Li, A.M., Miao, J.H., Liu, H., Ma, Y.Z., & Sun, Z.C. (2015). Drug-induced skin toxicity and clinical nursing of VitK cream on colorectal cancer patients. Pakistan Journal of Pharmaceutical Sciences, 28(Suppl. 4), 1499–1503. Retrieved from http://connection.ebscohost.com/c/articles/109346621/drug-induced-skin-…
To discuss the affect of 0.1% VitK1 cream on cetuximab-induced skin toxicity in patients with colorectal cancer
Routine nursing was implemented for all patients. The experimental group also received VitK1 cream smeared on the face, neck, chest, back, and nail edges three times on the day of cetuximab infusion at 9 am, 3 pm, and 9 pm.
Dry skin, itchy skin, acne-like rash, skin dehiscence, and paronychia were evaluated in both groups after four cycles of cetuximab therapy (56 days) using the Common Toxicity Criteria, version 3.0, assessment scale. No grade 4 results were observed in either group. No significant differences existed in acne-like rash, paronychia, or dehiscence in either group. A significant difference existed in skin dryness and itch, favoring the experimental group. All patients had skin toxicities. No reports of discomfort were received from the experimental group, receiving VitK1 cream.
The VitK1 cream appeared to reduce skin dryness and itching.
Reducing or improving the existence of skin toxicities from cetuximab therapies allows patients to stay on therapies without an extreme decrease in quality of life. VitK1 cream had not been available in China; therefore, this study used the compounding of this cream with specific directions. Safeguarding the production of emollients and creams from compounding pharmacies has met recent scrutiny. Nurses need to ensure consistency with medical interventions when able. Providing for symptom management options, such as VitK1 cream, should promote patient adherence to therapy and improve outcomes. Few interventions have been shown effective for the prevention and management of skin toxicities. Further research is needed.
Li, N.L., Yu, B.L., Tseng, S.C., Hsu, C.C., Lai, W.J., Hsieh, P.F., . . . Chen, C.M. (2011). The effect on improvement of recovery and pain scores of paravertebral block immediately before breast surgery. Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists, 49(3), 91–95.
To investigate whether paravertebral block (PVB) implemented immediately before breast cancer surgery can affect pain and emesis and improve the quality of life of patients after breast cancer surgery
Consecutive patients received general anesthesia or PVB plus anesthesia before breast cancer surgery. Researchers compared the pain scores of both groups of patients at one hour and at six hours postoperatively and at midmorning of postoperative day 1 (POD1). At one hour, patients were observed in the postanesthesia care unit for one hour, where they were provided with analgesics to achieve a pain score of less than 4 on the Numeric Rating Scale (NRS). Choices of analgesic for patients with moderate to severe pain included intravenous morphine, 3–6 mg, and intravenous ketorolac, 30 mg. Patients with mild to moderate pain (a score of 4–7) received acetaminophen, 500–1000 mg, at the patient’s request. At six hours after surgery and on POD1, pain scores were recorded with patients at rest and during movement. Movement consisted of moving the arm until the arm and body were at a 90-degree angle. The amount of postoperative narcotics and the time to first request for pain medication was recorded.
Intervention study
After breast cancer surgery, PVB plus GA may provide better pain relief than does GA alone. The researchers observed higher QoR scores and less antiemetic use in the GA + PVB than in the GA group.
PVB may be a useful tool to decrease pain after breast cancer surgery and to reduce PONV, but more research is needed before researchers can draw definitive conclusions.
Li, X.M., Yan, H., Zhou, K.N., Dang, S.N., Wang, D.L., & Zhang, Y.P. (2011). Effects of music therapy on pain among female breast cancer patients after radical mastectomy: Results from a randomized controlled trial. Breast Cancer Research and Treatment, 128(2), 411–419.
To explore the effects of music on pain, in patients with breast cancer, after radical mastectomy
The intervention group consisted of 60 patients who received MP3 players with headphones. The players were loaded with 202 selections of music; the music was of four types. Patients were instructed to listen to music, during the postoperative period and two chemotherapy periods (18.9 days, SD = 7.1 days), for 30 minutes twice a day, between 6 and 8 a.m. and between 9 and 11 p.m. While patients were in the hospital, a researcher encouraged adherence to the schedule. After the patients were discharged, a researcher used the telephone to encourage adherence. The control group consisted of 60 patients who were not blinded regarding the music intervention. All patients took four tests (one at baseline and three postrandomization). Pain levels were assessed before the surgery, on the first preoperative day; on the day before disharge; and upon admission for the first and second chemotherapy sessions. Cycle lengths for chemotherapy were 14, 21, or 28 days. The assesment one day prior to discharge was known as the first post-test. The assesments before the chemotherapy sessions were known as the second and third post-tests, respectively.
Clinical applications: late effects and survivorship
Randomized controlled trial
Both groups reported improvement in all areas of assessment from baseline through the third post-test. At the first post-test (day prior to discharge), the difference between the two groups was –2.38% in favor of music (p < 0.05). By the third post-test, the differences had decreased to –1.87 (p < 0.05).
Findings show that listening to music was associated with reduction in pain severity.
This study should be refined to determine and differentiate types and quality of pain and to consider the fact that pain typically decreases during the postoperative period. The differences noted between groups may indicate that music could play a role in reducing the pain that patients experience in the period immediately following surgery.
Li, M., Kennedy, E.B., Byrne, N., Gerin-Lajoie, C., Katz, M.R., Keshavarz, H., . . . Green, E. (2016). Management of depression in patients with cancer: A clinical practice guideline. Journal of Oncology Practice, 12, 747–756.
RESOURCE TYPE: Evidence-based guideline
PHASE OF CARE: Multiple phases of care
Several clinical practice guidelines and two meta-analyses of 21 RCTs and some integrative reviews were included. Guideline quality was assessed with the AGREE II instrument, and a systematic review quality was assessed with the Assessment of Multiple Systematic Reviews (AMSTAR) tool.
Some recommendations were consensus-based.
A quick reference algorithm for the initial management of depression in patients with cancer and the stepped care model for delivering care interventions depending on the severity of depression are great tools nurses and other healthcare professionals can use in their clinical practice while managing depression.
Li, L., Yuan, L., Chen, X., Wang, Q., Tian, J., Yang, K., & Zhou, E. (2016). Current treatments for breast cancer-related lymphoedema: A systematic review. Asian Pacific Journal of Cancer Prevention, 17, 4875–4883.
STUDY PURPOSE: To summarize the effects of different breast cancer–related lymphedema (BCRL) treatments
TYPE OF STUDY: Systematic review
PHASE OF CARE: Multiple phases of care
APPLICATIONS: Elder care
Based on the study limitations, the most effective treatment for BCRL could not be identified, because of varying quality and small sample sizes with high risk of bias. Different treatments for BCRL might reduce volume, but effects and well designed randomized, controlled trials with reported placebo effects are needed.
CDT remains the standard of care for the treatment of lymphedema. Complementary therapies may be safe, but more well designed randomized, controlled trials are needed.
Livingston, P.M., Craike, M.J., Salmon, J., Courneya, K.S., Gaskin, C.J., Fraser, S.F., . . . ENGAGE Uro-Oncology Clinicians' Group. (2015). Effects of a clinician referral and exercise program for men who have completed active treatment for prostate cancer: A multicenter cluster randomized controlled trial (ENGAGE). Cancer, 121, 2646–2654.
To determine the effectiveness of referrals from nurses or medical providers to a 12-week exercise program compared to usual care for the outcome of self-reported physical activity among men after completion of active prostate cancer treatment.
Participants were randomly assigned to the intervention or to the control: The intervention was a 12-week exercise program that included two gym sessions and one home-based session per week beginning 3–12 months after active treatment for prostate cancer was completed. Intervention participants were given a referral slip stating that the clinician recommended participation in the exercise program. The 12-week exercise program was at a local community gym, supervised by exercise physiologists, and followed exercise guidelines for cancer survivor exercises by the American College of Sports Medicine and the Exercise and Sport Science Australia. The exercise intervention also used social cognitive theory. The control group had usual care, which included a recommendation to exercise.
Intervention participants indicated positive reports about clinician referral influencing participation in the exercise program. Prostate cancer-related anxiety declined more in the control group (d = 0.42, p = 0.02). Effects on depression were not significant, but there was greater decline in the intervention group (d = -0.35, p = 0.06). There was no significant change in the cognitive subscale of the QOL measure. A higher percentage of those in the intervention group reported achievement of aerobic exercise guidelines.
Clinician referral from doctor or nurse care provider influences decision to participate in a tailored exercise program among men who have completed prostate cancer treatment. Exercise program supervision helps to ensure that exercise is tailored to each individual, risk of injury is reduced, and potential for adherence is improved.
Nurse clinicians may influence participation in an exercise program for men who have completed radiation, chemotherapy, or surgery for prostate cancer, touting benefits of improved physical activity, cognition, QOL, and other health outcomes, including significant reduction of anxiety self-report and moderate reduction of depression symptoms. A specific referral or prescription for exercise may enhance exercise participation and activity that meets current national recommendations.
Liu, Y., Zhang, J., Teng, Y., Zhang, L., Yu, P., Jin, B., … Li, Z. (2009). Thalidomide improves prevention of chemotherapy-induced gastrointestinal side effects following a modified FOLFOX7 regimen: Results of a prospective randomized crossover study. Tumori, 95, 691–696.
To evaluate the safety and effectiveness of thalidomide plus ramosetron and dexamethasone in controlling delayed chemotherapy-induced GI side effects following a moderately emetogenic FOLFOX7 regimen
Patients who were chemotherapy-naïve and scheduled to receive a moderately emetogenic FOLFOX7 regimen were randomized to two groups. Group A-B received ramosetron plus dexamethasone on day 1 in the first cycle. Group B received thalidomide twice a day on days 2-5 in cycle 1. Group B-A received the same drugs in reverse sequence.
All patients received ramosetron. All patients were permitted to receive a rescue dose of 10 mg dexamethasone IV if vomiting occurred more than two times within 24 hours.
The study was conducted at a single site at the China Medical University in China.
All patients were in active treatment.
This was a prospective, randomized, crossover-controlled study.
Neither palonosetron or aprepitant are commercially available in China. Thalidomide was associated with greater complete response of delayed nausea and delayed emesis. No significant adverse effects were noted with thalidomide.
Thalidomide has some efficacy in controlling delayed chemotherapy-induced nausea and vomiting (CINV) in patients receiving FOLFOX7 therapy in combination with other antiemetic regimens.
Liu, C., Hsiung, P., Chang, K., Liu, Y., Wang, K., Hsiao, F., . . . Chan, C. (2008). A study on the efficacy of body-mind-spirit group therapy for patients with breast cancer. Journal of Clinical Nursing, 17, 2539–2549.
To examine the effects of body-mind-spirit group therapy on anxiety, depression, and holistic well-being among women with breast cancer
Patients in the control group received standard care. Patients in the experimental group received standard care plus 10 sessions of weekly group therapy, 180 minutes per session. Therapy integrated concepts and practices, such as qigong exercises of vital energy, massage, meditation, positive thinking, group mutual support, long-term survivors’ sharing, songs, home assignments, and exercises. These activities were based on traditional Chinese medicine, the Eastern philosophies of Taoism and Confucianism, and the practice of Buddhism. The goal of the activities were to manage physical, psychosocial, and spiritual distress. Sessions included qigong exercises provided for 20 minutes each week by a qigong master and body-mind-spirit group assignments that included sharing and singing. The qigong master facilitated the first 20 minutes of each session. Then the primary investigator and co-investigators, working as mental health nurses, managed the rest of each session. Co-investigators held a 90-minute focus group interview after the last group therapy session. They conducted the interview in Mandarin and transcribed it. A bilingual researcher translated the transcription.
A coinvestigator implemented the randomization so that the patients, physician, and primary investigator were blinded to the randomization process. The primary investigator conducted groups after randomization and completion of initial surveys. Participants completed a baseline questionnaire after informed consent. After two months of intervention, participants completed a postintervention questionnaire.
Mixed-methods design incorporating a randomized controlled trial and focus-group interviews
Culturally sensitive body-mind-spirit group therapy reduced anxiety among outpatients with breast cancer.
Mental health nurses who provide group therapy for patients with cancer could help to enhance quality of care in psycho-ontological nursing. Further research with older and younger women — as well as with patients in stages I, III, and relapse — are suggested.
Liu, J., & Huang, X.E. (2014). Efficacy of bifidobacterium tetragenous viable bacteria tablets for cancer patients with functional constipation. Asian Pacific Journal of Cancer Prevention, 15, 10241–10244.
To determine the efficacy and tolerance of using a probiotic to treat functional constipation in patients receiving chemotherapy
All patients received chemotherapy appropriate for their diagnosis. Patients were divided into two groups. The treatment group received, in addition to chemotherapy, Bifidobacterium tetragenous viable bacteria tablets three times a day for four weeks.
There was significant improvement of functional constipation (p < 0.05) with the use of four Bifidobacterium tetragenous viable bacteria tablets.
Probiotics may be beneficial for some patients receiving chemotherapy who suffer from functional constipation.
Additional research on the use of probiotics and a variety of chemotherapy regimens in patients with functional constipation needs to be completed.
Liu, M.Y., & Huang, X.E. (2015). Effects of analgecine on oxaliplatin-induced neurotoxicity in patients with gastrointestinal cancer. Asian Pacific Journal of Cancer Prevention, 16, 4465–4468.
To assess the safety and effectiveness of analgecine for the control of oxaliplatin-induced neurotoxicity
Patients scheduled to receive oxaliplatin as adjuvant or palliative therapy were divided into experimental and control groups. Neurotoxicity was measured at four and eight weeks/cycles. Timing and dosage of the experimental agent were not described.
PHASE OF CARE: Active antitumor treatment
Parallel group trial
Common Criteria Criteria for Adverse Events (CTCAE), version 3.0
The occurrence rate of toxicity was lower in the experimental group at four (p = 0.043) and eight (p = 0.05) weeks, and those in the experimental group generally had lower grades of toxicity.
Analgecine may have some role as a neuroprotective agent for patients receiving oxaliplatin; however, well designed research is needed to explore this.
There is very limited evidence for interventions that can prevent or reduce neurotoxic side effects of chemotherapy. Additional research for analgecine is needed to determine if it has any role in this area.