Massage relieves nausea in women with breast cancer who are undergoing chemotherapy

OBJECTIVES: The aim of the present study was to examine the effect of massage on nausea, anxiety, and depression in patients with breast cancer undergoing chemotherapy. DESIGN: This work was a single-center, prospective, randomized, controlled trial. SETTINGS/LOCATION: This study was conducted in an oncology clinic, in a hospital in southwestern Sweden. SUBJECTS: Thirty-nine (39) women (mean age = 51.8) with breast cancer undergoing chemotherapy were enrolled. INTERVENTIONS: The patients were randomly assigned to a massage therapy group (20 minutes of massage on five occasions) or a control group (five 20-minute visits). OUTCOME MEASURES: All patients recorded nausea and anxiety on the Visual Analogue Scale before and after each intervention. They also completed the Hospital Anxiety and Depression Scale. RESULTS: Massage treatment significantly reduced nausea compared with control treatment (p = 0.025) when improvement was measured as a percentage of the five treatment periods. Differences in anxiety and depression between the two treatment regimes could not be statistically demonstrated. CONCLUSIONS: This study complements previous studies on the effect of massage and supports the conclusion that massage reduces nausea in these patients.     

渐进式肌肉放松训练对乳腺癌高致吐方案化疗所致恶心呕吐的效果观察

目的 探讨渐进式肌肉放松训练对乳腺癌高致吐方案化疗所致恶心呕吐(CINV)的治疗效果。方法 收集我院2017年1月-2017年6月行表阿霉素联合环磷酰胺(EC)方案化疗的乳腺癌患者68例,按照随机数字表法分为观察组和对照组,每组各34例。对照组给予托烷司琼注射液、地塞米松治疗;观察组在此基础上进行渐进式肌肉放松训练,比较两组对预防CINV的临床疗效。结果 急性期两组恶心、呕吐发生率、恶心缓解率及呕吐频次比较,差异均无统计学意义(P>0.05);延迟期两组恶心发生率比较,差异无统计学意义(P>0.05),观察组呕吐发生率、呕吐频次明显低于对照组,恶心缓解率明显高于对照组,差异有统计学意义(P<0.05)。结论 渐进式肌肉放松训练能显著降低乳腺癌高致吐方案化疗延迟期呕吐发生率、呕吐频次和恶心程度,简便易行,可用于临床防治乳腺癌高致吐方案化疗所致CINV。     

The impact on sexual functioning of chemotherapy-induced menopause in women with breast cancer

This article presents a comprehensive review and synthesis of empirical and conceptually based literature documenting the impact of chemotherapy-induced menopause on the sexual functioning of women with breast cancer. A literature search of the CINAHL, MEDLINE, and Psych Lit from 1980 to 1999 databases was undertaken. This literature was systematically assessed to determine key findings and conclusions. Two major themes were identified and are reported here: physical and psychological sequelae associated with altered sexual functioning. Recommendations and suggestions for further directions in research are identified.     

Review of acupressure studies for chemotherapy-induced nausea and vomiting control

The purpose of this review was to evaluate the effects of a noninvasive intervention, acupressure, when combined with antiemetics for the control of chemotherapy-induced nausea and vomiting (CINV). Ten controlled acupressure studies were included in this review. The review evaluated one quasi-experimental and nine randomized clinical trials, which included two specific acupressure modalities, that is, acupressure band and finger acupressure. The effects of the acupressure modalities were compared study by study. Four of seven acupressure band trials supported the positive effects of acupressure, whereas three acupressure band trials yielded negative results regarding the possible effects of acupressure; however, all the studies with negative results had methodological issues. In contrast, one quasi-experimental and two randomized finger acupressure trials all supported the positive effects of acupressure on CINV control. The reported effects of the two acupressure modalities in each phase of CINV produced variable results. Acupressure bands were effective in controlling acute nausea, whereas finger acupressure controlled delayed nausea and vomiting. The overall effect of acupressure was strongly suggestive but not conclusive. Differences in the acupressure modality, the emetic potential of chemotherapeutic agents, antiemetic use, and sample characteristics of each study made study-to-study comparisons difficult. Suggestive effects of acupressure, cost-effectiveness, and the noninvasiveness of the interventions encourage researchers to further investigate the efficacy of this modality. Acupressure should be strongly recommended as an effective, nonpharmacologic adjuvant intervention for CINV control if its positive effects are reproduced in future acupressure clinical trials.     

穴位按压缓解胃肠道肿瘤化疗患者恶心呕吐的效果观察

目的探讨穴位按压对缓解胃肠道肿瘤化疗患者恶心、呕吐的效果。方法对78例胃肠道恶性肿瘤患者化疗期间进行内关穴按压,用中文版恶心呕吐干呕症状评估量表评估患者化疗后出现的恶心、呕吐和干呕症状。结果统计分析显示,穴位按压对缓解化疗患者恶心、呕吐等不良反应有一定效果,且具有统计学意义(P0.01)。结论穴位按压能有效地降低患者恶心、呕吐的发生频率,缩短经历时间及减轻症状的严重程度,提高患者对化疗的耐受性,减轻痛苦。     

Development and validation of an evidence-based auricular acupressure intervention for managing chemotherapy-induced nausea and vomiting in breast cancer patients

BackgroundAuricular therapy (AT) has been utilized as a promising complementary health approach to alleviating chemotherapy-induced nausea and vomiting (CINV) in breast cancer patients. However, current evidence on AT for CINV management has been inconclusive, and relevant AT treatment protocols have varied considerably in the intervention dosage and acupoint formula without an evidence-informed intervention protocol tailored to CINV symptoms. This study aimed to develop an evidence-based AT intervention protocol for CINV management in breast cancer patients receiving chemotherapy.MethodsThis study adopted the Medical Research Council Framework for Developing and Evaluating Complex Interventions (the MRC framework) to guide the AT intervention development process. The process consists of four steps: identification of the evidence base, identification of theories and practice standards, identification of cancer symptom characteristics, and modelling and validation. The preliminary AT intervention was then evaluated through a content validity study to identify its theoretical and practical appropriateness. The content validity index (CVI) was used to determine the consensus level of the panel.ResultsA preliminary AT intervention protocol, including a true AT intervention and a sham AT intervention, was developed based on research evidence identified from five systematic reviews, the homuncular reflex theory, the zang-fu organs and meridian theory, relevant AT practice standards, and the natural symptom progress of CINV. The true AT was designed as a daily manual acupressure for five consecutive days. While the sham AT was designed with the same intervention duration and acupoint formula as the true AT without manual acupressure. The content validity study demonstrated excellent consensus among the expert panel to support the AT intervention as a theoretically and practically feasible program with the item-level CVI ranging from 0.83 to 1.0 and the scale-level CVI reaching 1.0.ConclusionThis study followed the MRC framework to develop an evidence-based AT intervention for CINV management which is well supported by systematic review research evidence, AT theories and practice standards, CINV symptom characteristics, and expert panel consensus. The AT intervention would be further evaluated in a pilot randomised controlled trial to confirm its utility, feasibility and acceptability in clinical settings.     

The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study

As an adjunct to standard antiemetics for the relief of chemotherapy-induced nausea and vomiting (NV), 739 patients were randomly assigned to either: 1) acupressure bands, 2) an acustimulation band, or 3) a no band control condition. Patients in the acupressure condition experienced less nausea on the day of treatment compared to controls (P<0.05). There were no significant differences in delayed nausea or vomiting among the three treatment conditions. Additional analyses revealed pronounced gender differences. Men in the acustimulation condition, but not the acupressure condition, had less NV compared to controls (P<0.05). No significant differences among the three treatment conditions were observed in women, although the reduction in nausea on the day of treatment in the acupressure, compared to the no band condition, closely approached statistical significance (P=0.052). Expected efficacy of the bands was related to outcomes for the acupressure but not the acustimulation conditions.     

Insight in the prediction of chemotherapy-induced nausea

Purpose  

To identify risk factors for chemotherapy-related nausea.     

Non-pharmacological management for chemotherapy-induced nausea and vomiting in patients with cancer: a scoping review

Objective: This review aimed to map and summarize published studies that tested non-pharmacological management for chemotherapyinduced nausea and vomiting(CINV). Methods: We searched for eligible studies in 5 electronic databases and screened the retrieved studies using the inclusion and exclusion criteria. Data were then collated according to the types of interventions, measurement tool, and outcomes. Results: The search yielded 2343 records, of which 11 were included. Four categories of non-ph...     

Involving women with breast cancer in the development of a patient information leaflet for anticipatory nausea and vomiting.

As chemotherapy regimens increase in toxicity and changes in service provision move towards a more ambulatory outpatient basis, patients are often coping with side effects of treatment in isolation. Despite advances in pharmacological control, for some patients nausea and vomiting can be problematic. For some this can develop into anticipatory nausea and vomiting (ANV), which can severely effect the patients physical and psychological well-being. It is well recognised that the giving of realistic and understandable information is paramount to empower patients in their individual coping. A plethora of literature supports the use of Patient Information Leaflets as a means to educate and empower patients within their treatment trajectory. This paper discusses the authors' experiences in developing a Patient Information Leaflet, designed to assist breast cancer patients in understanding and coping with the symptoms of ANV. The patient's needs were sought to add clarity to the development and design of the leaflet. The authors conclude that developing a Patient Information Leaflet was a major undertaking in terms of time and resources.     

Dronabinol and prochlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting.

Dronabinol (Marinol, Roxane Laboratories, Columbus, OH) and prochlorperazine were tested alone and in combination in a randomized, double-blind, parallel group, multicenter study. Patients were randomized to receive either 1) dronabinol 10 mg every 6 hr plus placebo; 2) placebo plus prochlorperazine 10 mg every 6 hr; or 3) dronabinol and prochlorperazine, each 10 mg every 6 hr. Antiemetic treatment was begun 24 hr prior to and continued for 24 hr after the last dose of chemotherapy; all was given orally. Only 29% of patients in group 3 versus 47% in group 1 and 60% in group 2 experienced nausea after chemotherapy. In addition, the median duration per episode and severity of nausea were significantly less with combination therapy. Vomiting occurred after chemotherapy in 41%, 55%, and 35% of patients in groups 1, 2, and 3, respectively. The median duration per episode of vomiting was 1 min in group 3 versus two in group 1 and four in group 2. Side effects, primarily CNS, were more common in group 1 than in group 2; addition of prochlorperazine to dronabinol appeared to decrease the frequency of dysphoric effects seen with the latter agent. The combination was significantly more effective than was either single agent in controlling chemotherapy-induced nausea and vomiting.     

Rehabilitation in women with breast cancer

The diagnosis and treatment of breast cancer in women has undergone profound changes in the past century. Although much research and clinical attention has been focused on saving the lives of women with this condition, less focus has been on rehabilitation aspects. This postacute care should be a distinct phase of treatment. The field of physical medicine and rehabilitation has much to offer women who undergo extremely toxic although life-prolonging therapies for breast cancer. The focus of rehabilitation should include improving strength and cardiovascular conditioning, alleviating pain and improving fatigue. With respect to exercise, this can help women to physically recover from treatment and potentially prevent cancer recurrence. Many exciting opportunities will be available for rehabilitation specialists to improve the care of women with breast cancer and to participate in research in the field of oncology rehabilitation.     

Effectiveness of palonosetron for preventing delayed chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy in patients with gastrointestinal cancer

Purpose

Patients with gastrointestinal cancer who were receiving moderately emetogenic chemotherapy (MEC) were switched from granisetron, a first-generation 5-hydroxytryptamine-3 receptor antagonist, to palonosetron at our hospital. In the present study, we compared effectiveness before and after switching antiemetic treatment.

Methods

Among patients who were receiving MEC for gastrointestinal cancer, we prospectively observed 46 patients given granisetron and 46 given palonosetron. To allow adverse reactions to be graded in accordance with the Common Terminology Criteria for Adverse Events, version 4.0, a questionnaire designed at our hospital was used to compare the occurrence of delayed nausea and vomiting between patients who received granisetron (GRA group) and those who received palonosetron (PAL group).

Results

The incidence of delayed nausea was significantly lower in the PAL group (8.7 %, 4/46; p?<?0.01) than in the GRA group (37 %, 17/46). Delayed vomiting developed in five patients (10.9 %) in the GRA group, but did not occur in the PAL group. On the basis of the results of multivariate analysis, young age, female gender, and the use of granisetron were significant risk factors for delayed nausea.

Conclusion

Our survey showed that palonosetron effectively controls delayed nausea caused by MEC for gastrointestinal cancer.     

Effect of acupressure on chemotherapy-induced nausea and vomiting in gynecologic cancer patients in Turkey

PurposeThe aim of the current study was to assess the effect of acupressure applied to the pericardium 6 (P6 or Neiguan) acupuncture point with a wristband (Sea-Band™) on nausea–vomiting in addition to the standard antiemetic medications used to prevent nausea–vomiting due to chemotherapy in gynecologic cancer patients.MethodIn this prospective research we used pre- and posttests. The study consisted of 34 patients with gynecologic cancer.ResultsWe found a significant decrease in the patients' mean scores of nausea and the use of antiemetic medications following acupressure applied to the patients with a wristband, when compared with their mean scores of nausea and the use of antiemetic medications prior to the application (p < 0.05), and we also observed a decline in their mean scores of vomiting and retching episodes; however, this decline was not found to be statistically significant (p > 0.05).ConclusionsThe findings from this study suggest that the acupressure applied to P6 acupuncture point with wristbands may be effective in reducing chemotherapy-related nausea and may decrease the antiemetic use after chemotherapy. Further research with more subjects is needed.     

Acupuncture and acupressure for the management of chemotherapy-induced nausea and vomiting

PURPOSE: To review existing research, the National Institutes of Health (NIH) consensus statement, and federal regulations regarding the use of acupuncture and acupressure in the management of chemotherapy-induced nausea and vomiting in order to give nurse practitioners (NPs) the information they need to provide the best care for patients undergoing chemotherapy treatment for cancer. DATA SOURCES: Selected scientific literature and Internet sources. CONCLUSIONS: Research supports the effectiveness of acupuncture and acupressure for the treatment of chemotherapy-induced nausea and vomiting. Used in conjunction with current antiemetic drugs, acupuncture and acupressure have been shown to be safe and effective for relief of the nausea and vomiting resulting from chemotherapy. IMPLICATIONS FOR PRACTICE: Even with the best antiemetic pharmacological agents, 60% of cancer patients continue to experience nausea and vomiting when undergoing chemotherapy treatments. Because the NIH supports the use of acupuncture for nausea and vomiting, the NP is obligated to be knowledgeable about the use of these and other effective complementary treatments in order to provide the best care.     

Meaning of illness for women with breast cancer

The meaning that women with breast cancer ascribe to their disease may well have an impact on the effectiveness of coping strategies used to come to terms with breast cancer Health rare professionals need to know what meanings women with breast cancer are ascribing to their disease if they are to identify maladaptive coping strategies and ensure that women receive the support that they need in order to promote physical and psychological recovery This study involved assessing meaning of illness for a group of women with breast cancer at two points in time, the time of diagnosis and a mean of 21 months from diagnosis The eight meanings of illness devised by Lipowski were depicted by the following words challenge, enemy, punishment, loss, strategy, relief, weakness and value The most popular choice of meaning for the women was challenge, although some women's choices indicated that maladaptive coping strategies were being used The implications of the study for nurses and other health care professionals are discussed     

Measuring the impact of guideline-based antiemetic therapy on nausea and vomiting control in breast cancer patients with multiple risk factors

Purpose

The objective of this exploratory analysis was to determine if individual patient risk factors could be used to optimize chemotherapy-induced nausea and vomiting (CINV).

Methods

Through validated risk prediction models which quantify patient risk factors, 152 patients with early-stage breast cancer scheduled to received adjuvant anthracycline-based chemotherapy were categorized as being at low (level 0) or high-risk (level 1) for CINV. Prior to the first cycle of chemotherapy, low-risk patients received ondansetron and dexamethasone, while high-risk level 1 patients also received aprepitant. For subsequent cycles, patients who experienced CINV had their antiemetics changed in a stepwise manner to level 2 (extended-duration dexamethasone) or level 3 (extended-duration dexamethasone and low-dose olanzapine).

Results

The study enrolled 152 patients who received 484 cycles of chemotherapy. Forty patient cycles were classified as low risk (level 0) compared to 201, 162 and 81 that were classified as high-risk levels 1, 2 and 3, respectively. Complete control of acute and delayed vomiting was comparable and was achieved in over 85 % of patients across all risk levels (p = 0.56 and p = 0.99). In contrast, complete control of acute and delayed nausea was reduced in risk levels 1 to 3 compared to level 0 (acute = 51.2, 58.0, 45.7 vs. 70.0 %; p = 0.013)—(delayed = 32.8, 45.7, 34.6 vs. 62.5 %; p < 0.001).

Conclusions

Despite the addition of aprepitant, extended-duration dexamethasone and olanzapine, patients at high risk for CINV due to personal risk factors failed to achieve good nausea control.