Cancer Patients Undergoing Chemotherapy Treatment Research Articles

Functional Gelato for cancer patients undergoing chemotherapy treatment

A large amount of organic waste is generated every year, mainly due to food waste, causing negative impacts on the environment. At the same time, cancer incidence and mortality are rapidly growing world-wide and have a great impact on patients' quality of life, especially during chemotherapy treatment. Therefore, the aim of this study was to develop a sustainable gelato with orange peel for cancer patients undergoing chemotherapy. The orange peel gelato developed presented protein content of high biological value, easily digested fat, low glycemic carbohydrate, phenolic and flavonoid content, and antioxidant potential. The orange peel may be used to develop sustainable gelato aiming to increase the intake of bioactive compounds in the general population, control chemotherapy symptoms of oncological patients and to contribute to the environment by reducing the generation of organic waste.

Malnutrition status and related factors in gastric cancer patients undergoing chemotherapy treatment at Ho Chi Minh City oncology hospital

Chemotherapy is one type of systemic treatment for cancer that causes side effects on eating and energy supply, leading to weight loss and malnutrition. Detecting malnutrition early in gastric cancer patients plays a critical role in implementing an effective nutritional regimen that can improve their nutritional status, prevent weight loss, and enhance their ability to withstand and respond to chemotherapy. The cross-sectional study was performed on 95 patients in Ho Chi Minh City Oncology Hospital from October 2021 to June 2022. According to the PG-SGA, MUAC, and BMI, the percentage of malnutrition are 69.5%, 33.7%, and 31.6%, respectively. There is a statistically significant connection between malnutrition rate by PG-SGA with age categories, cancer treatment methods, side effects of chemotherapy, and anemia.

Impact of a food enhancement strategy on food appreciation in cancer patients undergoing chemotherapy treatment

Impact of a food enhancement strategy on food appreciation in cancer patients undergoing chemotherapy treatment

Incidence of Candida Species Biofilms in Pediatric Cancer Patients Undergoing Chemotherapy Treatment

The oral thrush due to biofilms of Candida species is a common infection for the oral cavity of cancer patients undergoing chemotherapy, leading to oral infections. These biofilms, composed of Candida organisms, pose challenges in terms of diagnosis and treatment due to their increased resistance and ability to persist in the oral environment. This study aimed to determine the frequency of Candida species biofilm colonization in the oral cavity of pediatric cancer patients receiving chemotherapy. By examining the incidence of Candida sp. biofilms, this research provides valuable insights into the oral health challenges specific to children with cancer, emphasizing the need for targeted preventive and management strategies to address these infections effectively. In this study, a total of 100 oral cavity swabs were collected, with 50 swabs obtained from cancer patients undergoing chemotherapy and suspected to have oral candidiasis, and the other 50 swabs collected from non-cancer healthy individuals serving as control. All swabs were cultured on Sabouraud Dextrose agar (SDA) media, followed by microscopic examination of positive samples. The API identification candida system was utilized for the identification of Candida species, along with the implementation of biochemical tests to further study the characteristics of the identified species.The findings demonstrated that out of the 50 cancer patients, approximately 47% (23 patients) exhibited positive yeast growth on SDA agar. Among the 50 non-cancer control cases, approximately 30% (15 cases) showed positive growth on SDA agar. Furthermore, using the API candida system, we confirmed the presence of candida species in 25 cases. Candida albicans was identified as the most prevalent species, followed by Candida parapsilosis, Candida krusei, and Saccharomyces cerevisiae, which were detected less frequently.In conclusion, there were a significant increase in Candida species among cancer patients undergoing chemotherapy treatment in comparison to non-cancer control individuals. This finding highlights the impact of chemotherapy on the prevalence of Candida infections in cancer patients, emphasizing the need for heightened attention and appropriate management strategies in this vulnerable population.

Glucocorticoid Receptors Drive Breast Cancer Cell Migration and Metabolic Reprogramming via PDK4.

Corticosteroids act on the glucocorticoid receptor (GR; NR3C1) to resolve inflammation and are routinely prescribed to breast cancer patients undergoing chemotherapy treatment to alleviate side effects. Triple-negative breast cancers (TNBCs) account for 15% to 20% of diagnoses and lack expression of estrogen and progesterone receptors as well as amplified HER2, but they often express high GR levels. GR is a mediator of TNBC progression to advanced metastatic disease; however, the mechanisms underpinning this transition to more aggressive behavior remain elusive. We previously showed that tissue/cellular stress (hypoxia, chemotherapies) as well as factors in the tumor microenvironment (transforming growth factor β [TGF-β], hepatocyte growth factor [HGF]) activate p38 mitogen-activated protein kinase (MAPK), which phosphorylates GR on Ser134. In the absence of ligand, pSer134-GR further upregulates genes important for responses to cellular stress, including key components of the p38 MAPK pathway. Herein, we show that pSer134-GR is required for TNBC metastatic colonization to the lungs of female mice. To understand the mechanisms of pSer134-GR action in the presence of GR agonists, we examined glucocorticoid-driven transcriptomes in CRISPR knock-in models of TNBC cells expressing wild-type or phospho-mutant (S134A) GR. We identified dexamethasone- and pSer134-GR-dependent regulation of specific gene sets controlling TNBC migration (NEDD9, CSF1, RUNX3) and metabolic adaptation (PDK4, PGK1, PFKFB4). TNBC cells harboring S134A-GR displayed metabolic reprogramming that was phenocopied by pyruvate dehydrogenase kinase 4 (PDK4) knockdown. PDK4 knockdown or chemical inhibition also blocked cancer cell migration. Our results reveal a convergence of GR agonists (ie, host stress) with cellular stress signaling whereby pSer134-GR critically regulates TNBC metabolism, an exploitable target for the treatment of this deadly disease.

Lived Experiences of Adult Cancer Patients Undergoing Chemotherapy Treatment at University of Gondar Specialized Hospital, North West Ethiopia, 2021.

Cancer is a global public health problem and it exposes patients with a wide range of physical, psychological, social, and financial problems. Experiences, feelings and thoughts patients have during the course of the disease are the determining factors of disease management. However, most of the studies analyzing cancer patients' experiences have been performed only in high-income countries and the situation for cancer patients in Ethiopia is largely unknown. This study aimed to explore the lived experiences of adult cancer patients undergoing Chemotherapy treatment at University of Gondar specialized Hospital, Ethiopia. A phenomenological study design was conducted among adult cancer patients undergoing chemotherapy treatment at University of Gondar specialized Hospital. In-depth interview was conducted with 13 participants by using purposive sampling technique from March 15 to April 15, 2021. The data collection process facilitated by using semi-structured Amharic interview guide. After transcription and translation, data were analyzed by using a thematic analysis method. The ATLAS.ti software version 9 was used for coding and categorization. The result was reported using narrative and mentioned indirect quotation. The findings of the study revealed four main themes: "psychological discomfort," "functional status impairment," "experiences about chemotherapy treatment," and "coping mechanism." The findings revealed that being diagnosed with cancer is the most traumatic experience and affect all aspect of a patient life. Despite the side effects, the treatment gives hope for a new life. Social and spiritual supports have importance in coping the negative effects of living with cancer. Therefore, health care providers should provide psychosocial care to cancer patients from there diagnosis and in there treatment in dealing with this difficult process.

Quality of Life and Associated Factors Among Adult Cancer Patients Undergoing Chemotherapy Treatment at Amhara National, Regional State, Ethiopia, 2021.

In cancer, quality of life (QoL) is an important patient-reported metric; evaluating how patients feel physically and emotionally while fighting the disease could lead to better treatment. Despite its therapeutic effects, chemotherapy treatment causes a plethora of side effects that can affect QoL. Factors affecting the QoL of cancer patients undergoing chemotherapy treatment in Ethiopia have not been thoroughly investigated. As a result, this study assesses QoL and associated characteristics among adult cancer patients receiving chemotherapy at Amhara Region, Ethiopia in 2021. From February 15 to May 15, 2021, an institutional based cross-sectional study was done in Amhara region. Three hundred fourteen patients were included in the study. The data was gathered using Amharic version of European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ C-30) through a face-to-face interview. Epi Data 4.6 was used to enter the data, which was then exported to SPSS version 23 for statistical analysis. Multivariable logistic regression analysis was used to determine the relationship between independent and dependent variables. The statistical significance was determined by a p-value of less than .05. Cancer patients in Amhara Region had a 44.32 average QoL. Emotional functioning AOR 1.01 (1.0-1.04), social functioning AOR 1.02 (1.01-1.03), nausea and vomiting AOR 0.95 (0.93-0.98), pain AOR 0.95 (0.93-0.98), financial difficulty 0.97 (0.95-0.99), education AOR 4.3 (1.49-12.32), underweight AOR 0.45 (0.24-0.84), > 5th cycle of chemotherapy AOR 4 (1.78-9.11), stage IV cancer AOR 0.21 (0.06-0.71), comorbidity AOR 0.28 (0.14-0.57), anxiety AOR 0.32 (0.12-0.84), and depression AOR 0.29 (0.13-0.63) were all significantly associated with QoL in multivariable logistic regression. Adult cancer patients receiving chemotherapy in the Amhara region had a poor QoL. Emotional functioning, social functioning, nausea and vomiting, pain, financial difficulty, education, body mass index, cancer stage, chemotherapy cycle, comorbidity, anxiety, and depression all had association with QoL. To improve the QoL of cancer patients, QoL assessments, proper symptom management, nutritional support, and integration of psycho-oncology treatment should be considered.

Nutritional Status and Its Determinants among Adult Cancer Patients Undergoing Chemotherapy Treatment at Hawassa University Comprehensive Specialized Hospital, Hawassa, Southern Ethiopia.

Background Malnutrition is a common problem in cancer patients. It has an impact on all aspects of the patient's life such as increasing the risk of infection, treatment toxicity, hospital stay, and health-care costs. Factors influencing the nutritional status of adult cancer patients undertaking chemotherapy treatment in Ethiopia have not been thoroughly investigated. As a result, the purpose of this study is to assess the nutritional status and its determinants among adult cancer patients undergoing chemotherapy treatment at Hawassa University Comprehensive Specialized Hospital. Objectives The objective of this study is to determine the nutritional status and its determinants among adult cancer patients undergoing chemotherapy treatment at Hawassa University Comprehensive Specialized Hospital. Methods A cross-sectional study was conducted among adult cancer patients undergoing chemotherapy treatment at Hawassa University Comprehensive Specialized Hospital Oncology Treatment Center, from January to May 2021. The data were gathered through a face-to-face interview and chart review method. Epi Data 4.6 was used to enter the data, which was then exported to SPSS version 25 for statistical analysis. Multivariable logistic regression analysis was used to determine the association between nutritional status and potential risk factors. A P value less than 0.05 was used to determine statistical significance. Result This study revealed that 48.1% of participants have some level of malnutrition. Lowest wealth index AOR 0.06 (0.016–0.2), food insecurity AOR 0.1 (0.05–0.24), vomiting AOR 0.2 (0.110–.444), poor appetite AOR 0.2 (0.11–0.44), no diarrhea AOR 2.6 (1.34–5.00), and poor functioning AOR 0.3 (0.2–0.54) were significantly associated with good nutritional status. Conclusion and Recommendation. The prevalence of malnutrition among adult cancer patients undergoing chemotherapy treatment at HUCSH was high. Wealth index, food security, poor appetite, diarrhea, and performance status were significantly correlated with the nutritional status of the patients. To improve the patient's nutritional status, economic support, early nutritional screening, and assessment, management of chemotherapy-induced symptoms should be considered.

Clinical and genetic factors associated with self-reported cognitive deficits in women with breast cancer: the “CAGE-Cog” study

BackgroundBreast cancer patients undergoing chemotherapy treatment are at particular risk of experiencing acute cognitive impairment leading to daily challenges in decision-making and reduced quality of life and functional autonomy. The aim was to assess the relationship between clinical and genetic factors and cognitive function in a sample of patients with breast cancer undergoing chemotherapy.MethodsA cross-sectional study was carried out between November 2017 and June 2019 on women (N = 112) treated for breast cancer by intravenous chemotherapy at the oncology outpatient unit of Hôtel-Dieu de France Hospital, Beirut. Patients were evaluated with the 37-item Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog). Other validated scales were also used to assess depression, anxiety, sleep disorders, pain, and fatigue. DNA was obtained by a buccal swab (FTA®technology) for genotyping of different genes (ABCB1, COMT, DRD2, OPRM1, CLOCK, CRY2, and PER2) using the Lightcycler®(Roche).ResultsThe mean age of participants was 56.04 years. Multivariable analysis, taking the four FACT-Cog subscores as the dependent variables, showed that the mean cognitive score decreased with higher depression, anxiety, and insomnia scores. Patients with university education levels had better perceived cognitive abilities than those with primary education. Moreover, carrying the G allele for the OPRM1 polymorphism (c.118A > G;rs197791) was significantly associated with a better cognitive function compared to AA patients (B = 2.05; p = 0.038).ConclusionsA comprehensive oncological care plan should include a personalized assessment of all factors related to cognitive functioning in cancer patients, particularly anxiety and depression, to achieve an optimal patient outcome.

Gambaran Rerata Kelelahan pada Pasien Kanker yang Menjalani Kemoterapi

This study aims to determine the average fatigue score in cancer patients undergoing chemotherapy treatment at RSUP. Dr. M. Djamil Padang. The type of research used is descriptive quantitative. The results of this study indicate that the average value of the respondent's level of fatigue is 28.78, with a minimum value of 19 and a maximum of 37 using 95% CI. If categorized as 66.6% of respondents experienced moderate fatigue, and as many as 33.4% experienced severe fatigue. In conclusion, the average value of the respondents' fatigue level mainly was in the intermediate fatigue category, and almost half of them were extreme fatigue.
 
 Keywords: Cancer, Fatigue, Chemotherapy

Quality of life and factors affecting it in adult cancer patients undergoing cancer chemotherapy in a tertiary care hospital.

BackgroundCancer is the second most common cause of deaths worldwide. Likewise, in India, it is a major health problem, and disease burden is escalating every year. Cancer chemotherapy produces unfavorable effects on the well‐being of an individual. Since the past few years, quality of life (QoL) is considered as the main goal of cancer treatment in the survival of a patient.AimThis current study aimed to assess the QoL and factors affecting it in adult cancer patients undergoing chemotherapy treatment.Methods and ResultsAn analytical, cross‐sectional study was conducted to achieve the objectives, employing the consecutive sampling method. A total of 120 adult (>19 years) patients were recruited from daycare chemotherapy unit of a tertiary care hospital. The data were collected using patient record form and Functional Assessment of Cancer Therapy‐General (FACT‐G), a quality of life (QoL) questionnaire. The overall mean score of quality of life (QoL) was 61.933 ± 5.85502. The domains of functional well‐being and emotional well‐being were most negatively affected after cancer chemotherapy. Education (illiteracy) and occupation (unemployment) were negatively associated with overall quality of life (QoL) of cancer patients on chemotherapy. Adverse drug reactions due to cancer chemotherapy negatively affect the quality of life (QoL) of cancer patients. Education (illiteracy) affects social well‐being domain of cancer patients. Working in the government/private sector has a positive impact on functional well‐being domain of quality of life (QoL).ConclusionThe study findings suggest an overall low quality of life (QoL) among adult cancer patients undergoing chemotherapy at our setup. It has been identified as a stressful therapy, also affecting both psychological and physical well‐being. Poor infrastructure, illiteracy, poverty, and lack of proper treatment facilities at most centres often lead to poor survival outcomes and hence focus has always been on achieving quantity of life rather than quality of life (QoL). This is further complicated due to nonavailability of validated tools in local vernacular, apathy of the treating physicians in the context of QoL aspects and social and cultural factors that are unique to this society. Psycho‐oncology needs to become an integral entity of comprehensive cancer care.

Use of Text Messaging (SMS) for the Management of Side Effects in Cancer Patients Undergoing Chemotherapy Treatment: a Randomized Controlled Trial.

Cancer patients are often not sufficiently oriented to manage side effects at home. Sending text messages with self-care guidelines aimed managing side effects is the main objective of this randomized controlled trial. Patients who started outpatient chemotherapy treatment between March and December 2017 at a hospital in southern Brazil were invited to participate in this study and were allocated to the intervention or control group (ratio 1: 1). Each patient in the intervention group received a daily SMS (short message service) with some guidance on management or prevention of side effects. All text messages were sent to the intervention group patients in an automated and tailored way by our app called cHEmotHErApp. Side effects experienced by patients were verified using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30). Results showed intervention group patients experienced fewer side effects compared to the control group in cycle 1 (p < 0.05), in general. In addition, intervention group experienced less nausea in relation to the control group, in the cycle 1 and cycle 2 (p < 0.05). This study indicate text messaging may be a tool for supporting side effect management in patients receiving chemotherapy. This study was enrolled in ClinicalTrials.gov with the identification number NCT03087422. This research was performed in accordance with the Declaration of Helsinki.Electronic supplementary materialThe online version of this article (10.1007/s10916-020-01663-x) contains supplementary material, which is available to authorized users.

A Systematic Review of Supportive Therapy Effect on Quality of Life in Cancer Patients

Introduction: Supportive therapy is considered an important element in the treatment of cancer patients which is often associated with efforts to overcome life-threatening problems. However, the application of this intervention in clinical practice has not yet been fully carried out. This systematic review summarizes the evidence regarding the effect of supportive therapy in improving the quality of life (QoL) of cancer patients.Methods: The review was performed according to PRISMA guidelines. We searched four electronic databases to identify studies comparing patients who received specific protocol interventions with the control group. The keywords used are "Supportive Therapy" AND "Palliative Supportive Care" AND "Quality of Life" OR "Health Quality" OR "Health-Related Quality of Life".Results: In the study, the average quality of life assessment was carried out at 12 weeks and six months after the intervention. Seven7 of the 15 studies used QLQ-C30 to measure the quality of life of patients with cancer, which was managed to validate and assess the quality of life in patients with cancer, whereas of the 15 studies evaluating results reported, patients reported differences in favor of the intervention group.Conclusion: The overall methodology quality is good. Several comparative studies have evaluated the impact of supportive therapy on the quality of life of cancer patients. The quality of this study is good and the results are acceptable in improving the quality of life of cancer patients undergoing chemotherapy treatment, and palliative care.

Oroxylum indicum extract prevents chemotherapy‐induced cognitive impairment in mice

Chemotherapy‐induced cognitive impairment (CICI) is an emerging concern among cancer patients undergoing chemotherapy treatment. Several mechanisms including neuronal oxidative stress and mitochondrial dysfunction have been proposed as the underlying mechanisms of CICI. While a few synthetic and natural compounds with different mechanisms of action have been proposed for targeting the CICI, their beneficial effects are outweighed by severe adverse effects including reduced efficacy of chemotherapy drugs. Therefore, search for novel and safer neuroprotective avenues to target CICI is needed. We sought to determine whether Oroxylum indicum extract (OIE, Sabroxy®) prevents CICI in a rodent model by suppressing chemotherapy induced neuronal oxidative stress and mitochondrial dysfunction. Male C57BL/6J mice were injected intraperitoneally with saline or doxorubicin (2mg/kg) and cyclophosphamide (50mg/kg) once a week for 4 weeks. While control mice received powdered rodent food alone, OIE treatment group received the powdered rodent food mixed with OIE (250 or 500mg/kg) daily for 4 weeks. After the treatment period, the mice were assessed for cognitive function using novel object recognition, Y‐maze, and Morris water maze analyses. Biochemical assays were performed using brain tissues to determine the underlying mechanisms of CICI. While the chemotherapy treatment impaired the performance of the mice in the novel object recognition, Y‐maze and Morris water maze tests, OIE significantly prevented the chemotherapy impaired performance in these tests. Additionally, OIE treatment prevented the chemotherapy‐induced changes in oxidative stress and mitochondrial dysfunction in the cortex and rest of the brain. Mechanistically, OIE enhanced mitochondrial function and counteracted chemotherapy‐increased reactive oxygen species formation and lipid peroxidation. Furthermore, OIE treatment increased the monoamine oxidase activity in the cortex and rest of the brain. Our results support the hypothesis that neuronal mitochondrial dysfunction induced by doxorubicin and cyclophosphamide treatment is an underlying cause of CICI, and that OIE may be offered as an adjuvant therapeutic strategy to treat CICI.Support or Funding InformationOIE (Sabroxy®) and funding was provided by Sabinsa Corporation.

Analysis of Routine Blood Profile as Data Supporting for Nursing Assessment in Breast Cancer Patients Undergoing Chemotherapy Treatment at the RSU. Dr. Wahidin Sudirohusodo

Chemotherapy is one of the modality therapies given to breast cancer patients to inhibit cancer cell metastases. The side effects of chemotherapy can suppress the hematopoietic system in the bone marrow and progressively affect the patient's prognosis. The aim of study was to analyze routine blood profiles as supporting data in developing nursing care for breast cancer patients undergoing chemotherapy at the RSU. Dr. Wahidin Sudirohusodo Makassar, Indonesia, from June to September 2018. This research was a descriptive research with descriptive survey method. This research was conducted at the RSU Surgical Polyclinic. Dr. Wahidin Sudirohusodo. The sampling technique used was Non-Probability Sampling a purposive sampling method. The participants of this study were patients with breast cancer who undergo chemotherapy treatment with a number of samples that meet the inclusion criteria as many as 32 people. of the 17 routine blood components which were assessed as one of the investigations in 32 patients were found to be 4 abnormal components, red blood cells mean ± SD (3.99 10^6/ uL ± 0.51), hemoglobin mean ± SD (11.18 gr/l ± 1.09), hematocrit mean ± SD (34.96% ± 3.96), and mean ± SD monocyte (15,043 10^3/uL ± 8.95). due to metastasis and side effects of chemotherapy treatment decrease red blood cells, hemoglobin, hematocrit, and increase in specific immune response through increase of monocytes indicator that performing phagocytosis.

THE INFLUENCE OF COFFEE MOUTHWASH ON ORAL MUCOSITIS DEGREE ON PATIENTS WITH CHEMOTHERAPY

Cancer patients undergoing chemotherapy treatment will experience various effects. One effect is a disruption in the oral cavity that is often known as oral mucositis. Oral mucositis is a collection of symptoms that can be observed by nurses. Side effects of oral mucositis can cause further infections in the oral cavity, decreased appetite, and will later affect the quality of life. The purpose of this study was to determine the degree of oral mucositis that occurs in patients undergoing chemotherapy at PKU Muhammadiyah Hospital in Yogyakarta before and after using coffee mouthwash. This research is a quasi study. Sampling was done with a purposive sampling technique with a sample size of 15. The results showed that The degree of oral mucositis mostly experienced by chemotherapy patients in this study was grade 1. There was a decrease in the degree of oral mucositis in patients after giving coffee mouthwash. The average degree of oral mucositis after the use of coffee mouthwash is 0.40. There was a significant change between before and after giving coffee mouthwash with a p-value

Relationship of family support and coping strategies with anxiety in cancer patients undergoing chemotherapy

Cancer patients undergoing chemotherapy generally have many side effects that cause physiological coping strategies to be able to adapt and psychological side effects such as anxiety. Social interaction in the form of social support obtained from family plays a role in adaptation to cancer patients. This study aims to examine the relationship of family support and coping strategies with anxiety. The samples were 102 cancer patients undergoing chemotherapy at the Hospital Dr. Pirngadi Medan. (1) The family support received cancer patients, more than half receive family support were medium as many as 54 people (53.0%). Coping strategies that use strategies Problem Focused Coping (PFC), more than half strategy PFC were medium as many as 56 people (54.9%). Anxiety experienced cancer patients, more than half anxiety was medium as many as 53 people (51.9%), (2) There is a negative relationship between support families received with experienced anxiety (r =-0.646; p<0.05), meaning that the higher the family support received by the diminishing anxiety experienced by cancer patients who are chemotherapy, there is a negative relationship with the strategic PFC use of anxiety experienced by cancer patients which chemotherapy (r =-0.545; p<0.05), meaning that the higher use of PFC strategy then decreased anxiety experienced by patients with cancer chemotherapy. Based on the results of this study concluded that there is a relationship of family support received and the use of PFC strategy with anxiety in cancer patients whose chemotherapy. The results of this study can be input to health care to help improve family support received and the use of strategy PFC with decreased anxiety in cancer patients undergoing chemotherapy treatment.

Nutritional assessment and food intake of cancer patients on chemotherapy treatment at day hospital

Rationale: The aim of this study was to assess the nutritional status of cancer patients undergoing chemotherapy treatment and their food intake through the analysis of the food they have wasted.

Investigating the Effects of the Progressive Muscle Relaxation-Guided Imagery Combination on Patients with Cancer Receiving Chemotherapy Treatment: A Systematic Review of Randomized Controlled Trials

Previous systematic reviews indicate that progressive muscle relaxation (PMR) and guided imagery (GI) are both effective interventions to decrease the psychological impact and to alleviate the adverse events in cancer patients undergoing chemotherapy treatment. To date, no review studies have investigated the effectiveness of a combination of PMR and GI. To systematically review the current state of knowledge regarding the effects of the PMR-GI combination on cancer patients receiving chemotherapy. A search for relevant records was carried out in four electronic databases (AMED, Cochrane Library, Pubmed and Scopus). After removing the duplicates 342 publications were screened and 71 were considered as potentially relevant. The flow of information of this study was in line with the PRISMA statement. Original articles investigating the application of both PMR and GI through a randomized trial on patients receiving chemotherapy were included. Those using PMR or GI alone and those combining other techniques together with PMR and GI were excluded. The trials' quality was assessed using the Jadad Scale. Eight papers reporting the results of seven independent trials were finally included. All of them included only breast cancer patients, apart from a single trial using a mixed sample of breast and prostate cancer patients. Seven of the included trials reported beneficial effects on mental state (mood, anxiety, and depression) and on toxicity (nausea and vomiting). Three trials reported an effect on biomarkers (heart rate, blood pressure, cortisol, and immunity). Four trials scored three of five points on the Jadad Scale, two trials scored two points and a single trial scored zero. Independent trials indicate that the PMR-GI combination is an effective way to tackle the impact of nausea and vomiting and to improve patients' mental state. However, studies involving other types of primary tumors would be useful because seven of the eight clinical trials only included breast cancer patients. Future research on the identification of potential effects on disease-related parameters (e.g., cytokines and disease-recurrence) and on patient survival is highly needed.

Maintenance of Postural Steadiness throughout Chemotherapy Treatment

Chemotherapy negatively affects postural steadiness of cancer patients, contributing to an increased risk of falling. Physical activity improves postural steadiness, and has been shown to reduce toxic effects of chemotherapy such as peripheral neuropathy and vestibular dysfunction; two known causes of decreased postural steadiness. PURPOSE: To determine whether postural steadiness improves in cancer patients undergoing chemotherapy following 12-weeks of exercise. METHODS: Cancer survivors (n = 25; mass = 79.0 ± 22.6 kg; ht = 1.66 ± 0.08 m; age = 61.3 ± 10.0 yrs) receiving chemotherapy participated in this study. Postural stability was assessed prior to and following a 12-week individualized exercise intervention that included cardiovascular, muscular strength, flexibility, and balance training. In both pre- and post- measures, center of pressure (COP) data were collected (1000 Hz) for 10 seconds in four conditions: rigid surface eyes open (RSEO), rigid surface eyes closed (RSEC), compliant surface eyes open (CSEO), and compliant surface eyes closed (CSEC) using the Bertec BalanceScreener™ (Bertec Corporation, Columbus Ohio). Root-mean square (RMS), mean velocity (VEL), 95% confidence ellipse area (95CE), and mean frequency (FREQ) were investigated (Prieto et al., 1996). A MANOVA with repeated measures (p < 0.05) was used to identify main effects between pre- and post-training assessments. RESULTS: From pre- to post- assessments mediolateral RMS decreased significantly for all conditions (p < 0.04 across all comparisons; RSEO by 35%, RSEC by 45%, CSEO by 43%, CSEC by 43%). A significant decrease was also observed in FREQ between pre- and post- assessments (p < 0.044 across all comparisons; RESEO by 29%, RSEC by 29%, CSEO by 31%, CSEC by 23%). No other variables changed significantly between pre and post assessments (p > 0.05). CONCLUSIONS: Postural stability in the mediolateral direction was improved in cancer patients after 12-weeks of individualized exercise training. In addition, there was evidence of increased postural control based on an increased mean frequency of the COP trajectory after training. These results suggest that exercise training is beneficial to postural stability in cancer patients undergoing chemotherapy treatment.