The need for improvement in the management of fatigue, depression and pain in pancreatic cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 429-429
Author(s):  
Amy Westermann ◽  
Lynn McCormick Matrisian ◽  
Lola Rahib
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Side Effects ◽  
Side Effect ◽  
Healthcare Costs ◽  
Pain Medication ◽  
Patient Registry ◽  
Patient Reported

429 Background: Pancreatic cancer (PC) and its treatment(s) results in symptom and side effect burden and can impact patient’s overall quality of life (QOL). Methods: Patient reported information on management of side effects and symptoms were collected using PanCAN’s Patient Registry (01/2016 – 07/2018). Results: Patient reported information on side effects, pain and depression is detailed in the table. Side effects: 94% reported fatigue and 8% reported taking anti-fatigue medication. 72% reported nausea or vomiting during treatment and 83% reported taking anti-nausea medication. Pain: Of the 90% of patients who reported pain related to PC, 27% did not take pain medication, 47% visited the ER and 32% were hospitalized due to pain. Depression: Of the 83% of users reported feeling depressed during PC, 46% were diagnosed with depression, 37% prescribed anti-depressant, and 48% did not see a therapist. Conclusions: Nausea was reported as most managed. Fatigue, pain and depression were generally unmanaged. ER visits and hospitalizations due to pain were frequently reported. An improvement in the management of these side effects and symptoms is needed as it can affect patient’s ability to tolerate treatment, improve overall QOL, and may lower overall healthcare costs. [Table: see text]

Efficacy analysis of a remote symptom management platform.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1566-1566
Author(s):  
Paris A. Kosmidis ◽  
Christie Lagogianni ◽  
Thanos Kosmidis
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Side Effects ◽  
Cancer Patients ◽  
Symptom Management ◽  
Side Effect ◽  
Substantial Improvement ◽  
Cancer Type ◽  
Patient Reported

1566 Background: Quality of life of cancer patients is a critical part of cancer care. Symptom management is evolving as a multidisciplinary approach, and is increasingly delivered through a combination of physical and remote interactions. CareAcross is an online platform offering personalized, guidelines-based support to cancer patients, that complements physicians’ support and enables remote monitoring. This analysis investigated the improvement in the quality of life of cancer patients delivered through such remote support. Methods: Patients engage with an online interactive platform to receive personalized support based on a variety of parameters, through algorithms incorporating their exact diagnoses, treatments and comorbidities, and more. For symptom management, patients report the presence of specific side-effects via brief questionnaires; for each side-effect reported, they receive tailored support (text and multimedia) to help overcome it. These online questionnaires are repeated periodically to capture the outcome of the supportive process, and provide additional support as necessary. A retrospective analysis evaluated the efficacy of the personalized support: each patient’s reported side-effects were compared before versus after receiving the support, hence calculating the reduced incidence. Results: 2203 patients from 8 countries, with breast, lung, prostate or colorectal cancer (1563, 404, 159 and 77, respectively) reported side-effects, received support, and updated their reports at least once. The median follow-up period was 4.9 months. The patient-reported outcomes on their quality of life revealed substantial improvement, regardless of cancer type (lowest recorded improvement = 25.7%). Commonly reported side-effects included sleep problems, dry mouth, constipation, changes in food taste, and more (see Table). Side-effects reported in specific cancer types also showed substantial improvement, including hot flushes (breast; 32.0% improvement), dyspnea (lung; 38.1%), bowel dysfunction (prostate; 80%) and others. The efficacy of the support to breast, prostate or colorectal cancer patients was similar; support to lung cancer patients exhibited the lowest efficacy (p < 0.05). Fatigue was the most common side-effect. It was also the most resistant to improvement compared to all others (p < 0.05). Conclusions: Digital remote support of cancer patients is a realistic option to improve quality of life. Randomized controlled trials can help quantify its impact on health economics, hospital admissions, resource utilization, and other aspects.[Table: see text]

Patient, provider, and nurse preferences regarding patient-reported outcomes (PRO) and side effect management during cancer treatment of minority, rural and economically disadvantaged patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18652-e18652
Author(s):  
Bernard Tawfik ◽  
Karen Quezada ◽  
Ellen Burgess ◽  
Mikaela Kosich ◽  
Shoshana Adler Jaffe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Low Income ◽  
Side Effect ◽  
Cell Phone ◽  
Smart Phone ◽  
Communication Device ◽  
Patient Reported ◽  
Pro Tools

e18652 Background: Side effects from treatment significantly impact quality of life and patients ability to continue cancer therapy. Patient Reported Outcomes (PRO) tools have been shown to significantly improve multiple key cancer endpoints including overall survival. However, preferences for PRO tool components, such as contact modality, is not well studied in minority, rural and low-income patient populations. As the only National Cancer Institute (NCI) Designated Cancer Center within a 500-mile radius, we care for the urban/rural, multiethnic communities we serve with tremendous cancer health and socioeconomic disparities. This study evaluated patient, provider and nurse perspectives with the goal of optimizing PRO tools for our unique population. Methods: A survey was developed to assess preferred PRO contact modality. Additional survey domains included side effect burden, quality of life, financial hardship and nutritional services accessed. The survey was offered to all patients receiving IV chemotherapy in the center infusion suite from June to August 2020 using the REDCap platform. Providers and nurses (P/N) were surveyed via email. Survey responses were analyzed using SAS 9.4 and compared via chi-square test where appropriate. Results: Ninety patient surveys were collected; 51.1% were minorities (44.4% Hispanic), 35.6% were rural and 40.0% had income < $30,000. All patients had access to a communication device but 12% did not have access to a cell phone of any kind. Device access included 68% smart phone, 20% cell phone, 22% landline, 53% computer, 39% tablet. Patients preferred a response to reported side effects within 0-3 hours (73%) while only 29% of 55 P/N surveyed shared this expectation (p < 0.0001). Almost half (48%) of patients felt side effect management was a moderate or significant issue with 58% experiencing nausea and/or vomiting, 41% diarrhea, 34% weight change, 33% pain, and 22% mucositis. While 72% of patients experienced nutritional related side effects and 95% of P/N preferred to answer nutritional issues by referring to a dietitian, only 9% of patients reported being referred. The majority of patients reported side effect quality of life implications (60.3%) or missed work / were unemployed (82%). Conclusions: In a minority, rural and low-income patient population, 88% of patients had access to a cell phone communication device, with smart phone access in the majority. Patients and P/N reported significantly different expectations regarding side effect management. Our data suggests an underutilization of nutritional referrals by P/N, despite a recognition of value. This study informs the implementation of a PRO tool to address side effects and develop nutritionist referral strategies in minority, rural and low-income patient populations.

Elucidating the Potential Side Effects of Current Anti- Seizure Drugs for Epilepsy

2021 ◽  
Vol 19 ◽  
Author(s):  
Enes Akyüz ◽  
Mohd. Farooq Shaikh ◽  
Betül Köklü ◽  
Cansu Ozenen ◽  
Alina Arulsamy
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Effects ◽  
Side Effect ◽  
First Line ◽  
Epileptic Patients ◽  
Life Threatening ◽  
Visual Problems ◽  
Gaba Transmission

: Over the decades, various interventions have been developed and utilized to treat epilepsy. However, majority of epileptic patients are often first prescribed with anti-epileptic drugs (AED), now known as anti-seizure drugs (ASD), as a first line of defense to suppress their seizures and regain their quality of life. ASDs exert their anti-convulsant effects through various mechanisms of action including regulation of ion channels, blocking of glutamate-mediated stimulating neurotransmitter interaction, and enhancing the inhibitory GABA transmission. About one third of epileptic patients are often resistant to anti-convulsant drugs, while others develop numerous side effects which may lead to treatment discontinuation and further deterioration of quality of life. Common side effects of ASDs include headache, nausea and dizziness. However, more adverse effects such as auditory and visual problems, skin problems, liver dysfunction, pancreatitis and kidney disorders may also be witnessed. Some ASDs may even result in life-threatening conditions as well as serious abnormalities, especially in patients with comorbidities and in pregnant women. Nevertheless, some clinicians had observed a reduction in the development of side effects post individualized ASD treatment. This suggest that a careful and well-informed ASD recommendation to patients may be crucial for an effective and side-effect free control of their seizures. Therefore, this review aimed to elucidate the anticonvulsant effects of ASDs as well as their side effect profile, by discussing their mechanism of action and reported adverse effects based on clinical and preclinical studies, thereby providing clinicians with a greater understanding of the safety of current ASDs.

Impact of stereotactic body radiation therapy on patient-reported quality of life in patients with unresectable or recurrent pancreatic cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 413-413
Author(s):  
Lauren M. Rosati ◽  
Zhi Cheng ◽  
Scott P. Robertson ◽  
Megan N. Kummerlowe ◽  
Amy Hacker-Prietz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Locally Advanced ◽  
Future Health ◽  
Stereotactic Body Radiation ◽  
Patient Reported ◽  
The Impact

413 Background: The impact of fractionated stereotactic body radiation therapy (SBRT) on patient-reported quality of life (QOL) and physician-reported toxicity in patients with recurrent or locally advanced pancreatic cancer (PCA) was prospectively evaluated. Methods: Forty-two PCA patients were treated with 25-33 Gy using SBRT in 5 fractions on a single-institution study. Both patient- and physician-reported outcomes were evaluated prior to SBRT and 4-6 weeks post-SBRT. Eight outcomes were consistently evaluated among both groups—performance status, fatigue, pain, anorexia, nausea, vomiting, constipation, and diarrhea. Patient-reported QOL metrics were assessed using a 4-point Likert scale on the EORTC QLQ-C30 and QLQ-PAN26, while physician-reported toxicities were graded using the NCI CTCAE version 4.0. Comparisons between those with paired patient- and physician-reported outcomes collected prior to and 4-6 weeks after SBRT were made using the Wilcoxon signed-rank test. Results: Of the 42 patients currently enrolled onto the study, 29 had both patient- and physician-reported outcomes collected prior to and 4-6 weeks after SBRT. Fifty-five percent were female and 83% were Caucasian. The median age at diagnosis was 65.6 years (range, 40.8-86.6). There was no significant impairment of any of the 8 physician-reported toxicities, nor were significant changes observed in patient-reported overall health (p = 0.66) or QOL (p = 0.18) scores following SBRT. Patients felt less worried about their future health (mean change [mD] = -0.45, p = 0.02), and an improvement in feeling less attractive as a result of disease and treatment reached borderline significance (mD= 0.31, p = 0.09). However, patients felt limited in planning activities in advance (mD= 0.45, p = 0.02) and were more constipated (mD= 0.38, p = 0.01) 4-6 weeks post-SBRT. Conclusions: Although the numbers are small, patients with unresectable or locally recurrent PCA do not appear to suffer any detriment of overall health or QOL after receiving a five-day course of SBRT. Moreover, this regimen may lead to a more optimistic point of view on future health and/or level of physical attraction. Clinical trial information: NCT01781728.

Determining the impact of chemotherapy-induced peripheral neuropathy: A survey of cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24080-e24080
Author(s):  
Eva Battaglini ◽  
David Goldstein ◽  
Susanna Park
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Peripheral Neuropathy ◽  
Side Effects ◽  
Cancer Survivors ◽  
Side Effect ◽  
Functional Disability ◽  
Health Conditions ◽  
The Impact

e24080 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a major yet poorly understood side effect of cancer treatment, leading to symptoms including numbness, tingling and pain. It can lead to cessation of effective treatment, long-term functional disability and reduced quality of life. Despite this, there is currently little understanding of its impact. Methods: The aim of the study was to investigate the impact of neurotoxic chemotherapy side effects on the lives of cancer survivors. Data was collected via an online survey covering demographics, cancer diagnosis and treatment, CIPN and other side effects of chemotherapy, using standardised measures to assess comorbidities, quality of life, physical activity, pain and CIPN symptoms. Results: Data was analysed from 986 respondents who were treated with neurotoxic therapies (83% female, 16% male), with mean age 59 years ( SD 10.7 years). A majority of respondents were treated for breast cancer (59%), 14% for colorectal cancer and 11% for multiple myeloma. Chemotherapy types received included paclitaxel (32%), docetaxel (32%) and oxaliplatin (13%), and respondents completed treatment a mean of 3.6 years ago. The majority of respondents (80%) reported experiencing neuropathic symptoms after finishing chemotherapy, with 77% reporting current CIPN. Those with CIPN reported functional impacts, with 23% reporting moderate to severe problems with hand function and 28% reporting moderate to severe walking difficulties. CIPN was second most commonly rated as the treatment side effect having the greatest impact, following fatigue. Respondents with high levels of current CIPN symptoms had poorer quality of life, more comorbid health conditions, higher BMI and more often received multiple neurotoxic chemotherapies than those with low levels of CIPN symptoms. In addition, respondents who reported meeting government physical activity guidelines had lower CIPN and higher quality of life scores than those who did not meet the guidelines. Regression analyses investigating the association between quality of life and clinical and sociodemographic characteristics resulted in a model with comorbid health conditions, CIPN symptoms, years since treatment, age and physical activity as significant predictors of quality of life. Conclusions: These findings suggest that CIPN has a lasting impact on cancer survivors, leading to decreases in quality of life, often occurring alongside poorer general health. This impact supports the need for further research to improve assessment, prevention and treatment.

scholarly journals A Novel Digital Patient-Reported Outcome Platform for Head and Neck Oncology Patients–-A Pilot Study

2016 ◽  
Vol 9 ◽  
pp. CMENT.S40219 ◽  
Author(s):  
Maria K. Peltola ◽  
Joel S. Lehikoinen ◽  
Lauri T. Sippola ◽  
Kauko Saarilahti ◽  
Antti A. Mäkitie
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Side Effects ◽  
Head And Neck ◽  
Cancer Patients ◽  
Early Stage ◽  
Patient Reported Outcome ◽  
Patient Reported

Introduction The patient's role in toxicity reporting is increasingly acknowledged. There is also a need for developing modern communication methods between the patient and the medical personnel. Furthermore, the increasing number of head and neck cancer (HNC) patients is reflected in the volume of treatment follow-up visits, which remains a challenge for the health care. Electronic patient-reported outcome (ePRO) measures may provide a cost-efficient way to organize follow-up for cancer patients. Materials and Methods We tested a novel ePRO application called Kaiku®, which enables real-time, online collection of patient-reported outcomes, such as side effects caused by treatment and quality of life. We conducted a pilot study to assess the suitability of Kaiku® for HNC patients at the Department of Oncology, Helsinki University Hospital, Helsinki, Finland. Patients used Kaiku® during and one month after radiotherapy to report treatment-related side effects and quality of life. Two physicians and a nurse performed the practical electronic communication part of the study. Results Five of the nine patients agreed to participate in the study: three of them had local early-stage larynx cancer (T2N0, T1aN0, and T2N0) and the remaining two patients had early-stage base of tongue cancer (T2N0 and T1N2b). The degree of side effects reported by the patients via Kaiku® ranged from mild to life threatening. The number of outcome data points on patients' progress was significantly increased, which resulted in a better follow-up and improved communication between the patient and the care team. Conclusions Kaiku® seems to be a suitable tool to monitor side effects and quality of life during and after radiotherapy among HNC patients. Kaiku® and similar tools could be useful in organizing a cost-effective follow-up process for HNC patients. We recommend conducting a larger study to further assess the impact of an ePRO solution in routine clinical practice. • ePRO solutions may aid in the follow-up for cancer patients. • They seem suitable to monitor, for example, side effects and quality of life. • These systems ensure fast patient-driven reporting.

Stereotactic body radiation therapy and patient-reported quality of life prospectively evaluated in patients with unresectable or recurrent pancreatic cancer.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 92-92
Author(s):  
Lauren M. Rosati ◽  
Zhi Cheng ◽  
Scott P. Robertson ◽  
Megan N. Kummerlowe ◽  
Amy Hacker-Prietz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Locally Advanced ◽  
Future Health ◽  
Stereotactic Body Radiation ◽  
Patient Reported ◽  
The Impact

92 Background: The impact of fractionated stereotactic body radiation therapy (SBRT) on patient-reported quality of life (QOL) and physician-reported toxicity in patients with recurrent or locally advanced pancreatic cancer (PCA) was prospectively evaluated. Methods: Forty-two PCA patients were treated with 25-33 Gy using SBRT in 5 fractions on a single-institution study. Both patient- and physician-reported outcomes were evaluated prior to SBRT and 4-6 weeks post-SBRT. Eight outcomes were consistently evaluated among both groups—performance status, fatigue, pain, anorexia, nausea, vomiting, constipation, and diarrhea. Patient-reported QOL metrics were assessed using a 4-point Likert scale on the EORTC QLQ-C30 and QLQ-PAN26, while physician-reported toxicities were graded using the NCI CTCAE version 4.0. Comparisons between those with paired patient- and physician-reported outcomes collected prior to and 4-6 weeks after SBRT were made using the Wilcoxon signed-rank test. Results: Of the 42 patients currently enrolled onto the study, 29 had both patient- and physician-reported outcomes collected prior to and 4-6 weeks after SBRT. Fifty-five percent were female and 83% were Caucasian. The median age at diagnosis was 65.6 years (range, 40.8-86.6). There was no significant impairment of any of the 8 physician-reported toxicities, nor were significant changes observed in patient-reported overall health (p = 0.66) or QOL (p = 0.18) scores following SBRT. Patients felt less worried about their future health (mean change [mD] = -0.45, p = 0.02), and an improvement in feeling less attractive as a result of disease and treatment reached borderline significance (mD= 0.31, p = 0.09). However, patients felt limited in planning activities in advance (mD= 0.45, p = 0.02) and were more constipated (mD= 0.38, p = 0.01) 4-6 weeks post-SBRT. Conclusions: Although the numbers are small, patients with unresectable or locally recurrent PCA do not appear to suffer any detriment of overall health or QOL after receiving a five-day course of SBRT. Moreover, this regimen may lead to a more optimistic point of view on future health and/or level of physical attraction. Clinical trial information: NCT01781728.

Financial toxicity in gynecologic cancer survivors and its impact on quality of life.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 53-53
Author(s):  
Akhil Mehta ◽  
Jukes P. Namm ◽  
Ellen D'Errico ◽  
Eric Lau ◽  
Linda Hong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Survivors ◽  
Cancer Care ◽  
Uterine Cancer ◽  
Gynecologic Cancer ◽  
Financial Toxicity ◽  
Patient Reported ◽  
The Continuum

53 Background: Financial toxicity (FT) is a critical concern for cancer survivors. There is limited data about the relationship between FT throughout the continuum of cancer care, demographics, disease factors, and quality of life (QoL) indicators in gynecologic cancer survivors. Methods: Gynecologic cancer survivors who received treatment from 2015 to 2019 at Loma Linda University Cancer Center were invited to complete an anonymous online survey. A modified version of the comprehensive score for financial toxicity (COST) survey was used to assess FT at baseline and after treatment. The patient-reported outcomes measurement information system (PROMIS) survey was used to assess QoL. Demographic data were summarized using descriptive statistics. Associations between disease factors and FT measured at baseline and after treatment were analyzed using univariable linear regression. Lower COST score coefficients indicate greater FT. Correlations between FT and QoL were evaluated using the Pearson correlation. Results: A total of 252 surveys were sent to gynecologic cancer survivors who met study criteria, of whom 28% responded. Amongst 70 patients included in this analysis, the median age was 64 (IQR 56, 70), 47% were white (n = 33), 20% were unemployed, 22% had a high school or lower level of education, and 50% had an annual income < $60,000. With respect to cancer subtype, 63% had uterine cancer (n = 44), 20% had cervical cancer (n = 14), and 17% had ovarian cancer (n = 12). The mean COST score at baseline and after treatment was 21.2 ± 9.2 and 12.9 ± 7.8, respectively. The following characteristics were associated with significantly greater FT at baseline: Hispanic ethnicity (-5.5; 95% CI: -1 to -10), Black race (-14.4; 95% CI: -3.4 to -25.4), household number > 4 (-6.9; 95% CI: -2.6 to -16.4), Medicare insurance (-6.5; 95% CI: -1.7 to -11.2), and Medicaid insurance (-11.2; 95% CI: -4.3 to -17.9) (p < 0.05). Patients who received combined modality surgery, chemotherapy, and radiation had significantly higher FT (-5.6; 95% CI: -1.3 to -9.8, p < 0.05) compared to those who received single-modality treatment. Likewise, patients with 5 or more treatment-related side effects had significantly higher FT (-6.3; 95% CI -1.13 to -11.4, p < 0.05) compared to those who reported no side effects. During treatment, 24% of patients turned down or skipped treatment, 38% quit their job, and 28% reported family members quit their job. Finally, COST scores measured after treatment correlated positively with physical and mental health (Pearson coefficient 0.57 and 0.56 respectively, p < 0.001). Conclusions: These findings support the need for assessing FT at baseline and throughout the continuum of cancer care to provide individualized assistance to patients facing financial strain. FT affects compliance to treatment which can adversely affect cancer-related outcomes and QoL. Additional policies are needed to address the increasing cost of cancer care.

scholarly journals KORELASI PERSEPSI TENTANG EFEK SAMPING KEMOTERAPI DENGAN KUALITAS HIDUP PASIEN KANKER PAYUDARA

2019 ◽  
Vol 1 (2) ◽  
pp. 40
Author(s):  
Shanti Lesmana Sari ◽  
Rani Lisa Indra ◽  
Raja Fitriana Lestari
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Side Effect ◽  
Research Result ◽  
Sampling Technique ◽  
Daily Lives ◽  
Quantitative Correlation ◽  
Cross Section Method

Chemotherapy treatments undergone by breast cancer patient’s have several side effect. From the side effects that, each patient perceives the side effects that will interfere with their daily lives which in turn affect the quality of life. This research was made for showing the correlation of chemotherapy side effect with the quality of life of breast cancer patient’s in Arifin Achmad Hospital in Riau Province. The research was one of quantitative correlation research with cross-section method that had been done to 63 respondents in Arifin Achmad Hospital in Riau Province by using consecutive sampling technique bye used was questionnaire. The test used unpaired t-test. This research result was gotten if Pvalue=0.216 (Pvalue=0.05), which mean is no correlation between chemotherapy side effect perspective and quality of life of breast cancer patient’s. Based on the result, we hope Arifin Achmad Hospital in Riau Province develop more health service to the community to increase positive judgement from chemotherapy treatment and quality of life of breast cancer patient’s.  

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