Effect of Nutritional Formula on Fatigue Among Patients With Advanced Lung Cancer at a University Hospital-Egypt.

Background: Lung cancer is the most common cancer and cause of death worldwide. Almost 50 percent of lung cancer cases are found in the developing countries. The estimated numbers of new lung cancer cases in the Arab world show a gradual increase every year. Cancer lung and its treatment modalities increase incidence of fatigue. Many studied documented that patients with cancer related fatigue described it as more distressing than other cancer-related symptoms such as pain, depression, and nausea. Correction of anemia, exercises, dietary supplements rich in vitamins specially beta-carotene, yoga, complementary and alternative medicine have been suggested as strategies/ guidelines of managing fatigue. Natural nutritional supplementations were recommended by oncologists, nurse specialists, as well authors in the field of applied nutrition and they recommend juicing fruits and vegetables. One of the recommended formulas for fighting fatigue consisted of carrot, beetroot, mixed with celery juice (energy juice). Carrot juice is known as a miracle juice as it removes bacterial infection, beetroot act as anti cancer factor as well as powerful blood detoxifying agent and celery juice is a source of folic acid, vitamin B1&6. Aim of the Study: Was to identify the effect of the nutritional formula on fatigue among lung cancer patients at a University Hospital-Egypt. Design: Time series longitudinal comparative study. Research questions: 1-a-What is the effect of the nutritional formula on fatigue among patients with advanced lung cancer before and after receiving chemotherapy? 1-b- Is there a difference between fatigue scores on the start of using the formula and at the end of rehydration period among patients with advanced cancer lung receiving chemotherapy? 2-a-Is there a relation between fatigue score prior and after taking the nutritional formula and the selected medical outcome (duration of illness, hemoglobin, WBCs)? 2-b-Is there a relation between fatigue score prior and after taking the nutritional formula and patients' age, metastasis occurrence and chemotherapy medication? Sample: A convenient sample of thirty patients with advanced lung cancer receiving chemotherapy was collected over a year. Two tools were used to collect data; Demographic & Medical data assessment sheet and the Revised Piper Fatigue Scale (PFS-R13).  Data were collected before receiving chemotherapy (on admission), one day after receiving chemotherapy (beginning of using the nutritional formula), after rehydration period (one week later), two weeks later & before discharge). Results: Fatigue scores increased after receiving chemotherapy and began to decrease gradually after rehydration period, so there was a significant statistical difference between fatigue scores measured before and after the use of the nutritional formula. And there is a statistical significant difference over the four readings of fatigue scores reading and the selected medical responses (duration of illness Hgb 1st reading & 2nd reading, WBCs 1st reading), age. Conclusion: The suggested nutritional formula helped in decreasing fatigue among lung cancer patients receiving chemotherapy. Key words: Fatigue, cancer lung, chemotherapy, nutritional values (Carrots, celery, parsley)

Symptoms-Related Distress among Patients Receiving Adjuvant Therapy: Radical Mastectomy versus Lumpectomy

Background: Breast cancer is the most common cancer in women worldwide. Although adjuvant therapy after breast-conserving surgery or mastectomy reduces the risk of breast cancer coming back but it induces many of physiological and psychological effects. The aim of the current study was to compare the Symptoms-related distress among patients receiving adjuvant therapy: Radical Mastectomy versus Lumpectomy at a University Hospital. Research Questions: Q1: What are the symptoms related distresses among radical mastectomy and lumpectomy patients receiving adjuvant therapy? Q2: Is there a difference in symptoms related distress between radical mastectomy and lumpectomy patients receiving adjuvant therapy? Design: A comparative descriptive -non-experimental design was utilized to achieve the aim of the current study. Tools: I) Socio-demographic and medical data sheet: It included data related to the studied subjects such as age, gender, marital status, types of received chemotherapy,…..etc. Tool II: Rotterdam Symptom Checklist (RSCL); it is useful in measuring the symptoms reported by cancer patients. It aims to enhance the insight into the consequences of the disease and its treatment. Setting: The study was conducted at the Nuclear Medicine Unit at Kasr Al-Aini Educational Hospital; affiliated to Cairo-University-Egypt. Subjects: A convenient sample of 60 adult female patients divided into two equal groups, patients with radical mastectomy (n=30) and patients with lumpectomy (n=30) both groups received chemotherapy after surgery. Results: 80% of mastectomy and lumpectomy cases overall their age was between 40 and less than 60 years old. 33.3% of the study sample can read and write. The study pointed out that 48.3% of the sample had breast cancer between 2 and less than 6 months. While 50% of them between 6 to less than 12 months with Mean+SD= 5.65+2.There was a perfect correlation between total score of RSCL and physical total score =0.826, 0.829 & 0.828 for patients overall cases, mastectomy cases only & lumpectomy cases only respectively. Also there was a strong correlation between the RSCL total score and psychological total score=0.705, 0.747 & 0.668 for the patients overall cases, mastectomy cases only & lumpectomy cases only respectively. Conclusion: The lumpectomy cases scored generally their physical, psychological & activity level impairment status much better than the mastectomy cases. Also lumpectomy cases their general QOl was better than the mastectomy cases. Recommendation of the study: 1-More close physical, psychological support must endorse in nursing care for patients with mastectomy. 2-QOL advanced tool is recommended on survey scale to evaluate patients' condition with mastectomy & lumpectomy. 3-All patients with breast cancer must join a rehabilitation program before & after proceed in either mastectomy or lumpectomy surgical management. Keywords: Adjuvant therapy, Mastectomy, lumpectomy, symptoms related distress

Effect of Deep Tissue Massage on Alleviating Pain Among Breast & Lung Cancer Patients at a Selected University Hospital-Egypt

Background: Cancer increased worldwide. Pain is the most significant problem related for such patients; it affects all aspects of life. Aim of the current study was to examine the effect of deep tissue massage on alleviating pain among breast & lung cancer patients at a selected university hospital, Egypt. Design: A quazi-experimental design was utilized, the study conducted at the Nuclear Medicine Unit at Kasr Al-Aini Educational Hospital, affiliated to Cairo-University. Research questions: 1-Is massage significantly decreased the mean pain intensity scores among study group when compared to control group among patients with breast and lung cancer? 2-Is massage significantly decreased the mean pain quality scores among study group when compared to control group among patients with breast and lung cancer? 3-Is massage significantly decreased the mean sleeping difficulty scores among study group when compared to control group among patients with breast and lung cancer? 4-Is massage significantly decreased the mean symptom burden scores among study group when compared to control group among patients with breast and lung cancer? Sample: A convenient sample of 60 adult male and female patients with breast and lung cancer over 6 consecutive months were randomly assigned into two equal groups, 30 patients each, the control group received only the routine hospital pain management and the study group received deep tissue massage in addition to the hospital routine pain management. Tools: Five tools were utilized to gather data as follow: 1) Demographic data sheet, numeric pain rating scale, pain quality assessment scale, the memorial symptom assessment scale and the difficulty sleeping scale. The study group received 3 sessions of massage per week for about 15 minutes each. All patients were followed up for 6 weeks. Results: The study results concluded that there was no statistical significant difference between study and control groups in relation to demographic variables, intensity and quality of pain, sleeping difficulties and symptom burden in the 1st reading as both groups were homogeneous, while by the end of the 6th week, there was a statistical significant difference between the study & control groups regarding intensity, quality of pain, sleeping difficulties and symptom burden. Conclusion: The study concluded that deep tissue massage is an effective method to decrease pain intensity; improve quality of pain; symptom burden as well as sleeping difficulties. Key words: Lung/breast cancer, massage, Knuckle technique, pain & sleeping difficulty.