Patients Undergoing Cancer Treatment Research Articles

The Role of Multimodality Cardiac Imaging in Patients Undergoing Cancer Treatment

Modern therapeutics have led to improved survival for many types of cancer but have also been associated with adverse effects including potentially life-threatening cardiotoxicities. We sought to review the uses of multimodality cardiac imaging for risk stratification, prevention, and identification of cardiotoxicities in patients undergoing cancer treatment. Advancements in both echocardiography and emerging modalities, like cardiac magnetic resonance imaging and cardiac computed tomography, continue to improve the pre- and during therapy cardiac evaluation of cancer patients. Echocardiography and cardiac magnetic resonance imaging, with the incorporation of global longitudinal strain, can identify overt and subclinical cancer therapy-related cardiac dysfunction and myocarditis, and stress echocardiography and cardiac computed tomography can noninvasively screen and monitor for coronary artery disease. Multimodality cardiac imaging is an evolving and critical tool for the pre-therapy screening and risk stratification, as well as during therapy surveillance of cancer treatment-related cardiotoxicity.

Assessing Immune Response to 3rd Dose of COVID-19 Vaccine Series in Patients Undergoing Cancer Treatment at University Medical Center- New Orleans

Background: COVID-19 pandemic remains a global emergencies. Vaccines against the virus SARS-CoV-2 have been shown to reduce incidence and severe complications from COVID-19 infection. Previous studies have shown that patients receiving active cancer therapies for solid or hematological malignancies demonstrated a significantly lower response after initial 2- doses of vaccines, in comparison to the general population. There is limited data on the immune response to a 3rd dose of the mRNA COVID-19 vaccine in patients receiving active treatment for malignancies and especially in minorities. This study aims to assess immune response against SARS-CoV-2 after 3rd dose of mRNA vaccination in this particular population. Study Design: Between September 2021 and January 2022, 119 patients on active cancer treatments at University Medical Center- New Orleans were enrolled on this prospective study (IRB Protocol 641). Plasma samples were collected before and approximately 3-6 weeks after the 3rd vaccine dose. 40 patients received the 3rd vaccine dose and completed the study. Serum antibody testing by ELISA was performed. IgG response was assessed by testing for antibodies against the wild type SARS-CoV-2 proteins RBD and N (natural COVID-19 infection). Results: Patient demographics consisted of 66.4% African American, 27.3% Caucasian, and 6.4% others. On the average, there was an approximately 8x fold increase in titer response after the 3rd dose of SAR-CoV-2 vaccination. Titer response was highest in patients on immunotherapy compared to those on cytotoxic chemotherapy. Higher titer response were also observed in patients with metastatic cancers compared to non-metastatic cancers, in African Americans compared to other ethnicities, and males. Patients who received the 3rd vaccine dose six months after initial 2-dose series tended to mount higher titer response compared to those who received their 3rd dose within 3 months. None of study subjects were hospitalized for COVID-19 infection during the duration of this study. Conclusion: 3rd dose mRNA vaccines against SAR-CoV-2 were effective in preventing infections and complications from COVID-19 infection in patients and ethnic minorities who are on active treatment for solid and liquid malignancies. Our study is limited by the small number of subjects. Studies are being conducted to evaluate duration of antibodies response in this patient group compared to general population.

Retrospective Data Collection Study: Hematologic Toxicities with Immunotherapy in Cancer Patients at the Allan Blair Cancer Centre

Background: Checkpoint inhibitors, anti-programmed cell death 1 (PD-1) and cytotoxic T lymphocyte- associated antigen 4 (CTLA-4) have been shown to be effective in the treatment of various malignancies. Though rare, the novelty of immunotherapy necessitates further investigations of its potentially serious and even morbid consequent toxicities. To better understand the clinical evidence of hematologic toxicities, we conducted a retrospective data collection study to help clinicians identify the risks burdening patients undergoing immunotherapy. Methods: A total of 490 patient charts from the Saskatchewan Cancer Agency will be reviewed. Charts reviewed will be pertaining to patients that received immunotherapy for any indication from 2013, when immunotherapy began being administered within the system, to May 30th, 2020. Data will be collected from charts including patients that received anti-P1/PDL1 and/or anti-CTLA4, and experienced anemia, neutropenia or thrombocytopenia within a time frame of therapy. Pertinent information is then input to a data collection tool using REDCap. Results: N/A (Will be available once we complete the study by the summer of 2023) Conclusion: The goal of this study is to identify the proportion and context of patients treated at the Allan Blair Cancer Centre experiencing immunotherapy related toxicities. The outcome of this research may assist clinicians in identifying the risks burdening patients undergoing cancer treatment and identify best management practices to reduce patient morbidity and mortality.

Identifying Suicidal Ideation in Cancer Patients

EXTRACT
 
 Keywords: Medical treatment, cancer diagnosis, suicide, suicidal thoughts, cancer patients, psychooncology.
 Introduction: Suicidality among oncology patients in Slovenia is still a relatively unexplored topic. After a review of the literature, it was found that the risk of suicide among people diagnosed with cancer is higher compared to the general population. Therefore, we wanted to determine the presence of suicidal ideation in patients undergoing cancer treatment.
 Methods: Qualitative research involved interviews (n=5) with people undergoing cancer treatment. In this paper, the transcripts of the interviews are analysed using grounded theory principles.
 Results. Some of them had a plan. Anxiety, insecurity, need for antidepressants and help from a psychologist were prominent. The very diagnosis and experience of the illness is extremely painful. They reported fear of starting treatment, a feeling of helplessness, of being affected, intertwined with a feeling of denial, then hope for a cure. The most disturbing aspect of the initial treatment process was the waiting for treatment and treatment. The illness itself and the treatment also have an impact on self-image, all leading to mental consequences due to physical changes. We found that a previous history of mental illness has a significant impact, but nevertheless all participants expressed a desire to live. The category analysis showed the category of support from family and surroundings, and the high importance of an orderly family status. In the experience of the medical staff, all participants felt that the need for individualised treatment in terms of person-centredness and the need for a psychooncologist at the beginning of treatment was inevitable.Pain is also an important element. More than physical pain, they mentioned psychological, internal pain, which was linked to feelings of helplessness and suicidal thoughts.
 Discussion and conclusion: Identification of suicidal oncology patients is a difficult process, as depressed mood and anxiety may be hidden during treatment. It is necessary to establish a trusting, empathic relationship with the patient. With mutual respect and trust, when suicidality occurs, healthcare staff can work together with the patient to try to solve the problem. Nurses who are present at all times with the patient should be educated in the identification of risk factors that increase the potential for suicide and in the use of prevention tools (e.g. questionnaires and interviews) and screening programmes that identify oncology patients at risk of suicidality at an early stage.

327 REVIEW OF ONCOLOGY PATIENTS ADMITTED FROM 2019-2021: DEFINING THE NEED FOR AN ONCO-GERIATRIC SERVICE

Abstract Background With an aging population, there is an increased need to consider older patients for cancer treatment. Involvement of a Comprehensive Geriatric Assessment (CGA) in an oncology workup can help guide cancer treatment and non-pharmacological treatment in older patients. We undertook a retrospective study looking at older patients admitted during their cancer treatment to establish the need for an onco-geriatric service in our hospital. Methods All patients over 85 admitted under oncology from 2019-2021 had a retrospective chart review. Patient demographics, indication for admission and discharge destination were collected. Clinical markers, such as total medications, comorbidities and social history were used to generate an overall understanding of the patient’s Clinical Frailty Score (CFS). We then retrospectively implemented a geriatric assessment to see how patients would benefit from a CGA if an onco-geriatric service was implemented in our hospital. Results A total of 22 patients over 85 accounted for 33 admissions, with 54.5% female (n=12). The median CFS was 4 (3-5). At time of admission, 90.1% were on concomitant cancer treatment; 41.7 concurrent chemo, 13.6% concurrent RT. The mean patient had conditions 5.61 (SD3.2 and took an average of 9.2 (SD3.7) regular medications. Most admissions (n=18) required at least one consult from another service (54.5%), with palliative care and cardiology having the highest burden of consults at 11 (33%) and 8 (26.7%) respectively. Only 1 patient had a geriatric consult, while another was seen by our Falls and Syncope Unit after a fall leading to admission. Patients following each attendance were discharge home in 75.7% cases (n=25). Hospice (12.1%), convalescence (3%) and nursing home (3%). Conclusion We identified multiple areas in which a CGA can improve management of older patients undergoing cancer treatment, including medication rationalisation. We feel that a onco-geriatric service development in our hospital will lead to better patient care for our older population.

A randomized controlled trial of routine financial toxicity screening via electronic patient-reported outcomes (AFT-39).

180 Background: Financial toxicity affects 20% of cancer survivors and is associated with decreased treatment adherence and poor clinical outcomes. No large-scale programs have been implemented to mitigate financial toxicity among patients undergoing cancer treatment. We evaluated the effect of monthly patient-reported financial toxicity screening as part of a larger digital monitoring intervention. Methods: PRO-TECT (AFT-39) is a cluster-randomized trial of patients undergoing systemic therapy for metastatic cancer. Practices were randomized 1:1 to digital symptom monitoring with patient-reported outcomes (“PRO practices”) or usual care (“control practices”). Digital monitoring consisted of between-visit online or automated telephone patient surveys containing symptom, functioning, and financial toxicity screening questions for up to one year, with automated alerts sent to practice nurses for concerning survey scores. Clinical team actions in response to alerts were not mandated. The primary outcome of this analysis was development or worsening of financial difficulties, assessed via the EORTC QLQ-C30 (“Has your physical condition or medical treatment caused you financial difficulties?”), at any time compared to baseline. A randomly selected subset of patients and nurses were interviewed about their experiences with the intervention. Results: 1,191 patients were enrolled (593 PRO; 598 control) at 52 US community oncology practices. Overall, 30.2% of patients treated at practices that received the intervention developed, or experienced worsening of, financial difficulties, compared to 39.0% of patients treated at control practices (p = 0.01). Patients and nurses interviewed stated that financial toxicity screening identified patients for financial counseling who otherwise would be reluctant to seek, or unaware of the availability of, assistance. Conclusions: Screening for financial toxicity as part of routine digital patient monitoring with PROs reduces the development, or worsening, of financial difficulties among patients undergoing systemic cancer therapy. Clinical trial information: NCT03249090.

Cardiovascular and metabolic determinants of quality of life in patients with cancer.

Maintaining quality of life (QoL) in patients with cancer has gathered significant interest, but little is known about its major determinants. We sought to identify determinants of QoL in patients undergoing cancer treatment as well as in treatment-naïve patients about to commence such therapy. QoL was assessed in 283 patients with cancer using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 questionnaire. All patients underwent a battery of tests including physical examination, resting electrocardiogram, hand grip strength, and biochemistry assessment. Using multivariable logistic regression, we found that age [odds ratio (OR) 0.954, 95% confidence interval (CI) 0.916-0.994], resting heart rate (OR 1.036, 95% CI 1.004-1.068), hand grip strength (OR 0.932, 95% CI 0.878-0.990), and the presence of cachexia (OR 4.334, 95% CI 1.767-10.631) and dyspnoea (OR 3.725, 95% CI 1.540-9.010; all P<0.05) remained independently predictive of reduced QoL. Therefore, it may be reasonable to address circumstances that are affecting muscle mass, body weight, and heart rate to maintaining QoL; however, prospective studies to test these endpoints are required.

HPV vaccination coverage for pediatric, adolescent and young adult patients receiving care in a childhood cancer survivor program

Pediatric, adolescent and young adult patients undergoing cancer treatment and/or hematopoietic stem cell transplant are at increased risk for developing a secondary human papillomavirus (HPV)-associated malignancy. The objective of this study was to determine HPV vaccination coverage among individuals participating in a childhood cancer survivor program (CCSP). A retrospective cohort study was conducted among CCSP patients age 11–26 years attending a CCSP visit between 2014 and 2019. Survivors were age-, sex-, and race-matched 1:2 with controls without cancer. Data were abstracted from the electronic health record and state-based vaccination registry. Analysis was limited to Minnesota residents to minimize missing vaccination data. Survivorship care plans (SCPs) were reviewed for vaccine recommendations.592 patients were included in the analyses (200 CCSP patients; 392 controls). By study design, mean age (18.4 years), race (72 % white), and sex (49 % female) were similar in the two groups. Among CCSP patients 22 % resided in a rural area compared to 3.8 % of controls. Vaccination coverage among CCSP patients was not statistically significantly different from controls [60.0 % vs 66.3 %, OR = 0.82, 95 % CI: (0.55, 1.23), p = 0.35]. Completion of 3 doses was not different between groups even though 3 doses is recommended for all CCSP patients regardless of age at initiation (28.5 % vs 30.1 %, p = 0.09). Only 8.0 % of SCPs recommended HPV vaccination.Although patients participating in a CCSP did not have significantly different HPV vaccination coverage compared to controls, HPV vaccination initiation and 3-dose series completion are still suboptimal in a patient population at high-risk of a secondary HPV-associated cancer.

CN79 Patients' experience of hope during cancer treatment: The different dimensions of hope

The authors work as oncolocy contact nurses at Karolinska University Hospital, Sweden. During the specialist nursing education in oncological care, we became aware that hope is a central concept in care science and this has aroused a curiosity to study the significance of hope. The common preconception regarding the experience of hope is that patients undergoing cancer treatment most of all hope to recover. We hope this study can contribute to a deeper and more multidimensional understanding of patients' experience of hope. We also hope that this knowledge leads to an improved and person-centered nursing in the meeting with the patient in the oncological context. Hope is essential to experiencing health and alleviates suffering. Cancer causes existential suffering. Nurses can be bearers of hope, however, nurses in cancer care experience that it can be difficult to define what hope means to the patient and this can cause ethical issues. The study was conducted as a qualitative literature review in accordance with Bettany-Saltikov and McSherry (2016). Systematic searches were conducted in PubMed and CINAHL. 10 studies were included. The studies were quality reviewed based on the template designed by Caldwell et al. (2011). Analysis was performed in accordance with Bettany-Saltikov and McSherry's (2016) description of Burnard's (1991) analysis method. Four categories were identified. The importance of cancer treatment for the experience of hope showed that the cancer treatment affected the hope of, among other things, living and surviving. The changing hope showed that patients felt that hope changed through the cancer trajectory and gave new perspectives. Hope as a driving force showed that spirituality could be a source of hope and that hope was a vital force. The importance of relationships for the experience of hope showed how relationships with relatives and care staff affected experiences of hope. Hope has a deep and multidimensional significance for patients undergoing cancer treatment. This knowledge can contribute to an improved and person-centered nursing in the oncological context, which in turn can promote the patient's experience of hope.

35341 The application of an emollient helps to reduce the skin side effects of anticancer treatments

Skin-related side effects of cancer treatment, a recurring complaint from patients, lead to further deterioration in patient’s quality of life (QOL). Patients also develop skin sores or cracks, causing discomfort or pain and increasing infection risks. The study objective was to assess skin acceptability in patients undergoing cancer treatment and receiving an emollient containing shea butter, Thermal Spring Water, niacinamide, microresyl and Aqua Posae Filiformis as actives. 47 patients were included, 42 were eligible for analysis.

35349 The use of photoprotection reduces skin side effects of patients undergoing anti-cancer treatments

The use of photoprotection reduces skin side effects of patients undergoing anti-cancer treatments. As some cancer treatments are photosensitizing, even indirect sunlight exposure requires protection. Using anti-UVB and anti-UVA sunscreens is an easily accessible way to prevent skin reactions. The study objective was to assess skin acceptability in patients undergoing cancer treatment who received a daily sun protector SPF100 UVA-PF36. 59 patients were included, 56 were eligible for analysis. Patients (mean age 60.2 years ± 12.8) were predominantly women (71%).

P22-22 Exposure data of cosmetic products for patients undergoing cancer treatments

P22-22 Exposure data of cosmetic products for patients undergoing cancer treatments

Effectiveness of Resistance Training on Fatigue in Patients Undergoing Cancer Treatment: A Meta-Analysis of Randomized Clinical Trials.

Objective To assess the effectiveness of the resistance training to improve fatigue levels in people with cancer who are enrolled in adjuvant and/or neoadjuvant treatment. Methods MEDLINE, Web of Science, Embase, SPORTDiscus, LILACS, CENTRAL, and CINAHL databases were searched from May to December 7, 2021. Randomized clinical trials (RCT) that evaluate the effects of resistance training on fatigue levels in people undergoing cancer treatment were included. The PEDro scale was considered to assess methodological quality of studies, and the evidence was summarized through the GRADE system. The standardized average differences, effect size, and inverse variance model for meta-analysis were calculated. Results Fifteen RCT for qualitative synthesis and thirteen for meta-analysis were selected. A moderate to high level of evidence of resistance training was identified to improve fatigue in people undergoing cancer treatment. Meta-analysis showed a significant reduction in fatigue (SMD = −0.31, CI 95% = −0.58, -0.12, P = 0.001) after 10 to 35 sessions of resistance training. Conclusion The 10 to 35 sessions of resistance training are effective in reducing fatigue level in cancer patients who are undergoing cancer treatment and have a moderate level of quality evidence.

Racial disparities in commercial U.S. oocyte donors.

e18501 Background: Patients undergoing cancer treatment are more likely to face infertility. Despite improvements in counseling and fertility preservation, some oncology patients will require the use of donor oocytes to complete their family. We investigated whether the current cohort of commercial oocyte donors reflects the racial profile of the U.S. population. We also evaluated whether there were differences in donors’ perception of pain and quality of informed consent by race to elucidate potential avenues to improve donor retention. Methods: Institutional Review Board approved, retrospective survey of commercial, U.S. oocyte donors was emailed to recent donors recruited through Donor Egg Bank USA prior to 2020. There were 246 respondents out of 503 opened emails (48.9%). Donors were recruited by twenty different clinics that are affiliated with the same donor egg bank. Results: Black and Hispanic donors were significantly underrepresented among commercial U.S. egg bank donors while Caucasian and mixed-race donors were overrepresented (Table - left). The perception of pain in donors, however, did not differ according to race (Table - right, p = 0.245). Over 80% of donors reported that they had received better than acceptable levels of preparation through the informed consent process. Respondents’ report of the quality of the informed consent process did not differ by race (p = 0.728). Conclusions: Our study represents one of the largest cohorts of recent U.S. oocyte donors. The racial composition of recruited donors overrepresents Caucasian and mixed-race donors while underrepresenting Hispanic and Black donors when compared to the racial identity self-reported in the 2020 US census. This may represent the demographics of the current recipient cohort; however, the lack of diversity is of particular concern for oncology patients seeking oocytes as their racial composition likely reflects the diversity represented in the U.S. population. Notably, there was no difference by race in the pain score of donors by race or the quality of their informed consent process suggesting that all donors were treated similarly regardless of racial identity. Donor egg banks should consider diversification of their donor profiles to provide equal access among oncology patient seeking donor oocytes.[Table: see text]

Examination of Provider and Patient Knowledge, Beliefs, and Preferences in Integrative Oncology at a National Cancer Institute-Designated Comprehensive Cancer Center.

Purpose:The use of integrative approaches for symptom management is highly prevalent among patients undergoing cancer treatment and among cancer survivors and is increasingly endorsed by clinical practice guidelines. However, access to and implementation of integrative oncology (IO) approaches are hindered by barriers at multiple levels, including logistic, geographic, financial, organizational, and cultural barriers. The goal of this mixed-method study was to examine oncology provider and patient knowledge, beliefs, and preferences in IO to identify facilitators, barriers, and recommendations for implementation of IO modalities.Materials and Methods:Data sources included patient surveys and provider semistructured interviews. Patients were in active treatment (n = 100) and survivors (n = 100) of heterogeneous cancer types. Patient and survivor surveys interrogated: (1) interest in types of IO approaches; and (2) preferences for delivery modality, frequency, and location. Providers (n = 18) were oncologists and nurse navigators working with diverse cancer types. Interviews queried their knowledge of and attitudes about IO, about their patients' needs for symptom management, and for recommendations for implementation of IO approaches in their clinic. We used the Consolidated Framework for Implementation Research framework to systematically analyze provider interviews.Results:The primary interests reported among actively treated patients and survivors were massage therapy, acupuncture, and wellness/exercise. Most patients expressed interest in both group and individual sessions and in telehealth or virtual reality options. Emergent themes from provider interviews identified barriers and facilitators to implementing IO approaches in both the internal and external settings, as well as for the implementation process.Conclusion:The emphasis on mind–body interventions as integrative rather than alternative highlights the importance of interventions as evidence-based, comprehensive, and integrated into health care. Gaining simultaneous perspectives from both patients and physicians generated insights for the implementation of IO care into complex clinical systems within a comprehensive cancer center.

Availability of child care resources for patients undergoing cancer treatment at NCI-designated cancer centers.

e13508 Background: The National Cancer Institute (NCI) estimates that approximately one-quarter of adults with cancer are parents to children less than 18 years. Further, it is estimated that 2.85 million minor children in the United States have a parent undergoing cancer treatment. Previous studies have demonstrated that parents with cancer experience significant stress and disruptions to familial life following a cancer diagnosis. In a study of women with breast, gynecologic cancer and other cancers undergoing cancer therapy, 48.7% of women endorsed needing help with childcare and 64.1% needing help with household management. Despite this evidence supporting both a need for childcare among patients with cancer, data regarding the availability of on-site childcare programs and resources at NCI-designated cancer centers is limited. The objective of this cross-sectional study was to assess the availability of childcare resources for parents who are undergoing cancer treatment at NCI-Designated Cancer Centers. Methods: The availability of childcare resources for parents undergoing cancer treatment at all 51 NCI-designated comprehensive cancer centers and 13 NCI-designated cancer was assessed in January 2021 and February 2021. Childcare resources were assessed via online search and telephone calls. Specifically, centers were queried regarding availability of daycare programs for children of patients undergoing treatment and whether resources were available to assist patients in need of childcare. Descriptive statistics were performed. Results: In total, only 1/64 (1.6%) of NCI-designated cancer centers currently offer childcare resources for patients undergoing cancer treatment. This center offers childcare for children ages 2–8, free of charge with multiple outpatient locations. One additional institution previously provided patients with access to daycare, but has closed due to the COVID-19 pandemic. Further, only 1/64 (1.6%) NCI-designated cancer center offers financial assistance grants to aid patients to subsidizing childcare costs during cancer treatment. Conclusions: Institution sponsored options for childcare for patients undergoing cancer treatments are highly limited, even in the best resourced cancer care settings. The COVID-19 pandemic has limited options further, and many hospitals now restrict visitors under the age of 18. Patient grants or institutionally sponsored childcare provider networks may represent an avenue for supporting parents who are facing a cancer diagnosis. Supporting families of patients with cancer has great potential to impact quality of life, economic and psychological stress.

NCCN Guidelines® Insights: Hematopoietic Growth Factors, Version 1.2022.

The NCCN Guidelines for Hematopoietic Growth Factors provide recommendations for the appropriate use of growth factors in the clinical management of febrile neutropenia (FN), chemotherapy-induced thrombocytopenia (CIT), and chemotherapy-induced anemia (CIA). Management and prevention of these sequelae are an integral part of supportive care for many patients undergoing cancer treatment. The purpose of these guidelines is to operationalize the evaluation, prevention, and treatment of FN, CIT, and CIA in adult patients with nonmyeloid malignancies and to enable the patient and clinician to assess management options for FN, CIT, and CIA in the context of an individual patient's condition. These NCCN Guidelines Insights provide a summary of the important recent updates to the NCCN Guidelines for Hematopoietic Growth Factors, with particular emphasis on the incorporation of a newly developed section on CIT.

Assessing Honey Jell® as a Treatment for Reducing Cancer-Related Fatigue in Breast Cancer Patients Undergoing Radiotherapy: Double Blind Phase III Clinical Trial

Background: Cancer-Related Fatigue (CRF) is one of the most common complaints among cancer patients, which is experienced by 50-90% of them. It can affect several physical, emotional, and social aspects of cancer patients' lives and reduce their quality of life. In recent decades, the number of studies has increased in this regard, and several different ways for CRF management have been introduced. We aimed to assess the effect of Honey Jell ® on reducing cancer-related fatigue among breast cancer patients undergoing cancer treatment. Methods: The current study was a 9-week, double-blind, randomized phase III clinical trial, which was carried out on 40 breast cancer patients at the Cancer Institute of Iran. The participants were randomly assigned to two groups by the Balanced-Block Randomization method. The study group received Honey Jell ® (natural product based on honey, royal jelly, and extract of Ziziphus zizyphus) while we used ordinary honey as a placebo for the control group. We assessed CRF at baseline, 2 and 4 weeks after the start of the study and four weeks after finishing the intervention using three different approaches. The mean score of fatigue was compared between the study groups during the study period using the T-test. Results: Mean of fatigue score for intervention and control cases was 39.80 (±9.6) and 38.4 (±11.1) at the baseline (P-value= 0.698). The figure reduced to 31.55 (±6.08) for the intervention group in the 2nd week, while for controls, it was 35.55 (±8.2) (P=0.041). The mean score of fatigue continuously reduced to 30.65 (±6.86) in the fourth week in the intervention cases, which was considerably lower than the figure for controls (36.05±5.20) (P=0.024). The mean score of CRF in the intervention group increased 31.80 (±6.91) four weeks after the end of the study, while it was almost unchanged for controls (36.64±6.13) and the observed difference was not statistically significant (P=0.148). Conclusion: Honey Jell ® could be considered as an effective treatment to alleviate cancer-related fatigue. However, more studies are required in this regard.

LVEF by Multigated Acquisition Scan Compared to Other Imaging Modalities in Cardio-Oncology: a Systematic Review.

Purpose of ReviewThe prevalence of cancer therapy-related cardiac dysfunction (CTRCD) is increasing due to improved cancer survival. Serial monitoring of cardiac function is essential to detect CTRCD, guiding timely intervention strategies. Multigated radionuclide angiography (MUGA) has been the main screening tool using left ventricular ejection fraction (LVEF) to monitor cardiac dysfunction. However, transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) may be more suitable for serial assessment. We aimed to assess the concordance between different non-radiating imaging modalities with MUGA to determine whether they can be used interchangeably.Recent FindingsIn order to identify relevant studies, a PubMed search was performed. We included cross-sectional studies comparing MUGA LVEF to that of 2D TTE, 3D TTE, and CMR. From 470 articles, 22 were selected, comprising 1017 patients in total. Among others, this included three 3D TTE, seven 2D harmonic TTE + contrast (2DHC), and seven CMR comparisons. The correlations and Bland-Altman limits of agreement varied for CMR but were stronger for 3D TTE and 2DHC.SummaryOur findings suggest that MUGA and CMR should not be used interchangeably whereas 3D TTE and 2DHC are appropriate alternatives following an initial MUGA scan. We propose a multimodality diagnostic imaging strategy for LVEF monitoring in patients undergoing cancer treatment.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11897-022-00544-3.

Potential Role of Neutrophil Extracellular Traps in Cardio-Oncology.

Cardiovascular toxicity has emerged as the leading cause of death in patients undergoing cancer treatment. Thus, cardio-oncology (CO) care must also focus on the prevention and management of related cardiovascular (CV) complications caused by cancer therapy. Neutrophil extracellular traps (NETs)—entities with released DNA, proteases, proinflammatory and prooxidative substances from blasted neutrophils—play an important role in cancer proliferation, propagation metastasis, and incident CV events (acute coronary syndrome, thromboembolic events, and heart failure). Although NETs have been shown to be involved in cancer progression and incident CV events, little is known about their relationship with cardio-oncology, especially on cancer treatment-related cardiovascular toxicity (CTRCT). This review aims to explore the evidence of the impact of NETs on cancer, CV events, and CTRCT, and the possible solutions based on the mechanism of NETs activation and NETs released toxic substances.