Pharmacological Issues in Cancer Patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S251-S251
Author(s):  
M. Alves ◽  
A. Tavares
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Drug Interactions ◽  
Cancer Patients ◽  
Psychotropic Drugs ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Mood Stabilizers ◽  
Psychiatric Disease ◽  
Competing Interest

IntroductionDepression and anxiety are the main causes of psychiatric disorder in cancer patients, associated with a decreased tolerance and adherence to cancer treatment, longer hospital stays, decreased quality of life and possibly influence prognosis and mortality.ObjectivesThis review will address psychopharmacological options in cancer patients, side effects and possible drug interactions between psychotropic drugs and chemotherapy, either by toxicity, to which these patients are more sensitive, or a reduction in efficacy in anti-tumor treatment.MethodsNon systematic literature review through the Medline and clinical key databases, with time constraints.ResultsSelective Serotonin Reuptake Inhibitors are the first line treatment for depression, because of their tolerability and safety profile. Venlafaxine is the safer choice for the treatment of depression and hot flushes in women with breast cancer undergoing chemotherapy with tamoxifen. Tricyclic antidepressants are used in patients with neuropathic pain, due to its analgesic properties. Haloperidol is the safest antipsychotic, with less drug interactions and lower metabolic risk. Benzodiazepines are used in anxiety states for short periods. Psychostimulants are an option in patients with depression and life expectancy of less than one month. Mood stabilizers are recommended to treat mania, commonly induced by corticosteroids.ConclusionsTreatment of psychiatric disease in cancer patients leads to an increased adherence to anti-tumoral treatment and improves quality of life. Regardless of the cancer stage there is indication to start treatment. We must, however, take into account possible side effects and drug interactions between psychotropic drugs and chemotherapy, through toxicity or diminished efficacy, when combined with anti-tumoral treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The impact of hyperbaric oxygen therapy on late radiation toxicity and quality of life in breast cancer patients

2021 ◽  
Author(s):  
Marilot C. T. Batenburg ◽  
Wies Maarse ◽  
Femke van der Leij ◽  
Inge O. Baas ◽  
Onno Boonstra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Cancer Patients ◽  
Oxygen Therapy ◽  
Radiation Toxicity ◽  
Breast Pain ◽  
Breast Cancer Patients

Abstract Purpose To evaluate symptoms of late radiation toxicity, side effects, and quality of life in breast cancer patients treated with hyperbaric oxygen therapy (HBOT). Methods For this cohort study breast cancer patients treated with HBOT in 5 Dutch facilities were eligible for inclusion. Breast cancer patients with late radiation toxicity treated with ≥ 20 HBOT sessions from 2015 to 2019 were included. Breast and arm symptoms, pain, and quality of life were assessed by means of the EORTC QLQ-C30 and -BR23 before, immediately after, and 3 months after HBOT on a scale of 0–100. Determinants associated with persistent breast pain after HBOT were assessed. Results 1005/1280 patients were included for analysis. Pain scores decreased significantly from 43.4 before HBOT to 29.7 after 3 months (p < 0.001). Breast symptoms decreased significantly from 44.6 at baseline to 28.9 at 3 months follow-up (p < 0.001) and arm symptoms decreased significantly from 38.2 at baseline to 27.4 at 3 months follow-up (p < 0.001). All quality of life domains improved at the end of HBOT and after 3 months follow-up in comparison to baseline scores. Most prevalent side effects of HBOT were myopia (any grade, n = 576, 57.3%) and mild barotrauma (n = 179, 17.8%). Moderate/severe side effects were reported in 3.2% (n = 32) of the patients. Active smoking during HBOT and shorter time (i.e., median 17.5 vs. 22.0 months) since radiotherapy were associated with persistent breast pain after HBOT. Conclusion Breast cancer patients with late radiation toxicity reported reduced pain, breast and arm symptoms, and improved quality of life following treatment with HBOT.

scholarly journals Role of Oxycodone Hydrochloride in Treating Radiotherapy-Related Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yinxia Wang ◽  
Ligang Xing
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Pain Control ◽  
Analgesic Drugs ◽  
Oxycodone Hydrochloride ◽  
Radiation Esophagitis

Radiotherapy is commonly used to treat cancer patients. Besides the curable effect, radiotherapy also could relieve the pain of cancer patients. However, cancer pain is gradually alleviated about two weeks after radiotherapy. In addition, cancer patients who receive radiotherapy may also suffer from pain flare or radiotherapy-induced side effects such as radiation esophagitis, enteritis, and mucositis. Pain control is reported to be inadequate during the whole course of radiotherapy (before, during, and after radiotherapy), and quality of life is seriously affected. Hence, radiotherapy is suggested to be combined with analgesic drugs in clinical guidelines. Previous studies have shown that radiotherapy combined with oxycodone hydrochloride can effectively alleviate cancer pain. In this review, we firstly presented the necessity of analgesia during the whole course of radiotherapy. We also sketched the role of oxycodone hydrochloride in radiotherapy of bone metastases and radiotherapy-induced oral mucositis. Finally, we concluded that oxycodone hydrochloride shows good efficacy and tolerance and could be used for pain management before, during, and after radiotherapy.

Young-onset colorectal cancer treatment side effects: Infertility, sexual dysfunction, and quality-of-life outcomes.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3587-3587
Author(s):  
Laura Diane Porter ◽  
Ronit Yarden ◽  
Kim Lynn Newcomer ◽  
Negeen Fathi ◽  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Cancer Treatments ◽  
Young Onset

3587 Background: Colorectal cancer is the third-most commonly diagnosed cancer and the second-leading cause of cancer death in men and women combined in the United States. Young-onset colorectal cancer refers to individuals diagnosed under the age of 50. In recent years, the incidence has increased by 2.2% annually in individuals younger than 50 years and 1% in individuals 50-64, in contrast to a 3.3% decrease in adults 65 years and older. Young-onset (YO) CRC patients and survivors face unique clinical challenges with fertility and sexual dysfunctions, but this risk is not well quantified. There is limited data and public discussion on the long-term effects of colorectal cancer treatments on fertility and sexual dysfunction and the long-term impact on the quality of life. Methods: To explore the unique challenges and unmet needs of the young-adult patient population, a cross-sectional study was conducted. Colorectal cancer patients and survivors (N = 884) diagnosed between the ages of 20 to 50 years old (median age 42 ± 7.0) completed an online questionnaire based on established instruments EORTC-QOL-30, EORTC-CR-29, and EORTC-SHC-22. Results: Thirty-one percent of respondents stated that a medical professional spoke to them about fertility preservation at the time of diagnosis and during treatment. Only 31% were referred to a reproductive endocrinologist, even though 37% of women and 16% of men reported that treatment left them infertile or sterile. Among survey respondents, 12% of women had an egg retrieval procedure, and 36% of men had their sperm preserved prior to the start of treatment. Fifty-three percent of women reported treatment led to premature menopause. Sixty-five percent of respondents suffer from some level of sexual dysfunction due to treatment. In patients who received radiation therapy, women were 12% less likely than men to have discussed sexual side effects with the provider before treatment. Patients who have an ostomy reported more severe sexual dysfunction (17.8%). Rectal cancer patients were 2.5 times more likely than those with colon cancer to report severe dysfunction after their treatment. More than 25% of the respondents said they would have considered alternative treatment if they would have known the risks of sexual dysfunction. Conclusions: Our survey demonstrates inadequate communications between patients and providers about the irreversible fertility and sexual effects of colorectal cancer treatments. Younger patients and survivors face unique long-term challenges and require further information about fertility preservation options and emotional support regarding their sexuality post-treatment. Other studies are needed to assess the physical and psychological side effects endured by young-onset CRC patients and survivors.

Psychopharmacological Treatment Issues in HIV/AIDS Psychiatry

2017 ◽  
Author(s):  
Kelly L. Cozza ◽  
Gary H. Wynn ◽  
Glenn W. Wortmann ◽  
Scott G. Williams ◽  
Rita Rein
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Drug Interactions ◽  
Antiretroviral Treatment ◽  
Team Member ◽  
Careful Monitoring ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Psychopharmacological Treatment ◽  
Hiv Aids

Attention to pharmacokinetics and pharmacodynamics and an understanding of intended effects, side effects, toxicities, and drug interactions are imperative when treating persons with HIV/AIDS. This chapter includes an essential review of drug interaction principles and an overview of current antiretroviral treatment (ART) and known side effects, toxicities, and drug interactions, in text and table format. The chapter concludes with a presentation of psychotropic-antiretroviral treatment issues. Most psychotropics are effective in the treatment of persons with HIV, but some, particularly the pan-inducing antiepileptics, are best avoided or at least should be very carefully monitored. Recognizing the potential for drug–drug interactions allows for more careful monitoring and for consideration of alternative treatments or precautions. Being a pharmacologically knowledgeable multidisciplinary team member can reduce morbidity and mortality in patients. An understanding of antiretroviral therapy and psychopharmacological treatment issues prevents morbidity, supports adherence to medications, and improves quality of life for persons with HIV.

Evaluation of side effects in cancer patients during oncological care: A project of the supportive care group of the tumor center Berlin

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20715-e20715
Author(s):  
P. C. Feyer ◽  
U. Steiner ◽  
N. Bangemann ◽  
S. Kurz ◽  
C. Rudolph ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Patients ◽  
Treatment Protocol ◽  
Specific Treatment ◽  
Well Being ◽  
Care Group ◽  
Specific Therapy ◽  
Tumour Therapy

e20715 Background: The therapeutic options in tumour treatment protocols include a maximum of tumour cell reduction and at the same time a minimum of side effects in order to secure a good quality of life for the cancer patient. Temporary side effects have been accepted in relation to the benefit risk calculation. A questionnaire for cancer patients was developed to improve the management of side effects of the cancer treatment, to optimize the patient-doctor communication and to register individual problems of the patient. Methods: Cancer patients received a questionnaire with 25 items and were asked for their problems during or after the last tumour specific treatment before having the consultation with the doctor. Gender, age, Karnofsky-index and treatment protocol were additional registered. During September 2007 until December 2007 a total of 272 questionnaires could be collected. The qualitative items have been evaluated with the contigens table method and the parameter free x2 test (Chi-Square-Test). Results: More than 50% of the patients documented additional important points influencing their well being. Nearly all of the evaluated patients had some tumour therapy specific side effects. The most pronounced problem was the physical exhaustion in 71% of the evaluated patients. More than 50% were influenced in their quality of life by more than normal fatigue since the start of their tumour specific therapy. Significant differences could be evaluated in relation to the age, diagnosis and tumour therapy with respect to the symptoms. Conclusions: The questionnaire was be found to be a good method to improve the communication between the patient and the doctor. It was easier to point out individual problems for the patient. The care givers can focus more precisely on important side effects of the tumour specific therapy in order to improve the quality of life of the treated patient. No significant financial relationships to disclose.

Impact of yoga on quality of life for young adult noncurative cancer patients: A pilot study.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 249-249 ◽  
Author(s):  
Melanie Keats ◽  
Hillary Woodside ◽  
S. Nicole Culos-Reed
Keyword(s):  
Quality Of Life ◽  
Young Adult ◽  
Side Effects ◽  
Cancer Patient ◽  
Cancer Patients ◽  
Well Being ◽  
Body Awareness ◽  
Hatha Yoga ◽  
Significant Difference

249 Background: A growing body of evidence is emerging to suggest that the practice of yoga can improve disease and treatment-related side effects in the non-curative cancer patient by addressing their physical, psychological, and spiritual needs. Regrettably, the literature regarding the positive benefits of yoga for the young adult (YA) non-curative cancer patient is limited. Accordingly, the purpose of this ongoing exploratory study is to examine the feasibility and safety of a 7-week home/hospice based instructive Hatha yoga intervention (Yoga Thrive - available on DVD) in non-curative, YA cancer patients. Secondary outcomes include the examination of the efficacy of yoga in mitigating cancer and treatment-related side effects through ratings of self-reported quality of life (QOL). Methods: A single-arm, non-randomized, pre and post-test, pilot investigation of a 7-week instructive home/hospice-based Hatha yoga program is currently ongoing. Pre/post program data include measures of QOL, specific to palliative disease and spiritual domains as well as open-ended measures of perceived program value. Feasibility data (e.g., recruitment, adherence, safety) are also collected. Results: To date, four YA non-curative cancer patients have participated in the 7-week yoga program. Preliminary data show a significant difference in both functional well-being (p= .047, ηp2= 0.78) and spirituality (FACIT-Sp) scores (p= 0.04, ηp2= 0.77). Although not statistically significant, a large effect in physical well-being (ηp2= 0.38); general cancer outcomes (FACT-G) (ηp2= 0.42); and palliative specific scores (ηp2= 0.62) have also emerged. Early responses to the post-program exit questions suggest that participants find the program as an opportunity for self-care, separate from traditional cancer therapies. Subjective improvements in flexibility and mindfulness (e.g., body awareness, relaxation, and calmness) have also been reported. Additionally, participants have complemented the program for its ease and flexibility of use. Conclusions: Early findings of this study provide support for the feasibility and efficacy of a home/hospice-based yoga program for YA non-curative cancer patients.

scholarly journals Ozone therapy can be considered as an integrative therapy in oncology? [abstract]

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Paolo Tordiglione ◽  
Fabio Silvio Mario Araimo ◽  
Carmela Imperiale ◽  
S. Zancla
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Side Effects ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
System Quality ◽  
Ozone Therapy ◽  
Integrative Therapy ◽  
Antioxidant Defence System

BACKGROUND: Our group in Policlinic Umberto I - University Hospital of Sapienza Rome - has decided to further investigate if Ozone therapy can be of support in oncology. In literature it has been reported that ozone applications in oncology or in cancer cells is associated with: high efficiency in preventing chemotherapy complications (nausea, vomiting, opportunistic infections, asthenia) as well as confining or restricting the expansion of tumours.(1-5) PURPOSE: The aim of our study in to evaluate and eventually confirm the validity of ozone treatments in order to consider such procedures as a possible and concrete support therapy for oncology patients undertaking chemotherapy. A statistical significance and clinical evaluation of our work would finally give a scientifically validation, still missing, to officially consider ozone therapy as one of the many possible integrative therapy in oncology. DESIGN: It is a pilot study designed and approved by the Ethical Committee of the University of Rome, La Sapienza (March 2017) to evaluate quality of life and reduction of side effects of adjuvant chemotherapy in 20 breast cancer patients. METHODS: The selected patients will be treated with systemic ozone treatment: Ozonated autohemotherapy will be performed according to the following method: 200 ml venous blood will be exposed an equal amount of O2 /O3 (200 ml) The ozone concentration will be gradually increased as follows: 20-30-40 mcrg/mL with a specific schedule until each patient will receive 15 applications overall. The sessions will be scheduled according to a specific timetable during the administration of adjuvant chemotherapy by means of Epirubicin and Cyclophsphamide (EC) every 3 weeks for 4 cycles followed by Paclitaxel for 12 consecutive weeks. Ozone therapy will not be applied on days of chemotherapy in order to avoid interaction between chemotherapeutics and ozonides. Biochemical blood analysis and stress oxidative blood test will be used as parameters for activity of antioxidant defence system. Quality of life will be evaluated with Fact G Test. It is the first study to have been evaluated and approved by an official university ethical committee and we will be glad to publish our result as soon as possible. On this behalf it would be great if any other centre could be interested in cooperating with us so to transform this pilot study into a multicentre study with larger numbers and therefore, with a greater impact on the international community. Our aim is to give cancer patients a better life quality in general and especially help them overcome all the side effects during the chemotherapy. This could open a new scenario in the alternative complementary treatments in oncology.

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