients, and has the potential for treatment. Chronic pain is a major healthcare problem for patients with cancer and a major treatment for cancer. Patients will often feel pain during illness or after following chemotherapy. This study aims to determine the relationship between chemotherapy actions and the incidence of muscle pain in breast cancer patients at Sembiring Deli Tua Hospital in 2022. This study used quantitative correlation using a cross sectional approach, the number of samples in this study was 30 people with total side technique. , data collection using research instruments, for independent variables using medical records, and the dependent variable using a Numeric Rating Scale (NRS) questionnaire and observation sheets. The results showed that from 30 respondents. Based on the results of statistical test analysis using the Chi square test with a p-value of 0.028, the p value <0.05. These results indicate that Ha is accepted. Thus, it can be concluded that there is a significant relationship between chemotherapy action and the incidence of muscle pain in breast cancer patients at Sembiring General Hospital Deli Tua in 2022.
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Balsanelli, Alessandra Cristina Sartore, and Sonia Aurora Alves Grossi. "Predictors of hope among women with breast cancer during chemotherapy." Revista da Escola de Enfermagem da USP 50, no. 6 (December 2016): 898–904. http://dx.doi.org/10.1590/s0080-623420160000700004.
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Abstract OBJECTIVE Identifying the predictors of hope in patients with breast cancer during chemotherapy treatment. METHOD A prospective longitudinal study. The sample was composed of 122 women who responded to the instruments of hope, anxiety and depression, coping, fatigue, religiosity and self-esteem in the first and last cycle of chemotherapy. These variables were used in adjusting the logistic regression model that characterized multivariate statistics, allowing identification of predictor variables. RESULT The increase of hope at the end of chemotherapy treatment was statistically significant (p = 0.012). The delay in undergoing treatment from the onset of breast cancer symptoms, Karnofsky Performance Status, depression, self-esteem and pain were characterized as factors being associated to hope by univariate analysis. Among the variables analyzed, pain was the only predicting factor of hope. CONCLUSION Pain was the predicting factor in this sample. Hope increased during treatment and revealed the following associated factors: Karnofsky Performance Status, delay in starting the treatment, depression, self-esteem and pain. This study brought forth a multidisciplinary contribution, allowing for understanding the factors that can influence hope and presenting support to nursing care. The data evidenced conditions of improvement or worsening of hope, which requires interdisciplinary attention in Oncology.
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Hartel, M. "Vanilloids in pancreatic cancer: potential for chemotherapy and pain management." Gut 55, no. 4 (April 1, 2006): 519–28. http://dx.doi.org/10.1136/gut.2005.073205.
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Hellerstedt-Börjesson, Susanne, Karin Nordin, Marie-Louise Fjällskog, Inger K. Holmström, and Cecilia Arving. "Women Treated for Breast Cancer Experiences of Chemotherapy-Induced Pain." Cancer Nursing 39, no. 6 (2016): 464–72. http://dx.doi.org/10.1097/ncc.0000000000000322.
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Bintang, Rahma Setia, Elmeida Effendy, and Mustafa M. Amin. "Correlation between Visual Analog Scale and Patient Health Questionnaire-9 among Breast Cancer Patient at Islamic Hospital of Malahayati Medan." Open Access Macedonian Journal of Medical Sciences 10, T7 (March 29, 2022): 97–99. http://dx.doi.org/10.3889/oamjms.2022.9246.
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World Health Organization reported that in 2018 the most prevalent cancer cases in Indonesia is breast cancer with a total of 58,256 cases (16.7%) from total cancer cases in Indonesia. Among cancer patients, pain is the most profound and definite effect that has been linked to reduced quality of life as well as the development of depression. In Indonesia, studies investigating the effect of pain among breast cancer patient with depression is still lacking.
The aim of this study is to investigate the effect of pain with depression among breast cancer patients undergoing chemotherapy at Islamic Hospital of Malahayati Medan.
Methods applied in this study was cross sectional numerical correlative study involved 35 breast cancer patients undergoing chemotherapy at Islamic Hospital of Malahayati Medan age 40 – 60 years old. In order to assess pain, we used the Visual Analogue Scale (VAS), and as for depression, Patient Health Questionnaire-9 (PHQ-9) was used. Pearson correlation test was used to assess the correlation between pain and depression
The results showed that most of our subjects graduated from university, are already married and employed. Most are already at the third stadium with VAS score of around 4.89 + 1.530 indicating moderate pain and PHQ-9 score of 8.23 + 3.456 indicating mild depression. Pearson test showed r = 0.511 (mild strength) indicating that pain severity is correlated positively to depression severity.
Conclusion: There is a correlation between VAS score and PHQ-9 score among breast cancer patients undergoing chemotherapy at Islamic Hospital of Malahayati Medan.
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Zylla, Dylan Michael, Michael Kuskowski, Kalpna Gupta, and Pankaj Gupta. "Association of opioid requirement and cancer pain with survival in advanced non-small cell lung cancer." Journal of Clinical Oncology 32, no. 31_suppl (November 1, 2014): 183. http://dx.doi.org/10.1200/jco.2014.32.31_suppl.183.
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183 Background: Pain is associated with shorter survival in non-small cell lung cancer (NSCLC). Lung cancer cells express opioid receptors. Opioids promote angiogenesis, tumor growth and metastases, and shorten survival in animal models. Methods: To examine if long-term opioid requirement, independently of chronic pain, is associated with survival, we studied 209 patients treated with chemotherapy for stage IIIB/IV NSCLC. Pain was stratified by proportion of time patients reported specific levels of pain. Opioids were converted to oral morphine equivalents (OME) for comparison. The effects of pain, opioid requirement, and known prognostic variables on survival were analyzed in univariable and multivariable models. Results: Both severity of pain and greater opioid requirement in first 90 days after starting chemotherapy were strongly predictive of shorter survival on univariable analysis. Patients with no/mild chronic pain and requiring <5 mg/day OME during first 90 days had nearly 12 months longer median survival compared to patients requiring ≥5 mg/day OME and/or experiencing more pain. Differences in survival remained remarkably similar when chronic pain and opioid requirement were assessed over the entire clinical course (until death or last follow-up). In multivariable models, both opioid requirement and chronic pain remained independent predictors of survival, after adjustment for age, stage and performance status. Conclusions: Severity of chronic cancer-related pain or greater opioid requirement are associated with shorter survival in advanced NSCLC, independently of known prognostic factors. While pain adversely influences prognosis, controlling it with opioids does not improve survival. Prospective studies should determine if achieving pain control using opioid-sparing approaches improves outcomes.
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Lyon, Debra E., Angela Starkweather, Yingwei Yao, Timothy Garrett, Debra Lynch Kelly, Victoria Menzies, Paweł Dereziński, Susmita Datta, Sreelakshmy Kumar, and Colleen Jackson-Cook. "Pilot Study of Metabolomics and Psychoneurological Symptoms in Women With Early Stage Breast Cancer." Biological Research For Nursing 20, no. 2 (December 19, 2017): 227–36. http://dx.doi.org/10.1177/1099800417747411.
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Many women with breast cancer experience symptoms of pain, fatigue, and depression, collectively known as psychoneurologic (PN) symptoms, during and after chemotherapy treatment. Evidence that inflammatory dysfunction related to cancer and its treatments contributes to the development and persistence of PN symptoms through several interrelated pathways is accumulating. However, a major limiting factor in more precisely identifying the biological mechanisms underlying these symptoms is the lack of biological measures that represent a holistic spectrum of biological responses. Metabolomics allows for examination of multiple, co-occurring metabolic pathways and provides a systems-level perspective on biological mechanisms that may contribute to PN symptoms. Methods: In this pilot study, we performed serum metabolome analysis using liquid chromatography high-resolution mass spectrometry of global and targeted metabolomics from the tryptophan pathway from archived samples from 19 women with early-stage breast cancer. We used paired t tests to compare metabolite concentrations and Pearson’s correlation coefficients to examine concomitant changes in metabolite concentrations and PN symptoms before and after chemotherapy. Results: Levels of pain, fatigue, and depression increased after chemotherapy. Compared with pre-chemotherapy, global metabolites post-chemotherapy were characterized by higher concentrations of acetyl-l-alanine and indoxyl sulfate and lower levels of 5-oxo-l-proline. Targeted analysis indicated significantly higher kynurenine levels and kynurenine/tryptophan ratios post-chemotherapy. Symptoms of pain and fatigue had strong associations with multiple global and several targeted metabolites. Conclusion: Results demonstrated that metabolomics may be useful for elucidating biological mechanisms associated with the development and severity of PN symptoms, specifically pain and fatigue, in women with early-stage breast cancer.
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Hong, Kyung Sook, Soon Sup Chung, Kwang Ho Kim, and Ryung-Ah Lee. "Efficacy of a rehabilitation program using minor muscles in colorectal cancer patients with chemotherapy-induced neuropathy: preliminary study." Korean Journal of Clinical Oncology 18, no. 1 (June 30, 2022): 11–16. http://dx.doi.org/10.14216/kjco.22002.
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Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the common reasons that colorectal cancer patients cannot maintain their routine chemotherapy schedules. Some medications are used for pain relief; however, the effect of medication is disappointing. We carried out this study to confirm that a rehabilitation program using minor muscles might provide a valuable aid in symptom relief of CIPN.Methods: Eleven colorectal cancer patients participated in the basic craftwork program which encouraged the use of the minor muscles of the hands to make and decorate the handicrafts and it was held for 2 hours once a week, for a total of four times. There were no limitations in the stage of cancer or types of chemotherapy to participate the program. Questionnaires were obtained from participants before and after the basic handicrafts program.Results: Of the 11 patients (3 men, 8 women; mean age, 53.0±11.2 years), six received 5-fluorouracil (5-FU) chemotherapy, four received FOLFOX4 (combination of 5-FU, leucovorin, and oxaliplatin) chemotherapy, and one received 5-FU, FOLFOX4, and FOLFIRI (combination of 5-FU, leucovorin, and irinotecan) chemotherapy sequentially. Patients attended the program a mean of 3.8±0.4 times. Common symptoms of CIPN were “throbbing pain,” “aching pain,” and “numbness.” The mean score of the questionnaires between pre- and post-program was 34.1±31.7 points and 24.4±21.5 points each, and it was significantly decreased (P=0.040).Conclusion: Patients often suffered from CIPN symptoms like throbbing or aching pain and numbness during their adjuvant chemotherapy. A rehabilitation program using minor muscles for CIPN is expected to be effective.
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Masarogulları, Guncel. "THE EFFECTS OF MUSIC THERAPY ON ANXIETY AND PAIN SYMPTOMS OF CHILDREN WITH CANCER." New Trends and Issues Proceedings on Humanities and Social Sciences 4, no. 7 (November 10, 2017): 139–53. http://dx.doi.org/10.18844/prosoc.v4i3.2654.
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Although music therapy is well documented in medical settings, the effects of the music therapy has not been well established yet. This study aimed to investigate the effectiveness of the music therapy on anxiety, and pain symptoms of children with cancer. Participants (aged ranged 6-16) were randomly allocated to one of two music therapy groups: 1) earphones with classical music, no choice (n = 20) or 2) earphones with classical music, free choice (n = 20) and a control group (n = 20) (earphones without music). In all groups, children listened to music (or the white noise) for 10 minutes before the chemotherapy. All of the symptoms were measured before the music therapy, during the chemotherapy (after the music therapy), and after the chemotherapy. State Trait Anxiety Inventory for Children (STAI-C), and Wong-Baker Faces Pain Rating Scale was used to measure the anxiety, and pain scores of the children. One-Way ANOVA and Mixed ANOVA analysis were used to analyse the effectiveness of the music. Results showed that the anxiety level of children decreased significantly in the music groups during and after the chemotherapy. However, music therapy did not affect the pain level of children Keywords: Music therapy, anxiety, pain, cancer;
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Masarogulları, Guncel. "THE EFFECTS OF MUSIC THERAPY ON ANXIETY AND PAIN SYMPTOMS OF CHILDREN WITH CANCER." New Trends and Issues Proceedings on Humanities and Social Sciences 4, no. 7 (August 5, 2017): 139–53. http://dx.doi.org/10.18844/prosoc.v4i7.2654.
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Although music therapy is well documented in medical settings, the effects of the music therapy has not been well established yet. This study aimed to investigate the effectiveness of the music therapy on anxiety, and pain symptoms of children with cancer. Participants (aged ranged 6-16) were randomly allocated to one of two music therapy groups: 1) earphones with classical music, no choice (n = 20) or 2) earphones with classical music, free choice (n = 20) and a control group (n = 20) (earphones without music). In all groups, children listened to music (or the white noise) for 10 minutes before the chemotherapy. All of the symptoms were measured before the music therapy, during the chemotherapy (after the music therapy), and after the chemotherapy. State Trait Anxiety Inventory for Children (STAI-C), and Wong-Baker Faces Pain Rating Scale was used to measure the anxiety, and pain scores of the children. One-Way ANOVA and Mixed ANOVA analysis were used to analyse the effectiveness of the music. Results showed that the anxiety level of children decreased significantly in the music groups during and after the chemotherapy. However, music therapy did not affect the pain level of children Keywords: Music therapy, anxiety, pain, cancer;
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Menendez, Alvaro G., Alejandro Ramon Carvajal, Regina Cobb, Tanmay Sahai, Diane D'Ambra, Kathi Healey, and Maria Soriano-Pisaturo. "Patient-reported benefits of massage therapy as treatment for chemotherapy-related pain." Journal of Clinical Oncology 34, no. 26_suppl (October 9, 2016): 192. http://dx.doi.org/10.1200/jco.2016.34.26_suppl.192.
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192 Background: Massage Therapy (MT) has been suggested to provide symptom relief of chemotherapy related side effects. Its impact on pain improvement, prevention, and overall quality of life (QoL) is characterized in this study and 2 different pain scales are being compared. Methods: Patients who were on active chemotherapy and agreed to receive at least one MT session over a 10-week period were included. Wong-Baker Pain scale (WBPS) and Numerical Pain Scale (NPS) were assessed pre and post every session. Results: 62 pts were included. 25 pts were on analgesics (Opiates 64%, Gabapentin 24%, NSAIDs 12%). 34/62 pts had no complaints of pain on enrollment and only 9% (3/34) developed pain as per WBPS on subsequent visits. In 27/28 pts (97%) who had pain initially according to WBPS (0-4 scale), improvement was reported from X = 1.25 (5±5, M = 0, SD 2.31) to X = 0.32 after one MT session (4±4, M = 0, SD 1.16) (p < 0.05). 25/28 pts (89%) had maintained improvement from 1st to 2nd session with an average of 50%. 11% (3/28) reported worsening of pain symptoms with an X increase average of 2.66 (3±1, M = 2). NPS was positive for 37 patients on initial visit. NPS revealed a similar trend with pre-massage X of pain from 2.76 (5±5, M = 2, SD 2.87) to 1.18 (4±4, M = 0, SD 2.01) after 1st session (39.5% improvement) (p < 0.05). 18/25 (72%) saw a decrease in pain level per NPS (X = 2.27) between each session, whereas 28% noted worsening of pain by the end of their participation. Conclusions: MT is a high-value, low-risk intervention for reducing cancer pain and cancer treatment-related pain. MT could be used to address patients' need for emotional and physical human connection at a time when their quality of life is fragile. MT may offer pain prophylaxis when provided in a cumulative manner. NPS appears to be more sensitive than WBPS for pain screening in oncologic patients. Further studies are necessary to confirm the suggested findings of massage therapy for pain prevention and treatment.
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Heras, P., A. Hatzopoulos, K. Kritikos, and S. Karagiannis. "Level of fatigue in colorectal cancer patients (ccp) receiving adjuvant chemotherapy." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e20612-e20612. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e20612.
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e20612 The aim of the study was to assess the level of fatigue during and after adjuvant chemotherapy in ccp. Methods: 52 patients (age 30–73 years) with colorectal cancer were recruited between May 2005 and November 2008. Fatigue intensity was measured according to 10-score visual analog scale (VAS, 0-no fatigue, 10-fatigue as bad as it could possibly be) before the start of adjuvant chemotherapy, once weekly during chemotherapy, 20 days and 6 months after. Results: Over half of the patients (56%) demonstrated no fatigue before the start of adjuvant chemotherapy. Fatigue intensity increased gradιιally during chemotherapy. It highest in the last week of treatment 20 days after the end of chemotherapy, fatigue intensity was still higher than before treatment, but 6 months after it was lower than the pretreatment level (mean fatigue-VAS was 1.17, 2.41, 1.45 and 0.61, respectively). However, 17% of the patients defined their fatigue as 2 or more in VAS six months after chemotherapy had ended. About 1/4 of the patients reported nο fatigue during chemotherapy. Increased level of fatigue was associated with an increased need of rest. Patients with pain (pain-VAS 1 or more) manifested higher fatigue level in comparison with individuals without pain (mean fatigue-VAS 3.20 vs 1.02 in the last week of treatment). Older patients (>65 years) estimated their fatique in the last week of treatment on lower level than younger patients (fatigue-VAS 1.79 vs. 2.83 No significant financial relationships to disclose.
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Gautam, Roshani, Bhagwati Kalikotey, Krishna Devi Shrestha, and Archana Shrestha. "Symptom Assessment among Cancer Patients Receiving Chemotherapy In A Cancer Hospital." Tribhuvan University Journal 37, no. 02 (December 31, 2022): 1–14. http://dx.doi.org/10.3126/tuj.v37i02.51591.
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People with cancer usually experience various distressing symptoms while receiving chemotherapy. Early identification of distressing symptoms of patients receiving treatment is a crucial step toward providing quality nursing care for patients. This study aimed to assess the frequency, severity and distressing symptoms and its predictors among cancer patients who are receiving chemotherapy. An Analytical cross-sectional study was done among 233 people receiving cancer chemotherapy in a Cancer Hospital. Convenience sampling method was adopted to select sample and data was collected by in-person interview. Out of 233 respondents, less than half(42.6%) belonged to the 40-59 years age group and male (53.6%). The common physical symptoms were pain (70%), lack of energy (67.8%), nausea (58.8%) and psychological symptoms were feeling sad (43.8%), worrying (43.8%) and difficulty sleeping (18.5%). The most severe symptoms experienced by respondents were pain, dry mouth, lack of energy and shortness of breath. Patient’s age (β=0.321, p <0.001), education ( β= 0.094, p <0.001). Eastern Cooperative Oncology Group (EOCG) ( β=0.340, p <0.001), number of chemotherapy cycle ( β=0.147, p 0.004) were found to be predictors for the physical symptoms. Likewise, for the global distress index, these variables explained 88.9% of this variance (p<0.001, r 2 =0.889). Education (β=0.078,p <0.001), duration of illness (β=0.081, p =0.032) , age (β=0.0.211, p <0.001), ECOG(β=0.0264, p <0.001) were found to be predictors for the global distress index.
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Leung, Mova, Joy Eustaquio, Jessica Kano, Tiffany Marr, Brian Patrick Higgins, Robert Edward Myers, Jenny Kim, and Glenn Jones. "Pain severity and impairment of activity between pegfilgrastim (P) and fixed-dose filgrastim (F) in women with early-stage breast cancer receiving chemotherapy." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e19570-e19570. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e19570.
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e19570 Background: In comparative trials of P and F, bone and joint pain are evident and with similar incidences. Also, muscle pain is clinically noted. Pain severity may differ between P and F, especially when a short fixed-dose regimen of F is used. Methods: This is a prospective observational and ethics-approved study. It compares the incidence & severity of muscle and/or joint pain (MJP) in patients (pts) receiving P (6mg SC for 1 day) or fixed-dose F (300mcg SC for 7-8 days) initiated 24 hours after chemotherapy. Eligible were women with breast cancer receiving neo- or adjuvant chemotherapy, and P or F. Choice of P or F were at the oncologist’s discretion based on patient preference & insurance coverage. Pts were ineligible if they could not complete the pain diary, or had received P or F in the past 6 months. Efficacy of P and F was evaluated by comparing febrile neutropenia (FN) and neutropenia (N) requiring delay of the second cycle of chemotherapy. Patient & treatment characteristics were captured to assess for risk factors for developing MJP. A pain diary assessed MJP severity, its management and impact on everyday activities. It was completed starting the evening of chemotherapy for 14 consecutive days. Statistical analysis was performed with Stata 12, including multi-level longitudinal mixed models for MJP scores. Results: 140 pts were enrolled with mean age 52 yr and 58% receiving docetaxel-based chemotherapy. One-third received F and two-thirds received P. Both diary muscle and joint pain peaked in prevalence and severity on days 3 to 6. Over 50% of pts reported MJP at the peak. Pain that increased ≥3 points from baseline was reported by 48% of pts. Daily activities were affected in 48% of 1,960 reporting-days, with 26% reporting moderate or severe impairment. Despite similar incidences of pain, P was associated with lower mean muscle (p=0.0049) and joint (p=0.014) pain scores by regression analyses. FN and N were not different. Use of docetaxel was the sole baseline risk factor for developing MJP. Conclusions: Patients experience substantial MJP with impairment of daily activities but pts receiving pegfilgrastim experience less pain and less burden relating to pain.
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Gregory, Stephanie A., May Mo, Charles Vogel, Jorge Sierra, and Lee S. Schwartzberg. "Reported Bone Pain in Cancer Patients Receiving Chemotherapy in Pegfilgrastim Clinical Trials: A Retrospective Analysis." Blood 114, no. 22 (November 20, 2009): 4561. http://dx.doi.org/10.1182/blood.v114.22.4561.4561.
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Abstract Abstract 4561 Background Mild to moderate bone pain is the most commonly reported treatment-related adverse event (AE) associated with administration of granulocyte colony-stimulating factors (G-CSFs). There is a perception that bone pain associated with pegfilgrastim (the pegylated form of filgrastim) occurs at a higher frequency, is more severe, and is less predictable than bone pain associated with filgrastim. To evaluate this hypothesis, a retrospective analysis examining bone pain in cancer patients receiving chemotherapy in pegfilgrastim clinical trials was conducted. Methods Data analyzed were from 12 sponsor-supported trials of once per chemotherapy cycle pegfilgrastim (6 mg fixed dose or 100 mcg/kg) versus daily filgrastim (5 mcg/kg) or versus no G-CSF administered following chemotherapy in patients with non-Hodgkin's lymphoma (NHL), breast, lung, colorectal, or ovarian cancer. The AEs reported were coded according to MedDRA (version 11) and the preferred terms considered to include bone pain were determined prior to analysis. Incidences of any grade and grade 3/4 bone pain were calculated by treatment (pegfilgrastim, filgrastim, or no G-CSF) and chemotherapy cycle. Results Data for patients who received pegfilgrastim (n=1498), filgrastim (n=354) or no G-CSF (n=1102) were included in this analysis. In the 7 studies comparing pegfilgrastim (n=377) with filgrastim (n=354) in patients with NHL, breast or lung cancer, similar proportions of patients reported bone pain of any grade (Table 1). In both treatment arms, bone pain incidence was highest in the first cycle of chemotherapy and decreased in subsequent cycles. In both the pegfilgrastim and filgrastim arms, grade 3/4 bone pain incidence was low across all cycles (6.6% and 7.9%, respectively), in the first cycle (4.2% and 5.4%, respectively), and in subsequent cycles (Table 1). In the 5 studies comparing pegfilgrastim (n=1121) with no G-CSF (n=1102) in patients with NHL, breast, lung, colorectal, or ovarian cancer, 74% of the patients were female, 78% were white and the median (minimum, maximum) age was 65 (18, 88) years. Of these patients, 53% had breast cancer and 68% received a taxane-based regimen. Three of the 5 studies allowed pegfilgrastim use after cycle 1 in the control arm (ie, secondary prophylaxis); therefore, only cycle 1 bone pain incidences were compared for this analysis. The proportion (confidence interval [CI]) of patients who reported bone pain in the first cycle of chemotherapy was higher in the pegfilgrastim arm than the no G-CSF arm; 32.7% (30.0%, 35.6%) versus 23.0% (20.6%, 25.7%). Grade 3/4 bone pain was infrequently reported in these patients (3.4% [2.4%, 4.6%] pegfilgrastim, 2.0% [1.3%, 3.0%] no G-CSF). Conclusions In this analysis, bone pain was common in cancer patients receiving chemotherapy, and was most frequently reported in the first cycle of treatment. Bone pain incidences were similar for the pegfilgrastim and filgrastim arms and slightly higher in the pegfilgrastim than in the no G-CSF arm. Bone pain may be associated with a combination of factors including disease state (eg, metastatic site), co-morbid conditions (eg, arthritis, osteoporosis), type of chemotherapy received, and growth factor use. Severe bone pain can and does occur in this population; however, this was infrequently reported in the studies included in this analysis. Disclosures: Gregory: Amgen: Consultancy. Mo:Amgen: Employment, Equity Ownership. Vogel:Amgen: Consultancy, Honoraria, Research Funding, Speakers Bureau; GSK: Consultancy, Honoraria, Research Funding, Speakers Bureau; Genentech: Consultancy, Honoraria, Research Funding, Speakers Bureau; EMD Serono: Consultancy, Honoraria, Research Funding, Speakers Bureau; Astra Zeneca: Consultancy, Speakers Bureau; Roche: Consultancy, Speakers Bureau; Pfizer: Consultancy, Research Funding, Speakers Bureau; Norvatis: Consultancy, Research Funding, Speakers Bureau; BMS: Consultancy, Honoraria, Speakers Bureau; Sanofi Aventis: Consultancy, Honoraria; Ortho Biotech: Consultancy, Speakers Bureau. Schwartzberg:Amgen: Speakers Bureau; GSK: Speakers Bureau; BMS: Speakers Bureau.
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Kumar Muniandy, Rajesh, and Nagarajan Nagalingam. "Caudal Epidural for Pain Management of Prostate Cancer." Nepal Medical Journal 3, no. 2 (December 31, 2020): 64–67. http://dx.doi.org/10.37080/nmj.134.
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Prostate cancer is the second commonest cancer found in men. Pain can occur in both early and advanced stages of prostate cancer, with an incidence of 30-50%. The pain can be caused directly by the cancer or related to the cancer treatment. Currently, pain in prostate cancer is managed with surgery, medication, radiotherapy or chemotherapy. It can also be managed by intra-thecal morphine, psoas sheet catheter and superior hypogastric block. However, all these procedures involve risks. We present a case of Stage 4 Prostate Cancer who presented with severe lower back pain. We performed a caudal epidural, which was very successful to reduce the patient's pain and improve his quality of life. We recommend a caudal epidural should be considered as an option to manage metastatic bone pain in prostate cancer patients.
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Battaglini, Eva, David Goldstein, Peter Grimison, Susan McCullough, Phil Mendoza-Jones, and Susanna B. Park. "Chemotherapy-Induced Peripheral Neurotoxicity in Cancer Survivors: Predictors of Long-Term Patient Outcomes." Journal of the National Comprehensive Cancer Network 19, no. 7 (July 2021): 821–28. http://dx.doi.org/10.6004/jnccn.2021.7026.
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Background: Chemotherapy-induced peripheral neurotoxicity (CIPN) is a major adverse effect of cancer treatment. However, its impact remains poorly understood. This study aimed to investigate the impact associated with CIPN on the lives of cancer survivors. Patients and Methods: A volunteer sample of 986 individuals who had received neurotoxic chemotherapy completed an anonymous, cross-sectional survey. Outcomes assessed included CIPN symptoms, pain, neuropathic pain, quality of life (QoL), physical activity, and comorbid health conditions via the Self-Administered Comorbidity Questionnaire. Results: Respondents had a mean age of 58 years (SD, 10.7), and 83.2% were female. Most were treated for breast (58.9%) or colorectal cancer (13.5%); had received docetaxel (32.7%), paclitaxel (31.6%), or oxaliplatin (12.5%); and had completed treatment 3.6 ± 3.5 years previously. We found that 76.5% of respondents reported current CIPN. Respondents reporting severe CIPN had poorer QoL, more comorbidities, and higher body mass index, and more often received multiple neurotoxic chemotherapies than those with mild CIPN. Respondents who completed the survey ≤1 year after completing chemotherapy did not differ in reported CIPN or pain compared with respondents who completed chemotherapy ≥6 years earlier. However, respondents who completed chemotherapy ≥6 years earlier reported better QoL. Multivariable linear regression analyses revealed predictors of CIPN severity as follows: F(7, 874) = 64.67; P<.001; R2 = 0.34, including pain (β = −0.36; P<.001), burning pain (β = 0.25; P<.001), sex (male sex associated with greater CIPN: β = 0.14; P<.001), years since completing chemotherapy (shorter time associated with greater CIPN; β = −0.10; P<.001), age (β = 0.80; P=.006), number of comorbid conditions (β = 0.07; P=.02), and body mass index (β = 0.07; P=.02). Conclusions: Respondents with a high CIPN symptom burden experienced poorer general health and QoL. Improvements in CIPN may be more likely soon after treatment. However, improvements in QoL may occur over time in those with chronic symptoms. CIPN seems to have lasting impacts on cancer survivors, and understanding risk factors is important to enable the design of further preventive and therapeutic management strategies.
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Oliveira, Priscila Isolani de, Carlos Alberto de Castro Pereira, Angélica Gonçalves Silva Belasco, and Ana Rita de Cássia Bettencourt. "Comparison of the quality of life among persons with lung cancer, before and after the chemotherapy treatment." Revista Latino-Americana de Enfermagem 21, no. 3 (June 2013): 787–94. http://dx.doi.org/10.1590/s0104-11692013000300019.
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OBJECTIVE: this prospective study aimed to assess the quality of life related to health (QLRH) of patients with lung cancer after chemotherapy treatment. METHOD: The QLRH was assessed using the questionnaires Quality-of-Life Questionnaire-Core 30 (QLQ-C30) and Lung Cancer Module (LC13), version 3.0. RESULTS: the sample was made up of 11 women and 19 men, with an average age of 68 years (51-87 years). After the chemotherapy treatment, the authors observed a clinically-relevant improvement in general quality of life, as well as in the symptoms of dyspnea, insomnia, hemoptysis, cough, thoracic pain, pain in the arm/shoulder, and financial difficulty. There was a worsening on the functional scale which assesses role performance and symptoms of fatigue, nausea and vomiting, sensory neuropathy, pain in other parts, constipation, loss of appetite and alopecia. CONCLUSION: although the patients have an improvement of their QLRH and symptoms related to the lung cancer after the chemotherapy treatment, there was a worsening of the symptoms which resulted from the toxicity of the chemotherapy medications.
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Moore, Donald C., Tsion Gebru, Annie Pellegrino, Adenike Fasan, Jolly Patel, and J. Tanner Ringley. "Neutropenia-Associated Outcomes in Patients With Breast Cancer Receiving Myelosuppressive Chemotherapy With Reduced Doses of Pegfilgrastim." Journal of Pharmacy Practice 33, no. 6 (March 27, 2019): 779–83. http://dx.doi.org/10.1177/0897190019838374.
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Background: Pegfilgrastim can be utilized to prevent neutropenia-associated complications in patients receiving myelosuppressive chemotherapy for breast cancer. A common adverse event associated with pegfilgrastim is bone pain. Clinicians may opt to reduce the dose of pegfilgrastim when administering it to patients with previous severe or refractory bone pain. There is limited and conflicting evidence with regard to the safety and efficacy of this practice. The purpose of this study was to investigate the impact of administering reduced doses of pegfilgrastim on neutropenia-associated outcomes in patients with breast cancer receiving myelosuppressive chemotherapy. Methods: A retrospective chart review was conducted at a large, multistate health system with several different medical oncology practice sites. The primary outcome was the incidence of febrile neutropenia. Secondary outcomes included the incidence and severity of neutropenia, hospitalization for febrile, use of intravenous antimicrobials for febrile, delays in chemotherapy or dose reductions in chemotherapy secondary to neutropenia or febrile, rationale for dose reduction of pegfilgrastim, and improvement in bone pain. Results: A total of 80 patients received reduced dose pegfilgrastim. Most patients had their doses reduced secondary to bone pain (54%) or leukocytosis (14%). One (1.25%) patient experienced febrile neutropenia that did not require hospitalization or intravenous antimicrobials. Chemotherapy treatment delays and dose reductions secondary to neutropenia or febrile neutropenia occurred in 1 (1.25%) and 2 (2.5%) patients, respectively. Conclusion: Reduced doses of pegfilgrastim in patients receiving myelosuppressive chemotherapy for breast cancer resulted in a low incidence of neutropenia-associated events, including febrile neutropenia and grade 3/4 neutropenia.
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Xu, Hairong, Qi Gong, Florian D. Vogl, Esteban Abella, and John H. Page. "Risk Factors For Bone Pain Among Patients Receiving Myelosuppressive Chemotherapy and Primary Prophylactic Pegfilgrastim." Blood 122, no. 21 (November 15, 2013): 1710. http://dx.doi.org/10.1182/blood.v122.21.1710.1710.
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Abstract Introduction Febrile neutropenia (FN) is a common, life-threatening side effect of myelosuppressive chemotherapy. Prophylactic pegfilgrastim (Neulasta) beginning with the first cycle of chemotherapy has been shown to reduce the incidence of FN (Vogel CL et al., J Clin Oncol., 2005). Bone pain is the most common adverse event associated with pegfilgrastim, and most incidences of bone pain can be managed with nonsteroidal anti-inflammatory drugs (NSAIDs). However, little is known about risk factors for bone pain in patients treated with pegfilgrastim. Methods This study used individual patient data from 23 Amgen-sponsored, randomized clinical trials and included adults receiving myelosuppressive chemotherapy and primary prophylactic pegfilgrastim. Bone pain was identified based on the adverse events reported in the trials. Multivariable logistic regression models were used to identify risk factors associated with the occurrence of moderate to severe bone pain (grade 2+) in cycle 1 (the primary outcome) and across cycles 1-6 and any grade bone pain in cycle 1 and across cycles 1-6. Data collected in the trials and included in the regression model include baseline patient characteristics (gender, race, and age); disease characteristics (primary tumor type and tumor stage); treatment characteristics (taxane vs no taxane treatment and dose of pegfilgrastim); and medical history (osteoporosis/osteopenia, hypercholesterolemia, anemia, neutropenia, osteomyelitis/osteonecrosis, arthritis, peripheral neuropathy, chronic fatigue syndrome, gout, bone fracture, and bone pain). Results This study included data from 1974 patients who received myelosuppressive chemotherapy and primary prophylactic pegfilgrastim. The most frequent tumor types in the study sample were breast cancer (54.8%), non-small cell lung cancer (17.1%), and non-Hodgkins lymphoma (13.6%). 41.2% of patients had stage IV disease. Grade 2+ bone pain was reported in 372 patients (18.8%) in cycle 1 and 564 patients (28.6%) across the first 6 cycles, while any grade bone pain was reported in 709 patients (35.9%) in cycle 1 and 1016 patients (51.5%) across the first 6 cycles. In the first cycle of chemotherapy, previous history of osteoporosis/osteopenia (odds ratio [OR] 1.28; 95% CI 1.04-1.56), gout (1.44; 0.98-2.13), and bone pain (1.28; 1.09-1.49), and pegfilgrastim dose (100 mcg/kg vs a fixed dose of 6 mg; 1.68; 1.13-2.51) were associated with increased risk of grade 2+ bone pain; compared with breast cancer, colorectal cancer was associated with reduced risk of grade 2+ bone pain (0.26; 0.11-0.60) and ovarian cancer with increased risk of grade 2+ bone pain (1.89; 0.98-3.64); compared with age <45 years, age ≥65 years was associated with reduced risk of grade 2+ bone pain (0.80; 0.63-1.01) (table). Conclusions History of osteoporosis/osteopenia, history of bone pain, breast cancer (vs colorectal cancer), and younger age appear to be risk factors for bone pain in chemotherapy-treated patients who received primary prophylactic pegfilgrastim. The study results may be used to identify patients at increased risk of bone pain who may benefit from pain therapy. Disclosures: Xu: Amgen Inc. : Employment, Equity Ownership. Gong:Amgen Inc. : Employment, Equity Ownership. Vogl:Amgen Inc. : Employment, Equity Ownership. Abella:Amgen Inc. : Employment. Page:Amgen Inc. : Employment, Equity Ownership.
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Deleemans, Julie M., Kirsti Toivonen, Raylene A. Reimer, and Linda E. Carlson. "The Chemo-Gut Study: A Cross-Sectional Survey Exploring Physical, Mental, and Gastrointestinal Health Outcomes in Cancer Survivors." Global Advances in Health and Medicine 11 (January 2022): 2164957X2211459. http://dx.doi.org/10.1177/2164957x221145940.
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Background Cancer treatments, such as chemotherapy, may adversely affect gastrointestinal (GI), physical and mental health in survivors of cancer. Objective This study investigated associations between GI, mental and physical health outcomes, and cancer treatment-related variables, such as chemotherapy, in adult cancer survivors. Methods A one-time cross-sectional survey with patient-reported outcomes was used. Cancer survivors (N = 317) aged ≥18 years, living in Canada, who completed cancer treatments were included. Descriptive statistics, correlation, and linear regression analyses are reported. Results Mean age at diagnosis was 40.90 ± 15.40 years. Most survivors received chemotherapy (86.1%). Persistent GI symptoms include constipation (53.6%), diarrhea (50.5%), and bloating/pain (54.9%). Mean GI symptom duration was 30.53 ± 33.42 months. Severity of GI symptom interference was moderate to extreme for 51.9% of survivors. Compared to normative values of 50 in healthy people, survivors scored poorer for mental health (M = 42.72 ± 8.16) and physical health (M = 45.55 ± 7.93), and reported more belly pain (M = 56.10 ± 8.58), constipation (M = 54.38 ± 6.81), diarrhea (M = 55.69 ± 6.77), and gas/bloating (M = 56.08 ± 8.12). Greater GI symptom severity was associated with poorer mental and physical health ( P < .01). Chemotherapy was associated with increased belly pain ( B = 4.83, SE = 1.65, P < .01) and gas/bloating ( B = 3.06, SE = 1.45, P = .04). Conclusion We provide novel evidence that many cancer survivors experience chronic, moderate to severe GI symptoms lasting for years after cancer treatment, which are associated with worse mental and physical health. Chemotherapy is associated with specific GI symptoms. Integrative therapies are needed to address GI symptoms in cancer survivors.
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Lim, Seungtaek, Tae-jun Kil, Hye Ryun Kim, Seonhui Han, and Sun Young Rha. "A Case of Gingival Candidiasis with Bone Destruction on Gastric Cancer Patient Receiving Cytotoxic Chemotherapy." Case Reports in Oncological Medicine 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/145394.
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We herein report a case of gingival candidiasis in an advanced gastric cancer patient while receiving palliative cytotoxic chemotherapy. A 46-year-old male patient admitted to our hospital for known advanced gastric cancer with newly developed multiple liver metastases. While receiving 2nd line cytotoxic chemotherapy with 5FU, leucovorin, and paclitxel, he complained of gingival swelling accompanied by pain and whitish plaque. Due to lack of response to the conservative oral care, incisional biopsy of gingiva was done and the pathology confirmed gingival candidiasis. Although the lesion healed apparently after two-week antifungal therapy, pain as well as bony destruction remains. By presenting this case report, we intend to emphasize the immunocompromising effect of cancer while being on systemic chemotherapy.
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Kelsen, D. P., R. K. Portenoy, H. T. Thaler, D. Niedzwiecki, S. D. Passik, Y. Tao, W. Banks, M. F. Brennan, and K. M. Foley. "Pain and depression in patients with newly diagnosed pancreas cancer." Journal of Clinical Oncology 13, no. 3 (March 1995): 748–55. http://dx.doi.org/10.1200/jco.1995.13.3.748.
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PURPOSE To evaluate the prevalence of pain and depression, their correlation, and their effect on quality of life in patients with recently diagnosed adenocarcinoma of the pancreas (PC). MATERIALS AND METHODS Cross-sectional pain and psychosocial distress were assessed using validated instruments, including the Memorial Pain Assessment Card (MPAC), Beck Depression Inventory (BDI), Hopelessness Scale (BHS), and Functional Living Index-Cancer (FLIC). Patients were evaluated before their first operation for PC or first treatment with chemotherapy at a large tertiary-care cancer center. RESULTS One hundred thirty patients with proven PC were studied: 83 before their operation and 47 before their first chemotherapy treatment. At the time of study entrance, 37% of patients had no pain and an additional 34% had pain that was mild or less severe. Only 29% of patients had moderate, strong, or severe pain. Chemotherapy patients reported significantly more intense pain than did preoperative patients (P = .02). Symptoms of depression were assessed using the BDI and BHS scales. A substantial minority of patients (38%) had BDI scores > or = 15, which suggests high levels of depressive symptoms. There was a significant correlation between increasing pain and depressive symptoms among those who experienced pain. Quality of life was assessed using the Weekly Activity Checklist (WAC) and the FLIC. Compared with patients who had no pain or mild pain, patients with moderate or greater pain had significantly impaired functional activity (P = .03) and poorer quality-of-life scores (P = .02) when compared with those with lesser degrees of pain. There were significant correlations between increasing pain and depression and between pain and depressive symptoms and impaired quality of life and function. CONCLUSION Our results indicate that moderate or severe pain and symptoms of depression are not as prevalent in recently diagnosed PC patients as is generally believed. However, one third have inadequate pain control despite the use of oral analgesics. These patients can be identified by the use of a simple self-report instrument (the MPAC card). Quality of life and function are adversely affected by moderate or greater levels of perceived pain intensity. A simple and rapid assessment is possible and can identify high-risk patients in need of intervention that may improve quality of life.
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Zhang, Lina, Yuntao Li, Zhonglin Fan, Meiqi Wang, Tianli Hui, Yanshou Zhang, Chunhui Gao, et al. "A randomized trial of pegylated recombinant human granulocyte-colony stimulating factor to prevent febrile neutropenia in breast cancer after chemotherapy." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e12516-e12516. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e12516.
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e12516 Background: The purpose of this study was to evaluate the incidence of febrile neutropenia (FN) in breast cancer patients with pegylated recombinant human granulocyte-colony stimulating factor (PEG-rhG-CSF) administration at 48 or 24 hours after chemotherapy for primary prevention. Methods: Patients with stage I-III invasive breast cancer who were scheduled to receive 4 cycles of adjuvant chemotherapy with EC regimen (epirubicin combined with cyclophosphamide) were eligible for this multicenter, open-label, randomized trial. Patients were randomized (1:1) to receive PEG-rhG-CSF (Jinyouli) 48 hours (48h group) or 24 hours (24h group) after the end of each cycle of chemotherapy. The primary endpoint was the incidence rate of FN. The secondary endpoints included the incidence rates of grade 3/4 neutropenia, chemotherapy dose reduction and chemotherapy delay due to neutropenia, antibiotic administration, the pain (bone, muscle, or joint), and the relative dose intensity (RDI) of the chemotherapy. Results: The preliminary results enrolled 197 patients including 96 in the 48h group and 101 in the 24h group. 78.1% of 48h group patients and 73.3% of 24h group patients completed four cycles of chemotherapy. The incidence rates of FN were 2.1% in the 48h group and 4.0% in the 24h group respectively. FN occurred in the first two cycles in the 48h group, while in the 24h group, it occurred only in the first cycles. The incidence rate of grade 3/4 neutropenia was 27.1% in the 48h group and 51.5% in the 24h group respectively. There was no delay in chemotherapy due to neutropenia in the two groups. The incidence rate of chemotherapy dose reduction due to neutropenia was 2.1% in the 48h group and 1.0% in the 24h group respectively. 2 (2.1%) patients in the 48h group and 4 (4.0%) patients in the 24h group received antibiotics. The mean RDI of each cycle of chemotherapy was 91.3% in the 48h group and 91.5% in the 24h group, respectively. The incidence rate of all grades pain (bone, muscle, or joint) was 25.0% in the 48h group, and 20.8% in the 24h group. With regard to 3 or higher grade pain, 1 (1.0%) patient in the 48h group experienced bone pain and 1 (1.0%) patient in the 24h group experienced muscle pain. Conclusions: Preliminary results suggest a similar effect of PEG-rhG-CSF administration at 48 or 24 hours after chemotherapy in primary prevention of FN in breast cancer patients receiving EC chemotherapy regimen. Recruitment is ongoing and updated data will be presented. Clinical trial information: ChiCTR1800019516. [Table: see text]
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Tsyb, Anatoly F., Vasily N. Dunchik, Oleg B. Karyakin, Gennady N. Grishin, Olga V. Sakharova, and Anatoly I. Dergachev. "Intraarterial Chemotherapy for Advanced Bladder Cancer." Tumori Journal 74, no. 4 (August 1988): 463–69. http://dx.doi.org/10.1177/030089168807400414.
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The results of prolonged intra-arterial chemotherapy in 61 patients with locally advanced bladder cancer (T3–T4) are discussed. Regional internal iliac artery infusion of chemotherapeutic agents was done daily for 5 or 7 days at a rate of 1 to 3 ml/h over an 18-20-h period. The total dosages of each course were 60–120 mg/m5 adriamycin, 2.5–3.5 g/m2 5-fluorouracil (5-FU), 20–40 mg/m2 methotrexate or 30–50 mg/m2 cisplatin. At 3 to 4 weeks after the completion of infusional chemotherapy the results were evaluated, based on data from control cystoscopy and sonography. One patient (1.6 %) was free of tumor; an objective response of greater than 50 % reduction in tumor size occurred in 26 (42.7 %) patients; 34 (55.7 %) demonstrated objective responses of less than 50 %. No further increase in tumor size during the management was detected. Hematuria, dysuria and urine infection were controlled and pain was relieved. The use of cytostatics and prolonged iliac artery catheterization did not incur any serious complications.