Counseling interventions delivered in women with breast cancer to improve health-related quality of life: a systematic review

Background

Higher survival rates for breast cancer patients have led to concerns in dealing with short- and long-term side effects. The most common complications are impairment of shoulder functions, pain, lymphedema, and dysesthesia of the injured arm; psychological consequences concern: emotional distress, anxiety, and depression, thereby, deeply impacting/affecting daily living activity, and health-related quality of life.

Objective

To perform a systematic review for assessing the efficacy or effectiveness of interventions aiming at improving health-related quality of life, return to daily activity, and correct lifestyles among breast cancer patients.

Methods

A literature search was conducted in December 2016 using the databases PubMed and Scopus. Search terms included: (counseling) AND (breast cancer) AND (quality of life). Articles on counseling interventions to improve quality of life, physical and psychological outcomes were included.

Results

Thirty-five articles met the inclusion criteria. The interventions were grouped in five main areas: concerning lifestyle counseling interventions, related to combined interventions (physical activity and nutritional counseling), physical therapy, peer counseling, multidisciplinary approach, included psychological, psycho-educational interventions, and cognitive-behavior therapy (CBT). Exercise counseling as well as physical therapy are effective to improve shoulder mobility, healing wounds, and limb strength. Psychological therapies such as psychoeducation and CBT may help to realize a social and psychological rehabilitation.

Conclusion

A multidisciplinary approach can help in sustaining and restoring impaired physical, psychosocial, and occupational outcomes of breast cancer patients.

     

Experimental study on cross‐reactivity of α‐arbutin toward p‐phenylenediamine and hydroquinone in guinea pigs

Hydroquinone (HQ) has been used as a skin‐lightening cosmetic ingredient, while it has been known that HQ shows sensitizing potential and cross‐reactivity toward a strong sensitizer, p‐phenylenediamine (PPD). α‐Arbutin, a glycoside of HQ (4‐hydroxyphenyl α‐D‐glucopyranoside), is used worldwide as a skin‐lightening agent. The aim of this study was to evaluate the cross‐reactivity of α‐arbutin toward PPD and HQ. All tests were performed using the guinea pig maximization test. In experiments on the cross‐reactivity of α‐arbutin or HQ to PPD, six animals in each group were induced with PPD at 0.1% by i.d. injection and at 1.0% by topical application. The animals were challenged with α‐arbutin, HQ or PPD (as a positive control) at concentrations of 0.01%, 0.05% and 0.1%. In experiments on the cross‐reactivity of α‐arbutin to HQ, four animals in each group were induced with HQ at 2% by i.d. injection and at 1% by topical application. The animals were challenged with α‐arbutin or HQ (as a positive control) at concentrations of 0.2%, 2% and 20%. The cross‐reactivity toward PPD was observed with HQ (4/6) only at 0.1% challenge. However, α‐arbutin showed no apparent cross‐reactivity to either PPD or HQ even at their highest challenge concentrations. Potent sensitization was observed with PPD (6/6) even at 0.01% challenge and with HQ (3/4) at 0.2%. In conclusion, glycosylation of HQ remarkably reduced the sensitization potency of HQ and the cross‐reactivity of HQ to PPD.