Patients Receiving Cancer Treatment Research Articles

Multi-Institutional Analysis of Cancer Patient Exposure, Perceptions, and Trust in Information Sources Regarding Complementary and Alternative Medicine.

Complementary and alternative medicine (CAM) use during cancer treatment is controversial. We aim to evaluate contemporary CAM use, patient perceptions and attitudes, and trust in various sources of information regarding CAM. A multi-institutional questionnaire was distributed to patients receiving cancer treatment. Collected information included respondents' clinical and demographic characteristics, rates of CAM exposure/use, information sources regarding CAM, and trust in each information source. Comparisons between CAM users and nonusers were performed with chi-squared tests and one-way analysis of variance. Multivariable logistic regression models for trust in physician and nonphysician sources of information regarding CAM were evaluated. Among 749 respondents, the most common goals of CAM use were management of symptoms (42.2%) and treatment of cancer (30.4%). Most CAM users learned of CAM from nonphysician sources. Of CAM users, 27% reported not discussing CAM with their treating oncologists. Overall trust in physicians was high in both CAM users and nonusers. The only predictor of trust in physician sources of information was income >$100,000 in US dollars per year. Likelihood of trust in nonphysician sources of information was higher in females and lower in those with graduate degrees. A large proportion of patients with cancer are using CAM, some with the goal of treating their cancer. Although patients are primarily exposed to CAM through nonphysician sources of information, trust in physicians remains high. More research is needed to improve patient-clinician communication regarding CAM use.

Sexual Behaviors and Intimate Relationships of Sexual Partners of Young Patients with Early-Stage Cervical Cancer: A Qualitative Study.

This study aimed to explore the sexual behaviors and intimate relationships of sexual partners of young patients with cervical cancer. This study employed a descriptive phenomenological research design, which falls within the realm of qualitative research methods. Qualitative research typically utilizes interview techniques for gathering participants' experiences, perceptions, and behaviors. This study conduct face-to-face semi-structured interviews with the sexual partners of 15 young cervical cancer patients receiving cancer treatment to collect their experiences and perspectives on intimate relationships and sexual behavior with cervical cancer patients, and use the Colaizzi method for data analysis. Four themes were identified through the interview analysis: (1) reduction or absence of sexual behavior, (2) unpleasant sexual experiences, (3) adjustment of intimate relationships, and (4) lack of sexual health education. The sexual partners of young cervical cancer patients have experienced significant shifts in their perspectives on sexual behavior and intimate relationships. These changes include reduction or absence of sexual behavior, unpleasant sexual experiences, adjustment of intimate relationships, and lack of sexual health education. Hospitals should pay more attention to the sexual behavior and intimate relationships of patients with cervical cancer and their sexual partners, and social support systems and psychological and emotional counselling services should be established for providing relevant knowledge and guidance.

Assessing oncology patient interest in using telehealth for routine cancer care and clinical trials.

525 Background: Since the onset of COVID-19, oncology practices across the U.S. have integrated telemedicine (TM) and remote patient monitoring (RPM) into cancer care. However, the future role of telehealth in oncology remains unknown. We conducted a survey among a diverse group of oncology patients to assess their access to technology and interest in using TM/RPM as part of routine cancer care and clinical trials. Methods: Between March 27 and June 21, 2023, we administered in person surveys to oncology patients receiving cancer treatment at an academic cancer center in New York City. We collected respondent demographic and clinical data, as well as information about their access to technology and interest in using TM/RPM as part of cancer care. Results: There were 50 respondents with a mean age of 60 (SD 16). 62% identified as female, 22% were Hispanic of any race, 16% were non-Hispanic Black, and 48% were non-Hispanic White. 52% had a yearly income below $70,000 and 40% had less education than a bachelor’s degree. 34% had Medicare, 24% had Medicaid only, and 42% had commercial insurance. Regarding travel, 28% of respondents lived over an hour from the cancer center, and 39% paid >$20 for travel each visit. The majority owned an electronic communication device (93%) and had internet access at home (98%). 80% had internet fast enough for video visits and 86% identified as comfortable using the internet. Prior to the survey, 66% of respondents had participated in a video visit and 59% had participated in a telephone visit with their oncologist. Of these patients, more than 95% were somewhat or very satisfied with their remote visit. If provided with internet, more than half of respondents were willing to participate in video visits (57%) and telephone visits (61%) as part of regular care. Convenience and eliminating travel were the most commonly cited reasons for preferring remote care. Regarding trial participation, 52% had previously enrolled in a cancer clinical trial and 67% reported openness to trial participation. If the risks and benefits of a trial were explained over the phone or in a video visit as opposed to in person, 73% of respondents reported they would be equally or more likely to enroll. If the risks and benefits had already been explained in person, 77% would be willing to sign consent electronically. A large majority (91%) would be equally or more likely to enroll in a clinical trial that reduced travel time by providing the option of remote visits. Similarly, 78% would be willing to use wearable technology and 80% would be willing to use a health app as part of a clinical trial. Conclusions: In this diverse and underprivileged group, patients have access to technology and are willing to use it for both routine cancer care and clinical trial enrollment and participation. In the future, oncology practices should incorporate remote technology into cancer care, including trials, to reduce travel time and enhance convenience.

Economic Evaluation of a Nonmedical Financial Assistance Program on Missed Treatment Appointments Among Adults With Cancer.

We retrospectively evaluated the clinical and economic impact of a program providing nonmedical financial assistance on missed treatment appointments among patients receiving cancer treatment at a large, Southeastern public hospital system. We used patient electronic health records, program records, and cancer registry data to examine the impact of the program on rates of missed (or no-show) radiation therapy and infusion chemotherapy/immunotherapy appointments in the 180 days after treatment initiation. We used propensity weighting to estimate the effect of the program, stratified by treatment appointment type (radiation therapy, infusion chemotherapy/immunotherapy). We developed a decision tree-based economic model to conduct a cost-consequence analysis from the health system perspective in a hypothetical cohort over a 6-month time horizon. Of 1,347 patients receiving radiation therapy between 2015 and 2019, 53% (n = 715) had ≥1 no-shows and 28% (n = 378) received program assistance. Receipt of any assistance was associated with a 2.1 percentage point (95% CI, 0.6 to 3.5) decrease in the proportion of no-shows, corresponding to a 51% decrease in the overall mean no-show proportion. Under the current funding model, the program is estimated to save the health system $153 in US dollars per missed appointment averted, relative to not providing nonmedical financial assistance. Of the 1,641 patients receiving infusion chemotherapy/immunotherapy, 33% (n = 541) received program assistance, and only 14% (n = 223) had ≥1 no-shows. The financial assistance program did not have a significant effect on no-show proportions among infusion visits. This study used a novel approach to retrospectively evaluate a nonmedical financial assistance program for patients undergoing active cancer treatment. Findings support investment in programs that address patients' nonmedical financial needs, particularly for those undergoing intensive radiation therapy.

The Nurse-Patient Interaction Scale: Translation and Psychometric Properties Among Hospitalized Cancer Patients in Turkey.

Background and Purpose: Cancer patients experience physical and psychological ailments resulting from cancer illness, a difficult and long treatment process and fear of death. Nurse-patient interaction seems to play an important role when responding to the psychological needs of patients with cancer. The aim of this study is to adapt and examine the psychometric properties of the Nurse-Patient Interaction Scale (NPIS) among Turkish cancer patients. Design and Method: In a cross-sectional design, patients receiving cancer treatment at Farabi hospital in Turkey responded to the Personal Information Form and the NPIS. Descriptive statistics, principal component analysis (PCA), and confirmatory factor analysis (CFA) were applied. Findings: The NPIS was found to be suitable for a single factor structure, including 11 out of the original 14 items. The 11-items uni-dimensional model showed an acceptable/good fit with the data: χ2 = 154.369, (df = 44), χ2/df = 3.51, p = .0001, RMSEA = 0.100, p-value for test of close fit = 0.0001, CFI = 0.98, TLI = 0.97 and SRMR = 0.012.

Association of limb morphometric and biokinetic anatomical changes with quality of life in lymphedema patients undergoing physiotherapy: a systematic review

Introduction: Lymphedema is a common complication of patients receiving cancer treatment. It has serious effects on mobility, self-care, functionality and quality of life. The purpose of this review was to show the effect of lymphedema on the morphometric and biokinematic characteristics of the limb and the quality of life of the patients. Methods: A systematic review of the literature was performed using the PRISMA statement. The search included studies from online databases, PubMed, Scopus and Google Scholar, which were published from 2000 to 2022. Studies assessed outcome variables such as range of motion, strength, sensation, body composition, quality of life. The screening process resulted in a total of 23 studies that met the inclusion criteria. Results: Of the 23 studies that met the inclusion criteria, seventeen referred to upper extremity lymphoedema and six referred to lower extremity lymphoedema. There was a variety of methods for identifying lymphedema between studies. Studies have shown reduced grip strength, range of motion, sensory perception, changes in body composition have been observed with fat tissue being increased compared to muscle tissue. The majority of studies reported reduced patient quality of life. The areas most affected were body image, role, mental health and sociability. Conclusions: Findings indicate that lymphedema has a high incidence among people treated for cancer, and has a significant impact on patients functionality and quality of life.

Outpatient Oncology Fall Risk: A Quality Improvement Project.

Patients receiving cancer treatment are at high risk for falls. No current guidelines or standards of care exist for assessment and prevention of outpatient oncology falls. This quality improvement project's purpose was to 1) describe and evaluate outpatient oncology falls data to determine root cause(s), and develop, implement, and evaluate intervention strategies for future policy refinement, and 2) compare fall rates pre/post implementation of a system-wide Ambulatory Fall Risk Bundle. Retrospective data were used to describe and categorize fall incidence for the University of Kansas Cancer Center over 12 months. Further analyses were conducted to describe fall rates per 10,000 kept appointments pre/post implementation of an Ambulatory Fall Risk Bundle protocol. Semi-structured interviews were conducted with medical assistants and nurse managers to evaluate the initiative's impact, staff satisfaction, and recommendations for refinement. The initial 12-month assessment yielded 58 patient falls retained for further analyses. Most patients were receiving chemotherapy (46, 79%). Common contributing symptoms included dizziness/ faintness and weakness (25, 43%). Tripping/falling over a hazard (12, 24%) and falls during transfer (10, 5.8%) also were cited. Subsequent analyses of fall rates indicated no change. Recommendations resulting from the qualitative interviews included: orthostatic vital sign protocol implementation, redesign of the electronic medical record fall risk alert, stakeholder involvement in protocol development, staff training, and related patient education strategies, and the procurement of additional assistive devices/equipment. System-related policy and culture change, investment in physical and human resource enhancements, and evidence-based protocols are needed to improve outpatient oncology fall rates.

WTP5.6 Enhanced Monitoring for Better Recovery and Cancer Experience in Greater Manchester (EMBRaCE-GM): A Qualitative Study of Clinician Experiences on Deploying and Supporting Consumer Wearable Devices

Abstract Introduction Consumer wearables such as smart watches and rings have the potential to provide continuous monitoring of patients receiving cancer treatment in their prehabilitation and rehabilitation phases of care. Enhanced Monitoring for Better Recovery and Cancer Experience in Greater Manchester (EMBRaCE-GM) is a multi-centre prospective trial evaluating feasibility and acceptability of wearable technologies for patients undergoing treatment for colorectal cancer, lung cancer or lymphoma within Greater Manchester (ClinicalTrials.gov NCT05099237). We report the initial findings of the clinician’s perspective on deploying and supporting the use of wearable devices. Methods A qualitative study was conducted to ascertain the experiences of researchers who recruited participants to EMBRaCE-GM. Three interviewers conducted structured interviews and a thematic analysis was performed. Results Thirteen researchers were interviewed, and 3 major themes identified. The first identifies the importance of the device set-up phase, such as integration into the patient’s existing technological ecosystem, and the training provided to clinical teams. The second theme was patient engagement with the technology, such as the burden of interacting with the device (‘digital load’), and comfort and aesthetics. The final theme involved the support infrastructure for technical issues and device maintenance as well as safe protocols and governance for responding to device alerts, particularly if patients were unwell. Discussion Wearable technologies have the potential to provide ongoing benefit through continuous monitoring outside the hospital setting for patients receiving cancer treatment. This study, as part of the EMBRaCE-GM project, identifies important themes critical for future patient and clinician adoption of wearable devices.

Fucoidan/chitosan layered PLGA nanoparticles with melatonin loading for inducing intestinal absorption and addressing triple-negative breast cancer progression

Melatonin and fucoidan are naturally active compounds that have been reported to have therapeutic benefits for patients receiving cancer treatment. However, both compounds face significant challenges, including physical, chemical, and biological metabolisms in the gastrointestinal tract, which limit their ability to achieve therapeutic concentrations at the tumor site. Furthermore, the effectiveness of melatonin and fucoidan as adjuvants in vivo is influenced by the route of administration through the digestive system and their accumulation at the endpoint of the tumor. In this study, we developed an oral administration of nanoparticle, MNPs@C@F, that consisted of PLGA nanoparticles modified with chitosan, to promote intestinal microfold cell transcytosis for the delivery of melatonin and fucoidan into tumors. The experimental results indicated that melatonin and fucoidan in the tumors could regulate the tumor microenvironment by decreasing P-gp, Twist, HIF-1α, and anti-inflammatory immune cell expression, and increasing cytotoxic T cell populations following doxorubicin treatment. This resulted in an increase in chemo-drug sensitivity, inhibition of distant organ metastasis, and promotion of immunogenic cell death. This study demonstrates a favorable co-delivery system of melatonin and fucoidan to directly reduce drug resistance and metastasis in TNBC.

Management of odontogenic foci of infection (dental caries, periodontal disease and odontogenic infections) in the oral functional management of patients receiving cancer treatments: Guidelines based on a systematic review

AbstractIn cancer treatment, perioperative oral functional management is used as a part of supportive care. Its main objectives are as follows: (1) preventing and reducing adverse events, (2) maintaining or improving nutritional status, (3) improving cancer treatment outcomes, (4) maintaining or improving quality of life, (5) providing high quality medical care through comprehensive oral care, (6) controlling odontogenic foci of infection, and (7) maintaining or improving oral function. A literature search was conducted using the electronic databases of Medical Journal and PubMed. Electronic database searches were performed using various combinations of the following key words: cancer, surgery, treatment, chemotherapy, radiotherapy and dental disease, oral care, oral management, dental intervention, oral health, dental care, and dental management. The selection of literature for inclusion in the review was restricted to dental management of patients receiving cancer treatment. In the course of the literature review, hand searches were also added as needed. The guideline was developed by summarizing the results of the review. Based on a review of the literature on the management of dental foci of infection in the oral functional management of patients undergoing cancer treatment, a guideline was developed by summarizing the results of the review. This report is a secondary publication of our previous review report “J. Stomatol. Soc. 70(4): 279–289. Dec 2021.”

The prevalence of COVID-19 infection among gynecologic oncology patients receiving cancer treatment in a COVID-19 referral hospital

INTRODUCTION: Cancer patients are more susceptible to coronavirus disease-19 (COVID-19) infection because they are immunosuppressed by their disease or therapy, most of them have coexisting medical conditions, and they frequently visit hospitals for treatment and surveillance. OBJECTIVE: The objective of this study was to determine the prevalence of COVID-19 infection among gynecologic oncology patients receiving treatment in a COVID-19 referral hospital. MATERIALS AND METHODS: A descriptive, cross-sectional study involving 47 gynecologic cancer patients receiving treatment from June 2020 to December 2020 was performed. All patients underwent SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) swab test and symptom and exposure assessment before the start of cancer treatment. Patients with negative SARS-CoV-2 RT-PCR swab test results received their planned treatment, and a repeat swab test and triage assessment were done midtreatment and after treatment. RESULTS: Five (10.6%) patients had positive baseline SARS-CoV-2 RT-PCR swab results, but all proceeded with treatment after negative results were obtained. Only 1 (2.13%) patient had a positive SARS-CoV-2 RT-PCR swab test result at midtreatment. All patients had no COVID-19-associated symptoms and none of them tested positive for COVID-19 infection posttreatment. CONCLUSION: The prevalence of COVID-19 infection among gynecologic cancer patients receiving cancer treatment is 2.13%. All patients who had positive SARS-CoV-2 RT-PCR swab test results at baseline or midtreatment were able to continue and complete treatment. There were no severe clinical events or mortalities among those affected with COVID-19 infection.

Financial Toxicity Following Cancer in a Middle-Income Country with a Pluralistic Health System: Validation of the COST Questionnaire

Background: Financial toxicity is the outcome of the objective financial burden and subjective financial distress experienced by patients receiving cancer treatment. Objective: To validate the English and Malay versions of the COmprehensive Score for financial Toxicity (COST) questionnaire in a multiethnic setting with a pluralistic healthcare system. Intervention/methods: A cross-sectional study was conducted on 720 adults with cancer from public and private hospitals across Malaysia. Reliability was estimated using Cronbach’s α for internal consistency. Construct validity was assessed by exploratory factor analysis. Criterion validity was tested using the European Organization for Research and Treatment of Cancer’s Quality of Life Questionnaire. Results: Overall, 362 respondents answered the English language questionnaire and 358 answered the Malay version. Both versions achieved high reliability (Cronbach’s α: .91 and 0.96, respectively). Exploratory factor analysis via the parallel analysis method identified a single factor solution with eigenvalues of 6.244 and 6.544, explaining 56.80% and 59.50% of variances, respectively. Low positive correlations and strong negative correlations were observed with global health status and financial difficulty, respectively. Subgroup analyses indicated that both versions performed well across diverse patient groups. Conclusion: The English and Malay versions of COST are psychometrically robust in measuring financial toxicity in multiethnic settings with pluralistic health systems and across diverse subgroups of cancer patients with varying clinical characteristics. Implications for Practice: The COST tool should be useful in accurately identifying patients with cancer who experience financial toxicity in Malaysian settings and potentially other similar settings. What is Foundational: Early identification of patients experiencing financial toxicity using validated tools in oncology practice would enable timely intervention.

Associations among anesthesia-induced brain biomarkers during surgery, preoperative exposure to cancer therapeutics, and clinical outcomes.

12095 Background: Cognitive impairment represents a key concern in oncology, as issues with memory and concentration can be a debilitating side effect of cancer and its treatment. Prior work demonstrates that the power of the alpha wave, a pattern of electroencephalographic (EEG) signals in the brain in patients under general anesthesia, correlates with cognitive function. In this study, we sought to investigate the associations among anesthesia-induced alpha power, preoperative exposure to cancer therapeutics, and clinical outcomes in a large cohort of patients undergoing surgery. Methods: We analyzed intra-operative EEG recordings of a retrospective cohort of patients with and without cancer who underwent surgery with general anesthesia at a single institution between 4/2016 - 12/2019. We used multivariable regression models (adjusted for age, sex, history of dementia) to determine associations of cancer-related covariates with patients’ alpha power (measured in decibels [dB]), and to determine associations of alpha power with clinical outcomes, such as hospital length of stay, discharge location, hospital readmission, and survival. Results: Among 1,084 total patients included in this study, 377 (35%) had a preoperative diagnosis of cancer. The most common cancer diagnoses were breast (87, 23% of those with cancer), gastrointestinal (85, 23%), genitourinary (73, 19%), and lung (47, 12%). We found that a cancer diagnosis alone was not associated with alpha power (-0.015 dB, p = 0.95). However, among patients with cancer, receiving chemotherapy within 3 months before surgery was associated with a 1.6dB drop in alpha power (p < 0.001). By comparison, having a preoperative diagnosis of dementia was associated with a drop of 2.86dB (p < 0.001). Decreased alpha power was associated with longer hospital stays (1.03 times longer per dB drop, p < 0.001), higher rates of discharge to a rehab facility (odds ratio [OR] = 1.22 per dB drop, p < 0.001), and higher mortality (hazard ratio = 1.085 per dB drop, p < 0.001). We found no association between alpha power and 30-day readmission (OR = 1.04, p = 0.24). Conclusions: In this large cohort of patients undergoing surgery, we found that alpha power correlated with several important clinical outcomes, and that recent receipt of chemotherapy was associated with a decrease in alpha power. Of note, the observed drop of 1.6 dB among those with recent chemotherapy is roughly equivalent to aging 10-15 years, while a diagnosis of dementia was associated with a nearly 3dB drop in alpha power. As evidence suggests that alpha power corresponds with patients’ cognitive function, our findings highlight the need to prospectively monitor and track longitudinal alpha power in patients receiving cancer treatment to determine if early detection of changes in alpha power may predict for future treatment-related cognitive decline.

Quality of care in the oncological outpatient setting: Individual interviews with people receiving cancer treatment.

To describe how patients receiving cancer treatment perceive quality of care in the oncological outpatient settings. A strategic sample of 20 adult patients with cancer treated in four oncological outpatient settings in four hospitals in Sweden participated in the study. Participants were interviewed using a semi-structured interview guide with open-ended questions. The interviews were audio-recorded, and the transcripts were analysed using a phenomenographic approach. Three descriptive categories emerged from the data: The patient's care is designed to meet individual needs, The patient's dignity is respected, and The patient feels safe and secure with the care. Overall, quality of care in the oncological outpatient setting is perceived as something positive and described in normative terms by the participants. The results emphasises that in order to achieve quality of care it is important to the patients that they are able to meet with the same well-educated, professional, caring and sensible health care professionals every time.

Developing machine learning algorithms incorporating patient reported outcome measures to predict acute care events among patients with cancer.

1516 Background: Clinical trials have shown that collecting patient-reported outcome measures (PROMs) can improve outcomes among oncology patients. However, there remains uncertainty about how to best collect and use PROMs in routine clinical care. Since 2016 we have collected PROMs for patients receiving cancer treatment within a large health system containing academic and community sites. We sought to examine whether combining PROMs with electronic health record (EHR) data improves the performance of machine learning algorithms predicting patients’ risk of 30-day acute care events. Methods: The sample included patients with solid tumors receiving curative- or palliative-intent systemic therapy between 9/1/20 and 7/31/22 who completed at least one PROMs survey. PROMs were collected via a 12-item questionnaire based on the Common Terminology Criteria for Adverse Events measurement system. Patients completed questionnaires via the EHR’s patient portal or on tablets in waiting rooms. EHR data included 176 variables describing demographics, laboratory values, vital signs, diagnoses, medications, and prior healthcare encounters. A binomial outcome was calculated for each patient encounter to indicate whether the patient had an acute care event (ED visit or hospitalization) in the subsequent 30 days. Data were randomly assigned to training (70%) and test (30%) sets and were used to train and test four models: EHR + PROMs, EHR alone, PROMs alone, and ‘PROMs plus,’ which included PROMs and minimal EHR data such as age, sex, and site of cancer treatment, which served as an accessible proxy for cancer type. For each model, we compared multiple architectures and selected the best-performing model for comparison. Results: Between September 2020 and June 2022, 4,193 patients completed 20,359 PROM surveys during outpatient encounters. There were 2,118 30-day acute care events within the cohort. The area under the receiver operating curves (AUCs) were 0.84 (95% CI 0.81 to 0.86) for the EHR + PROMs model, 0.82 (95% CI 0.80 to 0.84) for the EHR alone model, 0.67 (95% CI 0.65 to 0.69) for the PROMs alone model, and 0.79 (95% CI 0.77 to 0.82) for the PROMs plus model. In the EHR alone and EHR + PROMs models, the most important variables were last albumin, white blood cell count and hemoglobin. In the PROMs plus model, the most important variables were age, treatment site, patient-reported pain, and patient-reported fatigue. Conclusions: Incorporating PROMs into machine learning models to predict risk of acute care events can improve model performance. Notably, the model combining PROMs with a small number of easily accessible EHR variables performed nearly as well as models including all EHR data. These models demonstrate the predictive value of PROMs in oncology patients and they lay the foundation for future interventions aiming to reduce acute care events among high-risk patients.

Experiences of patients on cancer treatment regarding decentralization of oncology services at a tertiary hospital in the Eastern Cape

BackgroundThe cancer burden is a global public health concern associated with high morbidities and mortalities. Low and middle-income countries are more affected including South Africa. Limited access to oncology services contributes to the late presentation, late diagnosis, and treatment of cancer. In the Eastern Cape, oncology services were previously centralized with negative effects on the quality of life of the already compromised health status of the oncology patients. To mitigate the situation, a new oncology unit was opened to decentralize oncology services in the province. Little is known about the experiences of patients after this transformation. That prompted this inquiry.AimThis study aims to explore the experiences of cancer patients regarding the decentralization of oncology services at a tertiary hospital in the Eastern Cape.MethodologyA qualitative approach with a descriptive, explorative, and contextual design was undertaken, to obtain the perspective of oncology recipients following the decentralization of oncology services at a selected public tertiary hospital in the Eastern Cape. After obtaining ethical clearance and permission to conduct the study, interviews were conducted with 19 participants. All interviews were transcribed verbatim against their audio recordings. Field notes were taken by the primary researcher. The concept of trustworthiness was used to ensure rigour throughout this study. Thematic analysis was done using Tesch’s approach to open coding in qualitative research.ResultsThree themes emerged from the data analysis: 1) Access to oncology services; 2) Oncology services provided; and 3) Need for improved infrastructural facilities.ConclusionThe majority of patients had positive experiences with the unit. The waiting time was acceptable, and medication was available. Access to services was improved. The staff had a positive attitude towards patients receiving cancer treatment.

Can Nurses' Training and Documentation Audit Improve the Oral Care Practice among Patients Receiving Cancer Treatment? Results from the Pretest-Post-Pest Study.

Oral complications arising out of radiation therapy and chemotherapy significantly affect the oral health status of patients leading to severe distress. Poor oral health can impair nutritional intake and patient recovery. Trained nurses lack knowledge of oral care of patients receiving cancer treatment. The study is aimed at training the nurses and conducting a documentation audit to assess the effect of the training on their clinical practice. Methods: A quantitative research approach was adopted using one group pretest-post-test design to train 72 nurses on oral care of cancer patients working in radiation oncology wards of a tertiary care setting in the southern part of India. After the training program, 80 head and neck cancer patient records were audited to monitor the implementation of oral care. After completing the training program, the knowledge score increased to 13.54 with a mean difference of 4.15 at a p-value <0.001, which indicates that the training was effective, resulting in a gain in knowledge scores. Nurses reported usage of evidence-based intervention, and patient education materials helped them in the clinical practice and a few barriers to oral care practice were identified while implementing the oral care i.e increased frequency of oral care, increased documentation, and time issues. There was poor adherence to the implementation of oral care for cancer patients after the training program, as monitored by a documentation audit. Capacity building of the nurses in providing effective oral care of cancer patients will help in improving the standards of cancer nursing practice. An implementation audit of the records would help check adherence to the new oral care practice. A hospital-instituted protocol can result in the effective implementation of the practice change rather than a researcher-introduced protocol.

Cardiovascular outcomes of cancer patients in rural Australia.

Cancer and heart disease are the two most common health conditions in the world, associated with high morbidity and mortality, with even worse outcomes in regional areas. Cardiovascular disease is the leading cause of death in cancer survivors. We aimed to evaluate the cardiovascular outcomes of patients receiving cancer treatment (CT) in a regional hospital. This was an observational retrospective cohort study in a single rural hospital over a ten-year period (17th February 2010 to 19th March 2019). Outcomes of all patients receiving CT during this period were compared to those who were admitted to the hospital without a cancer diagnosis. 268 patients received CT during the study period. High rates of cardiovascular risk factors: hypertension (52.2%), smoking (54.9%), and dyslipidaemia (38.4%) were observed in the CT group. Patients who had CT were more likely to be readmitted with ACS (5.9% vs. 2.8% p = 0.005) and AF (8.2% vs. 4.5% p = 0.006) when compared to the general admission cohort. There was a statistically significant difference observed for all cause cardiac readmission, with a higher rate observed in the CT group (17.1% vs. 13.2% p = 0.042). Patients undergoing CT had a higher rate of mortality (49.5% vs. 10.2%, p ≤ 0.001) and shorter time (days) from first admission to death (401.06 vs. 994.91, p ≤ 0.001) when compared to the general admission cohort, acknowledging this reduction in survival may be driven at least in part by the cancer itself. There is an increased incidence of adverse cardiovascular outcomes, including higher readmission rate, higher mortality rate and shorter survival in people undergoing cancer treatment in rural environments. Rural cancer patients demonstrated a high burden of cardiovascular risk factors.

Hazardous Drug Safe Handling for Patients Receiving Cancer Treatment #454.

Journal of Palliative MedicineVol. 26, No. 4 Fast Facts and ConceptsHazardous Drug Safe Handling for Patients Receiving Cancer Treatment #454Katherine DickeKatherine DickeAddress correspondence to: Katherine Dicke, PharmD, BCOP, OhioHealth, System Oncology Pharmacist, OhioHealth David P. Blom Administrative Campus, 3430 OhioHealth Parkway, Columbus, OH 43202, USA E-mail Address: mailto:katie.dicke@ohiohealth.comSearch for more papers by this authorPublished Online:31 Mar 2023https://doi.org/10.1089/jpm.2022.0591AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetails Volume 26Issue 4Apr 2023 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:Katherine Dicke.Hazardous Drug Safe Handling for Patients Receiving Cancer Treatment #454.Journal of Palliative Medicine.Apr 2023.584-586.http://doi.org/10.1089/jpm.2022.0591Published in Volume: 26 Issue 4: March 31, 2023PDF download

Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials.

Oral mucositis is a common and most debilitating complication associated with cancer therapy. Despite the significant clinical and economic impact of this condition, there is little to offer to patients with oral mucositis, and the medications used in its management are generally only palliative. Given that mucositis is ultimately a predictable and, therefore, potentially preventable condition, in this study we appraised the scientific literature to evaluate effective methods of prevention that have been tested in randomised controlled trials (RCTs). Published high-level evidence shows that multiple preventative methods are potentially effective in the prevention of oral mucositis induced by radiotherapy, chemotherapy, or both. Anti-inflammatory medications (including benzydamine), growth factors and cytokines (including palifermin), cryotherapy, laser-and-light therapy, herbal medicines and supplements, and mucoprotective agents (including oral pilocarpine) showed some degree of efficacy in preventing/reducing the severity of mucositis with most anticancer treatments. Allopurinol was potentially effective in the prevention of radiotherapy-induced oral mucositis; antimicrobial mouthwash and erythropoietin mouthwash were associated with a lower risk of development of severe oral mucositis induced by chemotherapy. The results of our review may assist in highlighting the efficacy and testing the effectiveness of low-cost, safe preventative measures for oral mucositis in cancer patients.