Side Effects Of Chemotherapy In Patients Research Articles

An Overview of Chemotherapy Side Effects on Patients with Prostate Cancer, Bladder Cancer, and Testicular Cancer at Haji Adam Malik General Hospital Medan from 2020-2022

Background: Chemotherapy is an alternative anticancer therapy. In general, side effects that will occur are hair loss, decreased appetite, weight loss, headache, fatigue, mouth ulcer, diarrhea, nausea and vomiting, constipation, nosebleed, skin rash, painful urination, muscle pain, and heartburn.Objective: To identify the most and least chemotherapy side effects in patients with prostate cancer, bladder cancer, and testicular cancer.Methods: The method used is descriptive quantitative with a total sampling technique. The study population was patients with prostate cancer, bladder cancer, and testicular cancer at Haji Adam Malik General Hospital Medan in 2020-2022, with a total of 38 people. Results: From the calculation of the frequency distribution, the sequence of side effects of prostate cancer chemotherapy was hair loss (94.1%), fatigue (88.2%), decreased appetite (76.5%), nausea and vomiting (70,6%), constipation (58.8%), muscle pain (47.1%), diarrhea (47.1%), weight loss (41.2%), skin rash (35.5%), painful urination (35.3%), headache (23.5%) %), mouth ulcer (23.5%), and heartburn (17.6%). Bladder cancer namely, fatigue (100%), decreased appetite (90.9%), nausea and vomiting (90.9%), muscle pain (63.6%), weight loss (63.6%), painful urination (54.5%), hair loss (45.4%), headache (45.4%), diarrhea (45.4%), constipation (45.4%), heartburn (36.4%), mouth ulcer (18.2%), and skin rash (18.2%). Testicular cancer namely, hair loss, decreased appetite, nausea and vomiting (100%), muscle pain (80%), weight loss (70%), fatigue (70%), heartburn (60%), mouth ulcer (50%), constipation (50%), headache (40%), skin rash (40%), painful urination (40%), and diarrhea (30%).Conclusion: Most to the least chemotherapy side effects are studied in patients with prostate cancer, bladder cancer, and testicular cancer. Keywords: Bladder Cancer, Chemotherapy, Prostate Cancer, Side Effects, Testicular Cancer

The Association between Dietary Patterns and Chemotherapy Side Effects in Patients with Breast Cancer (BrCa)

This study aimed to determine the relationship between food pattern and dietary intake before and during chemotherapy with the severity of gastrointestinal side effects, cancer-related fatigue, and chemotherapy-induced pain. This study was performed on 204 patients with breast cancer who were undergoing chemotherapy. Dietary pattern was collected by food frequency questionnaire and dietary intake during chemotherapy using a 24-hour food recall questionnaire. The severity of chemotherapy side effects including nausea, vomiting, constipation, diarrhea, CRF, and pain was also assessed by valid questionnaires. The relationship between dietary pattern and mean score of chemotherapy side effects was calculated using linear regression analysis. Three dietary patterns were extracted from the participants. After adjusting the effect of all possible confounders, no significant relationship was found between the dietary pattern one year before the start of treatment and the mean of chemotherapy side effects severity. Although the mean of daily energy intake with the severity of nausea and vomiting (r = −0.258, P-value <0.01), constipation, fatigue, and pain have a significant inverse relationship. Nutrition education and following a healthy diet are needed to reduce the severity of chemotherapy side effects during this period.

\u201cChronic fatigue, quality of life and long-term side-effects of chemotherapy in patients treated for non-epithelial ovarian cancer: national case-control protocol study of the GINECO-Vivrovaire rare tumors INCa French network for rare malignant ovarian tumors\u201d

BackgroundGerm cell tumors and sex cord stromal tumors are rare cancers of the ovary. They mainly affect young women and are associated with a high survival rate. The standard treatment mainly involves conservative surgery combined with chemotherapy [bleomycin, etoposide and cisplatin (BEP)] depending on the stage and the prognostic factors, as for testicular cancers. As reported in testicular cancer survivors, chemotherapy may induce sequelae impacting quality of life, which has not yet been evaluated in survivors of germ cell tumors and sex cord stromal tumors. The GINECO-VIVROVAIRE-Rare tumor study is a two-step investigation aiming to assess i) chronic fatigue and quality of life and ii) long-term side-effects of chemotherapy with a focus on cardiovascular and pulmonary disorders.MethodsUsing self-reported questionnaires, chronic fatigue and quality of life are compared between 134 ovarian cancer survivors (cancer-free ≥2 years after treatment) treated with surgery and chemotherapy and 2 control groups (67 ovarian cancer survivors treated with surgery alone and 67 age-matched healthy women). Medical data are collected from patient records. In the second step evaluating the long-term side-effects of chemotherapy, a subgroup of 90 patients treated with chemotherapy and 45 controls undergo the following work-up: cardiovascular evaluation (clinical examination, non-invasive cardiovascular tests to explore heart disease, blood tests), pulmonary function testing, audiogram, metabolic and hormonal blood tests. Costs of sequelae will be also assessed. Patients are selected from the registry of the INCa French Network for Rare Malignant Ovarian Tumors, and healthy women by the ‘Seintinelles’ connected network (collaborative research platform).DiscussionThis study will provide important data on the potential long-term physical side-effects of chemotherapy in survivors of Germ Cell Tumors (GCT) and Sex Cord Stromal Tumors (SCST), especially cardiovascular and pulmonary disorders, and neurotoxicity. The identification of long-term side-effects can contribute to adjusting the treatment of ovarian GCT or SCST patients and to managing follow-up with adapted recommendations regarding practices and chemotherapy regimens, in order to reduce toxicity while maintaining efficacy. Based on the results, intervention strategies could be proposed to improve the management of these patients during their treatment and in the long term.Trial registrationThis trial was registered at clinicaltrials.gov: 03418844, on 1 February 2018.This trial was registered on 25 October 2017 under the unique European identification number (ID-RCB): 2017-A03028–45.Recruitment Status: Recruiting.Protocol versionVersion n° 4.2 dated from Feb 19, 2021.Trial sponsorCentre François Baclesse, 3 avenue du Général Harris, F-14076 Caen cedex 05, France.

Impact of skeletal muscle mass in patients with recurrent gastric cancer

BackgroundWe retrospectively examined the relationship among skeletal muscle mass index (SMI), prognosis, and chemotherapy side effects in patients with recurrent gastric cancer (RGC).MethodsSixty-seven patients who developed recurrence after undergoing curative gastrectomy for gastric cancer at Tottori University Hospital and received palliative chemotherapy were included in this study. Pretreatment computed tomography was performed to measure the skeletal muscle mass (SMM) and cross-sectional SMM at the third lumbar vertebra. We focused on haematologic toxicity (neutropenia, thrombocytopenia, and anaemia), febrile neutropenia, and gastrointestinal toxicity (diarrhoea, vomiting, and stomatitis) as the side effects of chemotherapy.ResultsMedian SMIs for males and females (43.9 and 34.7 cm2/m2, respectively) were used as cutoff values. The patients were classified into high (SMIHigh; n = 34) and low SMI groups (SMILow; n = 33). The SMILow group included more patients treated with monotherapy (P = 0.016) compared with the SMIHigh group, had a significantly lower number of chemotherapy lines (P = 0.049), and had a significantly higher incidence of grade 3 or 4 side effects (P = 0.010). The median survival rate was significantly higher in the SMIHigh group (17.8 vs 15.8 months; P = 0.034). In the univariate analysis, body mass index, SMI, histological type, and prognostic nutritional index were identified as prognostic indicators. The multivariate analysis identified SMI (P = 0.037) and histological type (P = 0.028) as independent prognostic factors.ConclusionThe incidence of grade 3 or 4 side effects was significantly higher in patients with SMILow RGC. SMI was a useful prognostic marker of RGC.

The Effect of Peer Education on Management of Chemotherapy Side Effects in Patients with Cancer.

Background:Chemotherapy drugs may have numerous side effects for patients. Thus, this study was conducted with the aim to determine the effect of peer education on the management of chemotherapy side effects in patients with cancer.Materials and Methods:This randomized, controlled trial was conducted on 80 patients with cancer in 2018. They were allocated to two groups of intervention and control. The self-care education on chemotherapy side effects was provided by the peers to the individuals in the intervention group. The data collection tools included a demographic characteristics form and the Self-Care Diary (SCD). Data analysis was performed using independent t-test and Chi-square test in SPSS software.Results:The results showed that the mean scores of the effectiveness of self-care behaviors were significantly higher in the intervention group compared to the control group after the intervention (p < 0.05).Conclusions:Peer education is recommended for cancer patients undergoing chemotherapy.

Incidence and severity of self-reported chemotherapy side-effects in patients with hematolymphoid malignancies: A cross-sectional study

Background: Chemotherapy is an indispensable part of the treatment regimen for most cancer types. However, it is difficult to predict the chemotherapy-related side effects in patients with cancer. Objectives: In this study, we aimed to assess the incidence and severity of self-reported chemotherapy-related side effects in patients with cancer. Materials and Methods: This cross-sectional study, with a univariate descriptive design was conducted on patients with blood cancers, including leukemia, lymphoma, and myeloma. Patients who were admitted to the hemato-oncology department of our tertiary care center in northern India to receive the second cycle of chemotherapy were interviewed. Patients were interviewed regarding the symptoms they experienced after the first cycle of chemotherapy using the chemotherapy symptom assessment scale. The incidence of the chemotherapy side-effects experienced by the patients after the first cycle of chemotherapy was assessed, and the most severe and common symptoms that led to botheration in the patients receiving chemotherapy were identified. Results: A total of 100 patients were enrolled in the study. Majority of the patients were men and aged between 41 and 50 years, with a diagnosis of lymphoma and an Eastern Cooperative Oncology group performance status of 1. The five most common severe symptoms reported by the patients after receiving the first cycle of chemotherapy were nausea, vomiting, constipation, pain, and shortness of breath. The three symptoms that led to maximum botheration in the patients after the first cycle of chemotherapy were nausea, vomiting, and diarrhea. The five symptoms that caused the least botheration in the patients were constipation, pain, change in temperature, problems with the skin, and problems with the mouth. Conclusion: The most common symptom experienced by the patients is nausea (93%), which is also the most commonly experienced severe symptom (80%). Identifying these symptoms and their severity can help in planning symptom management more comprehensively. Moreover, planned health education for patients with cancer can help us provide better evidence-based quality care to those receiving chemotherapy.

Anticancer Properties of Inositol Hexaphosphate and Inositol: An Overview.

Inositol hexaphosphate (IP6) and its parent compound myo-inositol (Ins) are active compounds from rice and other grains, with a broad spectrum of biological activities important in health and diseases. However, the most striking is the anticancer effect of IP6 and Ins that has been actively investigated during the last decades. A consistent and reproducible anticancer action of IP6 has been demonstrated in various experimental models. IP6 reduces cell proliferation, induces apoptosis and differentiation of malignant cells via PI3K, MAPK, PKC, AP-1 and NF-kappaB. Very few clinical studies in humans and case reports have indicated that IP6 is able to enhance the anticancer effect of conventional chemotherapy, control cancer metastases, and improve quality of life. Reduced burden of chemotherapy side-effects in patients receiving IP6 alone or in combination with Ins has been reported. Because of the highly promising preclinical and emerging clinical data, large clinical trials and further mechanistic studies are warranted.

Remote real-time monitoring for chemotherapy side-effects in patients with blood cancers

BackgroundChemotherapy for patients with blood cancers commonly results in distressing/potentially life-threatening toxicities/side-effects. Patients receiving outpatient chemotherapy are therefore responsible for monitoring/management of complex side-effects between clinical visits. The quality and safety of care in this patient group may be improved by a remote real-time Telehealth system which reports patient data directly to the clinical treatment team. AimThis study evaluated the acceptability, useability and feasibility of a real-time, remote Telehealth monitoring/management system. MethodsPatients with blood cancers receiving chemotherapy, who consented to study participation, were trained to use the Telehealth application on a smart-phone. Patients entered side-effect data for one-cycle of chemotherapy. Data exceeding pre-set thresholds triggered alerts (via Short-Message-Service) to clinic nurses for actioning. At study conclusion patients completed semi-structured interviews about the experience of using the Telehealth system which were: recorded, transcribed and; underwent content analysis. FindingsSeventeen patients used the system and completed the interview. The system was easy-to-use and fitted with daily routines. Perceived benefits included: reassurance; empowerment; increased health-awareness/adherence to self-care; promotion of timely clinical intervention and improved recall of side-effects and communication with clinicians/family/friends. The system was more beneficial to those experiencing more numerous side-effects. Suggested changes included: language clarification and additional side-effect monitoring. DiscussionUse of a revised system was supported as an adjunct to current practice. Future use of a similar Telehealth system would enhance current pre-chemotherapy education, patient self-care adherence, alongside improved side-effect communication. ConclusionAdditional randomised controlled trials are required to elucidate quantitative improvements in health outcomes prior to clinical introduction.

MON-P067: Radiation and Chemotherapy Side Effects in Patients With Head-Necktumors Receivingearly Nutrition Supporttherapy

MON-P067: Radiation and Chemotherapy Side Effects in Patients With Head-Necktumors Receivingearly Nutrition Supporttherapy

The Patient Remote Intervention and Symptom Management System (PRISMS) – a Telehealth- mediated intervention enabling real-time monitoring of chemotherapy side-effects in patients with haematological malignancies: study protocol for a randomised controlled trial

BackgroundOutpatient chemotherapy is a core treatment for haematological malignancies; however, its toxicities frequently lead to distressing/potentially life-threatening side-effects (neutropenia/infection, nausea/vomiting, mucositis, constipation/diarrhoea, fatigue). Early detection/management of side-effects is vital to improve patient outcomes, decrease morbidity and limit lengthy/costly hospital admissions. The ability to capture patient-reported health data in real-time, is regarded as the ‘gold-standard’ to allow rapid clinical decision-making/intervention. This paper presents the protocol for a Phase 3 multi-site randomised controlled trial evaluating a novel nurse-led Telehealth intervention for remote monitoring/management of chemotherapy side-effects in Australian haematological cancer patients.Methods/DesignTwo hundred and twenty-two patients will be recruited from two hospitals. Eligibility criteria include: diagnosis of chronic lymphocytic leukaemia/Hodgkin’s/non-Hodgkin’s lymphoma; aged ≥ 18 years; receiving ≥ 2 cycles chemotherapy. Patients will be randomised 1:1 to either the control or intervention arm with stratification by diagnosis, chemotherapy toxicity (high versus low), receipt of previous chemotherapy and hospital. Patients allocated to the control arm will receive ‘Usual Care’ whilst those allocated to the intervention will receive the intervention in addition to ‘Usual Care’. Intervention patients will be provided with a computer tablet and software prompting twice-daily completion of physical/emotional scales for up to four chemotherapy cycles. Should patient data exceed pre-determined limits an Email alert is delivered to the treatment team, prompting nurses to view patient data, and contact the patient to provide clinical intervention. In addition, six scheduled nursing interventions will be completed to educate/support patients in use of the software. Patient outcomes will be measured cyclically (midpoint and end of cycles) via pen-and-paper self-report alongside review of the patient medical record. The primary outcome is burden due to nausea, mucositis, constipation and fatigue. Secondary outcomes include: burden due to vomiting and diarrhoea; psychological distress; ability to self-manage health; level of cancer information/support needs and; utilisation of health services. Analyses will be intention-to-treat. A cost-effectiveness analysis is planned.DiscussionThis trial is the first in the world to test a remote monitoring/management intervention for adult haematological cancer patients receiving chemotherapy. Future use of such interventions have the potential to improve patient outcomes/safety and decrease health care costs by enabling early detection/clinical intervention.Trial registrationACTRN12614000516684.Date registered: 12 March 2014 (registered retrospectively).

Clinical study of Shenqi Fuzheng injection decreasing side-effects of chemotherapy for patients with ovarian epithelial cancer

The aim of the study was to observe the clinical effects of Shenqi Fuzheng injection decreasing sideeffects of chemotherapy for patients with ovarian epithelial cancer. The 36 cases of ovarian epithelial cancer in The Third Affiliated Hospital of SUN Yat-sen University (Guangzhou, China) from June 2010 to June 2013, were randomly divided into the study group and the control group. The study group contained 18 cases using Shenqi Fuzheng injection combined with TP (Taxol + Carboplatin/cisplatin) chemotherapy, and the control group contained 18 cases only using TP chemotherapy without Shenqi Fuzheng injection. During and after chemotherapy, the side-effects and therapy effects were observed. The grade II of nausea and vomit were less in the study group than that in the control group, which was significantly different (P 0.05). There was less degree of decrease of lymphocyte in the study group than that in the control group, which was significantly different (P 0.05). There was no significant difference in chemotherapy effect between the two groups (P > 0.05). Shenqi Fuzheng injection can in some degree relieve the side effects of TP chemotherapy for the patients with ovarian epithelial cancer, including relieving nausea and vomiting, protecting lymphocytes, and has no conflict effect on chemotherapy efficacy.

Biomarkers of Breast Cancer Apoptosis Induced by Chemotherapy and TRAIL

Treatment of breast cancer is complex and challenging due to the heterogeneity of the disease. To avoid significant toxicity and adverse side-effects of chemotherapy in patients who respond poorly, biomarkers predicting therapeutic response are essential. This study has utilized a proteomic approach integrating 2D-DIGE, LC-MS/MS, and bioinformatics to analyze the proteome of breast cancer (ZR-75-1 and MDA-MB-231) and breast epithelial (MCF-10A) cell lines induced to undergo apoptosis using a combination of doxorubicin and TRAIL administered in sequence (Dox-TRAIL). Apoptosis induction was confirmed using a caspase-3 activity assay. Comparative proteomic analysis between whole cell lysates of Dox-TRAIL and control samples revealed 56 differentially expressed spots (≥2-fold change and p < 0.05) common to at least two cell lines. Of these, 19 proteins were identified yielding 11 unique protein identities: CFL1, EIF5A, HNRNPK, KRT8, KRT18, LMNA, MYH9, NACA, RPLP0, RPLP2, and RAD23B. A subset of the identified proteins was validated by selected reaction monitoring (SRM) and Western blotting. Pathway analysis revealed that the differentially abundant proteins were associated with cell death, cellular organization, integrin-linked kinase signaling, and actin cytoskeleton signaling pathways. The 2D-DIGE analysis has yielded candidate biomarkers of response to treatment in breast cancer cell models. Their clinical utility will depend on validation using patient breast biopsies pre- and post-treatment with anticancer drugs.

A large study of the older cancer patient in the community setting: Initial report of a randomized controlled trial using pegfilgrastim to reduce neutropenic complications

8111 Background: There is a paucity of randomized controlled studies in older pts despite that most new cancer diagnoses occur in people ≥ 65 yrs. The increased risks of the older population, which mandate an individualized treatment approach, are obstacles to study accrual. The Geriatric Oncology Consortium (GOC), which includes a cooperative group of community practices, was established to facilitate the study of older cancer pts, thereby reducing the data gap in older pts. This study documents the feasibility of conducting community clinical trials in older pts and addresses age-related increased risk of neutropenia and its complications that may prevent optimal treatment of this special population. Methods: This is a large, prospective, open-label trial in pts ≥ 65 yrs scheduled to receive chemotherapy (CT) Q21 days for lung, breast, or ovarian cancer (solid tumor stratum), or NHL. Pts were randomized to either pegfilgrastim (Neulasta) in first and subsequent cycles, or, no pegfilgrastim in cycle 1 with use in subsequent cycles per MD discretion. Endpoints included incidence of neutropenia (ANC < 1 x 109/L) with or without fever (≥ 38° C), CT dose delays and reductions, hospitalizations, antibiotic use, and quality of life using multiple instruments. Results: A total of 852 pts were enrolled from Jun 02 to Jul 04, with the last subject ending treatment in Nov 04. Approximately 46% lung, 22% breast, 14% ovarian, and 18% NHL pts were treated; 32% had stage 1/2 or limited (SCLC) disease. Mean age was ∼72 yrs (range 65–88) with 34% ≥ 75 yrs. Solid tumor CT included carboplatin with: paclitaxel (29%), etoposide (12%), or docetaxel (10%); and doxorubicin with cyclophosphamide (12%). Over 80% of NHL pts received CHOP-R. Conclusions: This is the largest prospective trial focusing on CT side effects in patients ≥ 65 yrs. The GOC provided an effective platform for the study of older cancer patients, establishing the feasibility of community-based trials in this population. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Amgen Amgen Amgen Amgen Amgen

Efficacy of progressive muscle relaxation training and guided imagery in reducing chemotherapy side effects in patients with breast cancer and in improving their quality of life

This study was designed to assess the effectiveness of progressive muscle relaxation training (PMRT) and guided imagery (GI) in reducing the anticipatory nausea and vomiting (ANV) and postchemotherapy nausea and vomiting (PNV) of patients with breast cancer and to measure their effects on the patients' quality of life (QoL). Thirty chemotherapy-naive patients with breast cancer were randomized to the PMRT and GI group and 30 to the control group. Before each of six cycles of adjuvant chemotherapy, each patient was administered a self-report Multiple Affect Adjective Checklist (MAACL), and incidents of ANV and PNV for the first three postchemotherapy days were recorded. All patients were administered the Functional Assessment of Cancer Therapy-Breast (FACT-B) at baseline and after 3 and 6 months. We found that the PMRT and GI group was significantly less anxious, depressive, and hostile than the control group. We also found that the PMRT and GI group experienced significantly less ANV and PNV and that 6 months after CT, the QoL of the PMRT and GI group was higher than that of the control group. These results indicate that PMRT and GI were associated with both the improvements in ANV and PNV and in the QoL of patients with breast cancer.

Perception of chemotherapy side effects cancer versus noncancer patients.

This study was conducted to identify and compare perceptions regarding the disruption in quality of life caused by chemotherapy side effects in patients with cancer receiving chemotherapy and in noncancer, chemotherapy-naive patients. One hundred forty-six patients with cancer and 224 patients without cancer completed two instruments to assess the perceived magnitude of 41 physical and psychosocial chemotherapy side effects. Instrument 1 used a 5-point Likert scale (1 = not at all; 2 = a little bit; 3 = somewhat; 4 = quite a bit; and 5 = very much) to summarize patient responses to the question, "How much did or would each of the following side effects of chemotherapy bother you?" Instrument 2 was a serial ranking questionnaire that asked patients to select the 10 most bothersome side effects to numerically rank the top five. An index of the relative magnitude of chemotherapy side effects was calculated for each instrument. For patients with cancer, loss of hair 50%), changes in taste (46%), constantly being tired (42%), affects work duties (39%), changes in smell perception (35%) were most frequently perceived as bothering them "quite a bit" or "very much." Nausea and vomiting were ranked 11th and 22nd, respectively. With instrument 2, the five side effects perceived as most troublesome were, in decreasing order: nausea, loss of hair, constantly tired, vomiting, and changes in the way things taste. For noncancer patients, those factors potentially bothersome "quite a bit" or "very much" were: financial hardship (82%), hardship on family (78%), vomiting (73%), shortness of breath (70%), and ability to perform work duties (69%). Via instrument 2, the top five side effects, in decreasing order were: vomiting, hardship on family, loss of hair, financial hardship, nausea, having to move close to a treatment center. Noncancer, chemotherapy-naive patients perceived most chemotherapy-associated side effects as having greater impact on the quality of life than did cancer patients who had received chemotherapy. These findings can be used to direct patient education, education of the public, specific materials concerning cancer chemotherapy. The expertise of various members of the healthcare team can maximize the patient's comprehension of the adverse effects of the treatment options. The physician's knowledge of the overall treatment plan can assist in patient understanding; oncology pharmacists nurses are in a unique position to educate patients their families regarding potential chemotherapy side effects.