Quality of life and neuropathic pain in hospitalized cancer patients: A comparative analysis of patients in palliative care wards versus those in general wards

Context: While the survival of cancer patients is prolonged due to the development of new treatment strategies and advancing technologies, the prevalence of symptoms such as neuropathic pain affecting the quality of life is also increasing. Aims: The aim of this study is to determine the relationship between neuropathic pain (NP) and quality of life in hospitalized cancer patients and to compare patients in general wards and those in palliative care wards in terms of NP and quality of life. Subjects and Methods: A total of 156 patients, 53 cancer patients hospitalized in the palliative care unit and 103 cancer patients hospitalized in general wards, were included in the study. The Douleur Neuropathic 4 test was used for NP assessment, and the Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HAD), Brief Fatigue Inventory (BFI), and Short Form of Brief Pain Inventory (SF-BPI) were used for assessing pain characteristics and their effects on quality of life. Results: NP was present in 39.7% of cases and nociceptive pain (NP) was present in 32.7% of cases. There were no complaints of pain 27.6% of cases. The patients with no pain complaint were excluded, 54.9% of the patients had NP and 45.1% had NS. The scores of BFI, HAD-depression, ESAS overall, and ESAS tiredness were signifi cantly lower in patients with NP treated general wards compared to patients with NP in the palliative care wards (P < 0.05). Cancer patients with NP in general wards had signifi cantly higher scores of SF-BPI effect, SF-BPI severity, ESAS overall, ESAS pain, ESAS tiredness, ESAS nausea, ESAS appetite, and ESAS well-being as compared to those of general cancer patients with NS (P < 0.05). Conclusions: Since there was a homogeneous distribution among the groups in terms of both cancer treatment and pain management, we directly related the deterioration of the patients' quality of life to NP

Effects of Complete Decongestive Therapy on Primary and Secondary Lymphedema of Lower Extremity

Amaç: Primer ve sekonder alt ekstremite lenfödeminde kompleks dekonjestif tedavinin (KDT) etkinliğini araştırmak. Gereç ve Yöntemler: Çalışmaya dahil edilen 40 alt ekstremite lenfödemi tanılı hastanın verileri retrospektif olarak analiz edildi. Hastaların yaş, cinsiyet, tanı, ektremite volümü, lenfödem subtipleri ve kemoterapi/radyoterapi öyküleri kayıt edildi. Bacaklardaki ödem tedavi öncesi ve tedavi sonrasında volümetrik ölçümler ile hesaplandı. Ayak sırtından başlayarak 10'ar cm aralıklarla inguinal seviyeye kadar bilateral olarak çevresel ölçümler yapıldı. Ardından bilgisayar programı ile bu ölçümler volümetrik değerlere çevrildi. Bulgular: KDT'nin alt ekstremite lenfödem tedavisinde anlamlı gelişmeler sağladığı görüldü (p=0,01). Ancak istatiksel anlamlılığa yalnızca sekonder lenfödem grubunda ulaşıldı (p=0,008). Bununla birlikte yüzde değişim oranlarına bakıldığında iki grup arasında anlamlı farkın olmadığı saptandı (p>0,05). Tedavi öncesindeki volümlerin, volüm azalma oranları ile anlamlı oranda korele olduğu da (r=0,670, p=0,000) saptandı. Sonuç: KDT, alt ekstremite lenfödem tedavisinde etkili, güvenilir ve iyi tolere edilebilen bir tedavidir. Ancak her nekadar istatiksel anlamlılığa sekonder lenfödem grubunda ulaşılmış olsa da yüzde değişim oranlarına bakıldığında gruplar arasında anlamlı farklılığın olmadığı görülmüştür. Bu nedenle KDT'nin volüm azaltıcı etkisinin lenfödem etyolojisi ile korele olduğunu söyleyememekteyiz. Değişik etyolojilere sahip bireylerle yapılacak daha çok sayıda hastayı içeren prospektif çalışmalara ihtiyaç olduğunu düşünmekteyiz.Objective: To investigate the outcome of complete decongestive therapy (CDT) on primary and secondary lymphedema of the lower limb (LL). Material and Methods: Included 40 patients with LL lymphedema were retrospectively analyzed. Age, gender, diagnosis, extremity volume, subtype of lymphedema, radiotherapy chemotherapy history of all the patients were noted. the amount of limb edema was calculated with volumetric measurements before and after the treatment for each patient. Bilateral circumferential measurements were carried out at the level of metatarsophalangeal joints, mid-dorsum of the feet, ankle and every 10 cm till the inguinal level. Afterwards, a computer program was used to convert these values into limb volumes in milliliters. Results: It is found out that CDT causes a significant improvement in the average volume of the LL p=0.01). Nonetheless, the statistics showed significance (p= 0.008) only in secondary group. Moreover, there were no significant difference in percentage changes betwen both groups showed no significance after treatment (p>0.05). We also determined that initial volumes were significantly correlated with volume reduction rates (r= 0.670, p= 0.000). Conclusion: CDT is an effective, safe and well tolerated treatment for lymphedema of lower extremity limb. There was significant improvement in clinical outcomes particularly in secondary lymphedema group; whereas, percentage change in limb volumes of both groups showed no significance. Hence, our results suggest that the volume reductive effects of CDT is not correlated with the lymphedema (ethiology). Future studies comprising greater population with various ethiology are needed

Meme Kanseri ile İlişkili Lenfödemde Ekstremite Hacmi Üzerine Dört Farklı Tedavi Protokolünün Karşılaştırılması

Aim: Since lymphedema is generally a chronic and persistive disorder, there is still need to determine the comparative benefits of different therapies for this condition. in this study, we aimed to retrospectively compare the efficacy of different therapy protocols on extremity volume in breast cancer patients with lymphedema (BCRL). Methods: A total of 117 patients with BCRL were selected for the study. the patients were classified in 4 groups. the patients were treated with complex decongestive therapy (CDT) (n:25) in Group 1, with CDT + pneumatic compression therapy (PCT) (n:25) in Group 2, with CDT + PCT+ low- intensity laser therapy (LLT) (n:45) in Group 3, and with PCT+ LLT (n:22) in Group 4. Results: Our analysis between groups suggested statistically significant reduction in the average volume of the upper limbs in all groups (Groups 1, 2, and 3) (p<0.001) except Group 4 (p:0.592). Besides, the results of post-hoc analysis between groups demonstrated a significant difference by means of delta limb volume (p<0.001). We noted that PCT+LLT group caused the statistical difference. the delta values in this group were significantly lower than the other groups. Conclusion: the rationale behind conducting this study was to determine the most effective therapy protocol, and we observed that both CDT alone and CDT combined with PCT and LLT were effective in lymphedema treatment. However, since the PCT and LLT could reduce the volume significantly only in combination with CDT, we cannot conclude that they are effective treatments when applied solely.Amaç: Lenfödem kronik ve genelde kalıcı olan bir hastalık olduğundan, bu durum için farklı tedavilerin karşılaştırmalı yararlarını belirlemeye halen ihtiyaç duyulmaktadır. Bu çalışmada, farklı tedavi protokollerinin meme kanseri ile ilişkili lenfödem (MKİL) hastalarında ekstremite volümü üzerine olan etkilerini retrospektif olarak karşılaştırmayı amaçladık. Yöntem: Çalışmaya MKİL’si olan toplam 117 hasta dahil edildi. Hastalar 4 grupta sınıflandırıldı. Grup 1’deki hastalara (n: 25) kompleks dekonjestif tedavi (KDT), Grup 2’deki hastalara (n: 25) KDT + pnömotik kompresyon tedavisi (PCT), Grup 3’deki hastalara (n: 45) KDT + PCT+ düşük güçlü lazer tedavisi (LLT) ve Grup 4’deki hastalara (n: 22) PCT+ LLT tedavisi verildi. Bulgular: Gruplar arasındaki analizimiz, grup 4 dışındaki hemen hemen tüm gruplarda (grup 1, 2, 3) (p<0,001) üst ekstremitelerin ortalama volümünde istatistiksel olarak anlamlı azalmayı gösterdi (p:0,592). Ayrıca, gruplar arasındaki post-hoc analiz sonuçları, delta ekstremite volümü (p<0,001) ile anlamlı bir farklılığı ortaya koymuştur. PCT + LLT grubunun istatistiksel farka neden olduğunu belirledik. Bu grupta delta değerleri diğer gruplara göre anlamlı olarak düşüktü. Sonuç: En etkili tedavi protokolünü belirlemeyi amaçladığımız bu çalışmada; KDT tek başına ve KDT ile birlikte PCT ve LLT’nin lenfödem tedavisinde etkili olduğunu gözlemledik. Bununla birlikte, PCT ve LLT, KDT ile kombinasyon halinde kullanıldıklarında önemli miktarda volüm azalması ile sonuçlandığından tek başına kullanıldıklarında etkili tedaviler oldukları sonucuna varılamaz

Effects of complex decongestive therapy on quality of life, depression, neuropathic pain, and fatigue in women with breast cancer-related lymphedema

WOS: 000422788100007PubMed ID: 31453475Objectives: To investigate the effects of complex decongestive therapy (CDT) on the quality of life, depression, neuropathic pain, and fatigue in patients with breast cancer-related lymphedema (BCRL). Patients and methods: Between March 2015 and June 2015, a total number of 60 patients (mean age 55.7 +/- 10.3 years; range 18 to 85 years) with BCRL were included in the study. Demographic data and previous medical records were recruited from medical files. The European Organization for Research and Treatment of Cancer Quality of Life-C30 (EORTC QLQ-C30) for the quality of life, the Brief Fatigue Inventory (BFI) for fatigue, Douleur Neuropathique 4 Questions (DN4) for neuropathic pain, and the Beck Depression Inventory (BDI) for the emotional status were used before and after the treatment. All patients received 20 sessions (one hour) of CDT for four weeks (five days per week). Results: There was a statistically significant reduction in the volume of the involved limbs after the treatment (p<0.001). There was also a significant reduction in the general health and functional scores of the EORTC QLQ-C30 (p<0.001, p=0.004, respectively). The DN4, BFI, and BDI scores were significantly improved after the treatment (p<0.001, p=0.043, p=0.019, respectively). Conclusion: Our study results suggest that CDT is an effective and safe method to achieve not only a significant volume reduction in the limbs involved by lymphedema, but also good outcomes in the management of other symptoms related to BCRL

Can yoga have any effect on shoulder and arm pain and quality of life in patients with breast cancer? A randomized, controlled, single-blind trial

WOS: 000439902900008PubMed ID: 30057055Objective: To examine the effects of yoga on shoulder and arm pain, quality of life (QOL), depression, and physical performance in patients with breast cancer. Methods: This prospective, randomized study included 42 patients. The patients in Group 1 underwent a 10-week Hatha yoga exercise program. The patients in Group 2 were included in a 10-week follow-up program. Our primary endpoint was arm and shoulder pain intensity. Results: The group receiving yoga showed a significant improvement in their pain severity from baseline to post-treatment, and these benefits were maintained at 2.5 months post-treatment. When compared to the control group, there were no statistically significant differences between the 2 groups with respect to the parameters assessed at the end of week 10. Conclusion: Yoga was an effective and safe exercise for alleviating shoulder and arm pain, which is a complication with a high prevalence in patients with breast cancer