Non-pharmacological self-management strategies for chemotherapy-induced peripheral neuropathy in people with advanced cancer: A systematic review and meta-analysis

Non-pharmacological self-management interventions for chemotherapy-induced peripheral neurotherapy (CIPN) are of clinical interest; however, no systematic review has synthesized the evidence for their use in people with advanced cancer. Five databases were searched from inception to February 2022 for randomized controlled trials assessing the effect of non-pharmacological self-management interventions in people with advanced cancer on the incidence and severity of CIPN symptoms and related outcomes compared to any control condition. Data were pooled with metaanalysis. Quality of evidence was appraised using the Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB2), with data synthesized narratively. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was applied to assess the certainty of the evidence. Thirteen studies were included, which had a high (69 %) or unclear (31 %) risk of bias. Greatest confidence was found for physical exercise decreasing CIPN severity (SMD: −0.89, 95 % CI: −1.37 to −0.41; p = 0.0003; I2 = 0 %; n = 2 studies, n = 76 participants; GRADE level: moderate) and increasing physical function (SMD: 0.51, 95 % CI: 0.02 to 1.00; p = 0.04; I2 = 42 %; n = 3 studies, n = 120; GRADE level: moderate). One study per intervention provided preliminary evidence for the positive effects of glutamine supplementation, an Omega-3 PUFA-enriched drink, and education for symptom self-management via a mobile phone game on CIPN symptoms and related outcomes (GRADE: very low). No serious adverse events were reported. The strongest evidence with the most certainty was found for physical exercise as a safe and viable adjuvant to chemotherapy treatment for the prevention and management of CIPN and related physical function in people with advanced cancer. However, the confidence in the evidence to inform conclusions was mostly very low to moderate. Future well-powered and appropriately designed interventions for clinical trials using validated outcome measures and clearly defined populations and strategies are warranted

MPPUPM Pantau Harga Makanan

Majlis Perwakilan Pelajar Universiti Putra Malaysia (MPPUPM) giat memantau harga makanan yang dikatakan meningkat dengan ketara sehingga menimbulkan kegelisahan mahansiswa

Telehealth cancer-related fatigue clinic model for cancer survivors: A pilot randomised controlled trial protocol (the T-CRF trial)

INTRODUCTION: Cancer-related fatigue (CRF) is one of the most common and debilitating adverse effects of cancer and its treatment reported by cancer survivors. Physical activity, psychological interventions and management of concurrent symptoms have been shown to be effective in alleviating CRF. This pilot randomised controlled trial (RCT) will determine the feasibility of a telehealth CRF clinic intervention (T-CRF) to implement evidence-based strategies and assess the impact of the intervention on CRF and other clinical factors in comparison to usual care. METHODS AND ANALYSIS: A parallel-arm (intervention vs usual care) pilot RCT will be conducted at the Princess Alexandra Hospital in Queensland, Australia. Sixty cancer survivors aged 18 years and over, who report moderate or severe fatigue on the Brief Fatigue Inventory and meet other study criteria will be recruited. Participants will be randomised (1:1) to receive the T-CRF intervention or usual care (ie, specialist-led care, with a fatigue information booklet). The intervention is a 24-week programme of three telehealth nurse-led consultations and a personalised CRF management plan. The primary objective of this pilot RCT is to determine intervention feasibility, with a secondary objective to determine preliminary clinical efficacy. Feasibility outcomes include the identification of recruitment methods; recruitment rate and uptake; attrition; adherence; fidelity; apathy; and intervention functionality, acceptability and satisfaction. Clinical and resource use outcomes include cancer survivor fatigue, symptom burden, level of physical activity, productivity loss, hospital resource utilisation and carer\u27s fatigue and productivity loss. Descriptive statistics will be used to report on feasibility and process-related elements additional to clinical and resource outcomes. ETHICS AND DISSEMINATION: This trial is prospectively registered (ACTRN12620001334998). The study protocol has been approved by the Metro South Health and Hospital Services Human Research Ethics Committee (MSHHS HREC/2020/QMS/63495). Findings will be disseminated through peer-reviewed publications, national and international conferences and seminars or workshops. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry ID: ACTRN12620001334998; Pre-results. Trial Version: Version 1.1. Last updated 10 December 2020

Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatment-related side effects following breast cancer

Exercise for Health was a randomized, controlled trial designed to evaluate two modes of delivering (face-to-face [FtF] and over-the-telephone [Tel]) an 8-month translational exercise intervention, commencing 6-weeks post-breast cancer surgery (PS). Outcomes included quality of life (QoL), function (fitness and upper body) and treatment-related side effects (fatigue, lymphoedema, body mass index, menopausal symptoms, anxiety, depression and pain). Generalised estimating equation modelling determined time (baseline [5 weeks PS], mid-intervention [6 months PS], post-intervention [12 months PS]), group (FtF, Tel, Usual Care [UC]) and time-by-group effects. 194 women representative of the breast cancer population were randomised to the FtF (n = 67), Tel (n = 67) and UC (n = 60) groups. There were significant (p < 0.05) interaction effects on QoL, fitness and fatigue with differences being observed between the treatment groups and the UC group. Trends observed for the treatment groups were similar. The treatment groups reported improved QoL, fitness and fatigue over time and changes observed between baseline and post-intervention were clinically relevant. In contrast, the UC group experienced no change, or worsening QoL, fitness and fatigue, mid-intervention. Although improvements in the UC group occurred by 12-months post-surgery, the change did not meet the clinically relevant threshold. There were no differences in other treatment-related side effects between groups. This translational intervention trial, delivered either FtF or Tel, supports exercise as a form of adjuvant breast cancer therapy that can prevent declines in fitness and function during treatment and optimise recovery post-treatment

The need to research refractory breathlessness

High-quality research is needed to improve quality of life for people with chronic refractory breathlessness in COP

A path analysis modeling the symptom experience of cancer patients commencing adjuvant treatment in ambulatory clinics

Typically, patients experience multiple concurrent symptoms, or symptom clusters, in relation to cancer, its treatment, or the combined effect. Exploratory research of symptom clusters has established relationships between the most frequently occurring and bothersome symptoms for many cancers and treatments. There is a need for research to address the underlying relationships associated with the symptom experience of cancer patients, to improve patient outcomes following treatment. The purpose of this project is to conduct a secondary data analysis to test the complex relationships that exist between cancer-related symptoms, the medical antecedents, and consequences for patients, following ambulatory care treatment. The Theory of Unpleasant Symptoms (Lenz et al 1997) proposes physiologic, psychologic and situational factors interact with each other in relation to the symptom experience, resulting in problems associated with cancer and its treatment. Studies suggest the impact of cancer varies according to the diagnosis, stage of disease, type of treatment and non-medical factors, such as social support, age and gender. A sample of 219 adult cancer patients, about to commence adjuvant treatment, was consecutively recruited from two public hospitals in Brisbane. A secondary data analysis, implementing a path analysis, will model the influences between demographic, illness and social variables, the symptom experience, and patients’ performance outcomes. A modified Rotterdam Symptom Checklist assessed patients’ symptom experience indicating prevalence and distress of each symptom. Outcomes in the model are the ECOG performance status, assessed by an oncologist, and global quality of life, determined by self-report on the CARES-SF and a Life Satisfaction instrument developed by the Centre for Mental Health at Queensland University of Technology. Perceived social support, measured by the Social Support Questionnaire for Transactions, will be incorporated as an independent predictor and a mediator between demographic and illness variables and the symptom experience. These instruments have reported moderate to good reliability and validity. The majority of cancer symptom cluster research has been exploratory, utilising factor or cluster analysis. Path models allow the direct and indirect effects of variables to be considered with the potential to highlight a specific opportunity for intervention to improve cancer patient outcomes