Scalp cooling to reduce alopecia as a barrier to chemotherapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12537-e12537
Author(s):  
Isabel M. Pupo Wiss ◽  
Dina Hagigeorges ◽  
Chloe J. Walker ◽  
Kelly E. Flanagan ◽  
James T. James ◽  
...  
Keyword(s):  
Hair Loss ◽  
Post Treatment ◽  
Common Disease ◽  
Scalp Cooling ◽  
Treatment Regimens ◽  
Asian Patients ◽  
Patient Reported ◽  
Distress Scale ◽  
The Impact ◽  
To Receive

e12537 Background: Chemotherapy induced alopecia (CIA) is one of the most distressing adverse events reported by patients undergoing chemotherapy, yet there is limited data addressing the impact of CIA on treatment acceptance. Scalp cooling (SC) has been shown to decrease CIA. Here we report our assessment of CIA as a barrier to chemotherapy and the efficacy of SC using pre- and post-treatment surveys of patient reported outcomes. Methods: Patients who received alopecia-inducing chemotherapy and utilized SC between November 2018 and September 2020 at our institution were enrolled in a prospective IRB approved registry. Surveys including the Chemotherapy Induced Alopecia Distress Scale (CADS) were administered before and within two weeks after treatment. Using the CADS survey, patients were asked about their hesitation to receive chemotherapy and the burden they feel about alopecia as a side effect of chemotherapy. Results: Of 90 patients who completed the first or last treatment survey, the most common treatment regimens were docetaxel/cyclophosphamide (TC), docetaxel/carboplatin/trastuzumab/ pertuzumab (TCHP), and paclitaxel/trastuzumab (TH). The most common disease type was breast cancer (92.2%) and all participants were females. Of 74 SC patients who completed the pre-treatment survey, the median age was 50.5 (range 26-75) and included 65 (87.8%) Caucasian, 4 (5.4%) Black, and 3 (4.0%) Asian patients. 89.2% used Paxman SC and 10.8% used Penguin SC. Of those who completed the CADS survey prior to treatment, 8 (10.8%) reported ‘quite a bit’ to ‘very high’ hesitation, and 34 (46.0%) reported feeling that alopecia was either ‘quite’ or ‘very much’ a burden of chemotherapy. All 40 SC patients (median age 53.5, range 31-76) who completed the post-treatment survey were Caucasian and used Paxman SC. Self-reported efficacy of SC in these 40 patients was less than 10% hair loss in 10 (25.0%), 11-25% hair loss in 7 (17.5%), 26-50% hair loss in10 (25.0%), 51-75% hair loss in 9 (22.5%), and 76-100% hair loss in 4 (10%). Overall, 27 (67.5%) patients reported SC limited alopecia ‘a lot’ to ‘perfectly’. Conclusions: In our study, alopecia was identified as a notable burden to nearly half our SC patients and 10.8% hesitated when making their decision to receive chemotherapy. After using SC during treatment, 67.5% of patients reported less than 50% hair loss, and 67.5% reported that SC reduced alopecia ‘a lot’ or ‘perfectly’. Our study highlights the significance of alopecia as a chemotherapy burden and potential barrier to accepting treatment, and suggests SC may be efficacious in decreasing CIA, which may allow patients to feel less hesitation towards chemotherapy.

Evaluation of race as a prognostic factor in multiple myeloma. An ancillary of Southwest Oncology Group Study 8229.

1996 ◽  
Vol 14 (3) ◽  
pp. 974-977 ◽  
Author(s):  
M R Modiano ◽  
P Villar-Werstler ◽  
J Crowley ◽  
S E Salmon
Keyword(s):  
Multiple Myeloma ◽  
Prognostic Factor ◽  
Community Treatment ◽  
Oncology Group ◽  
Southwest Oncology Group ◽  
Treatment Regimens ◽  
Southwest Oncology Group Study ◽  
Blacks And Whites ◽  
The Impact ◽  
To Receive

PURPOSE The objective of this investigation was to assess the impact of race (black v white) on the survival of patients with multiple myeloma treated within the context of a large clinical trial. PATIENTS AND METHODS A cohort of patients randomized to receive one of two treatment regimens and monitored for at least 10 years was studied to assess the impact of race as a prognostic factor, after adjusting for other known factors such as stage of disease. Patients were recruited from the referral network of the Southwest Oncology Group (SWOG), a national multiinstitutional consortium that includes both academic and community treatment centers. Patients had a diagnosis of multiple myeloma and had not previously been treated for this disease. They were carefully characterized as to demographic and clinical features, and were randomized to receive one of two treatment regimens, which proved to have virtually identical outcomes. The outcome measure was survival, measured from the date of randomization to the date of last contact. Patients still alive at last contact date were treated as censored observation. RESULTS Survival for black myeloma patients was similar to that for white patients, both overall and adjusted for prognostic factors such as stage. CONCLUSION Observed differences in mortality between blacks and whites cannot be attributed to differences in survival after diagnosis, given comparable treatment.

scholarly journals Real Life Data on Patient-Reported Outcomes and Neuro-Cognitive Functioning of Lung Cancer Patients: The PRO-Long Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Lotte Van Der Weijst ◽  
Veerle Surmont ◽  
Wim Schrauwen ◽  
Yolande Lievens
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Visual Memory ◽  
Patient Reported Outcomes ◽  
Post Treatment ◽  
Lung Cancer Patients ◽  
Systemic Treatments ◽  
Patient Reported ◽  
The Impact ◽  
Over Time

IntroductionThis report investigates the impact of systemic treatments (chemotherapy or immunotherapy) with(out) loco-regional radiotherapy, on HRQoL, toxicity and neurocognitive functioning (NCF) in locally advanced and metastatic non-small cell lung cancer patients enrolled in the PRO-Long study.Materials and MethodsData on patient-reported HRQoL and fourteen toxicities was collected, while NCF was tested, up to one-year post-treatment. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer QLQ-C30. Lung cancer, treatment and neuro-psychological related toxicities were scored with the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events. NCF was evaluated with six neurocognitive tests. Mixed model analyses were conducted to determine statistical significance (p = .01). Meaningful clinical important differences (MCIDs) were applied for changes in HRQoL and NCF data, while toxicities were compared to baseline values.ResultsIn total, 50 patients were enrolled. Overall HRQoL (p = .357) nor its domains (physical, p = .643; role, p = .069; emotional, p = .254; cognitive, p = 494; social, p = .735) changed significantly over time. Meaningful improvements in overall HRQoL were seen in 22, 38 and 39% and deteriorations in 22, 5 and 28% of patients at 2–3, 6 and 12 months respectively post-treatment. Overall toxicity (p = .007), lack of appetite (p = .001), nausea (p = .004) and dysphagia (p = .000) significantly decreased over time. Treatment caused acute toxicity, such as dyspnoea (45%) and memory problems (42%), but also alleviated pre-existing symptoms, including lack of appetite (32%), anxiety (29%) and depression (28%) at 2/3 months. The NCF domains of visual memory (p = .000) and cognitive processing speed (p = .000) showed significant improvements over time. In terms of MCIDs, at 2–3 months (18%) and 6 months (15%), verbal memory was particularly impacted; at 12 months, visual memory (18%) and executive function (18%) deteriorated primarily.ConclusionThe results suggest that therapy has no significant negative impact on overall HRQoL, its domains, and NCF. About one-third of patients reported a meaningful improved HRQoL at 1 year post-treatment. Treatment caused toxicity, but also alleviated pre-existing symptoms.

Assessment of scalp cooling to prevent chemotherapy-induced alopecia using standard infusion room documentation and patient surveys.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24106-e24106
Author(s):  
Dina Hagigeorges ◽  
Mimi Bartholomay ◽  
Maryanne M Senna ◽  
Steven J. Isakoff
Keyword(s):  
Breast Cancer ◽  
Patient Reported Outcome ◽  
Disease Type ◽  
Cancer Center ◽  
Common Disease ◽  
Scalp Cooling ◽  
Breast Cancer Patients ◽  
Patient Surveys ◽  
Patient Reported ◽  
Room Nursing

e24106 Background: Chemotherapy induced alopecia (CIA) is one of the most distressing reported side-effects of cancer treatment, with patients (pts) reporting negative impacts on self-image and quality of life. Scalp cooling (SC) devices can prevent CIA. SC efficacy varies by chemotherapy regimen and dose, and taxane-based therapies report better outcomes. Here we report the efficacy of SC with the Paxman SC system using a standard infusion room nursing assessment and patient surveys. Methods: Pts using SC at the MGH Cancer Center between 4/2018 and 12/2019 were included in the analysis. Routine infusion room nursing assessments included CTCAE 4.0 grading for alopecia. A retrospective review of SC pts with documented CTCAE grades was conducted with success defined as grade (Gr) 0 or 1 alopecia at the final infusion. CTCAE results were compared to patient surveys of self-assessed success. Additional data include disease type, regimen and SC discontinuation details. Results: 64 pts who initiated SC and had CTCAE grade recorded were included. The most common chemotherapy regimens were docetaxel/cyclophosphamide (33%), docetaxel/carboplatin/trastuzumab/pertuzumab (19%), paclitaxel/trastuzumab (16%) and paclitaxel weekly/pertuzumab/trastuzumab (6%). Breast cancer was the most common disease type (92%). 77% of pts had successful hair retention (Gr 0 = 23 (36%), Gr 1 = 26 (41%)). 3 pts received anthracycline-based therapy and 1 successfully retained hair. Among 11 pts who completed post-treatment surveys, patient reported outcome and CTCAE were concordant in 9 (82%) pts. 13 (20%) pts terminated SC early; 9 (69%) after 2 treatments (tx), 2 (15%) after 3 tx, 1 (8%) after one tx and 1 (8%) after 5 tx. The most common reason for early dc was extent of alopecia (10, 77%). Other factors in the decision were time and discomfort. Of the 51 pts who completed SC for the entire chemotherapy tx, 48 (94%) received a taxane-based regimen and 46 (90%) had successful hair retention. Conclusions: In this single institution experience, we observed a high success rate of scalp cooling to prevent chemotherapy induced alopecia in a population of mostly breast cancer patients receiving taxane-based regimens. Concordance between patient reported outcome of success and routine standard of care nursing CTCAE documentation in the electronic medical record provides a simple and accurate method to monitor outcomes with scalp cooling. Despite high success, 20% discontinued SC, suggesting further studies to improve outcomes and tolerability are needed.

Outpatient cancer rehabilitation to improve patient reported and objective measures of function.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19325-e19325
Author(s):  
Mackenzi Pergolotti ◽  
Kelley Renee Covington ◽  
Ashley N Lightner ◽  
Jessica Bertram ◽  
Melissa Thess ◽  
...  
Keyword(s):  
Well Being ◽  
T Test ◽  
Post Treatment ◽  
Cancer Rehabilitation ◽  
Outpatient Rehabilitation ◽  
Measurement Information ◽  
Community Based ◽  
Persistent Symptoms ◽  
Patient Reported ◽  
The Impact

e19325 Background: Adults with cancer often struggle with persistent symptoms that negatively impact quality of life (QoL), physical and social function. Cancer rehabilitation delivered by a trained physical and/or occupational therapist (PT/OT) is recommended. However, evidence is lacking regarding the impact of community-based PT/OT on patients' functioning. Methods: We assessed adults (≥ 18 years) who completed cancer-specific visits in routine care at two outpatient rehabilitation clinics. Demographic and clinical data was patient-reported. Patient-Reported Outcomes Measurement Information System (PROMIS) measures included: Global Physical Health (GPH) and Mental Health (GMH) scale (10 item); Physical Function (PF; 4-item), and Ability to Participate in Social Roles and Activities (SRA; 4-item). Hand grip strength (HGS) and the Timed Up and Go (TUG) were administered by PT/OT. We compared outcomes collected during the first and final therapy evaluations using paired samples t-test and calculated effect size using Cohen’s d. We used independent t-test to compare mean pre-post change between patients on active treatment versus post-treatment. Results: Patients (N= 185) were predominantly female (75%), 41-64 years old (57%), and majority receiving cancer treatment (58%). Most (N =115, 62%) completed at least one follow-up evaluation over 6 weeks. From pre to post therapy, a significant (p<.05; d = 0 .35-.21) effect was observed for GPH, SRA, HGS, and TUG. There was no difference in the average improvement between active and post-treatment groups. Conclusions: Community-based cancer-specific PT/OT has a significant impact on the well-being and functioning of adults with cancer. Evidence supports the utilization of community-based, cancer-specific PT/OT throughout the cancer-care continuum. [Table: see text]

Impact of Reported β-Lactam Allergy on Management of Methicillin-Sensitive Staphylococcus aureus Bloodstream Infections

2019 ◽  
Vol 33 (6) ◽  
pp. 809-814 ◽  
Author(s):  
Michael P. Veve ◽  
Spenser E. January ◽  
Rachel M. Kenney ◽  
Edward M. Zoratti ◽  
Marcus J. Zervos ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Patient Outcomes ◽  
Bloodstream Infections ◽  
Antibiotic Use ◽  
Optimal Therapy ◽  
Immune Mediated ◽  
Patient Reported ◽  
Infectious Diseases Consultation ◽  
The Impact ◽  
To Receive

Background: Antistaphylococcal β-lactams antibiotics are the preferred treatment for methicillin-sensitive Staphylococcus aureus (MSSA) infections. Patient-reported β-lactam allergies may complicate antibiotic decision-making and delay optimal therapy, with potential implications on patient outcomes. Objective: To determine the impact of reported β-lactam allergies on the receipt of optimal therapy and outcomes for MSSA bloodstream infections (BSI). Methods: Retrospective, matched cohort of MSSA BSI patients with and without a reported β-lactam allergy. The primary end point was receipt of optimal therapy, defined as an antistaphylococcal β-lactam. Results: Two hundred twelve patients were included: 53 with reported β-lactam allergy and 159 without β-lactam allergy. Commonly reported β-lactam allergies were 26 (49%) immune-mediated reaction and 8 (15%) intolerance, with 19 (36%) having no documented reaction. Optimal antibiotics were given to 135 patients without a β-lactam allergy and 37 patients with a reported β-lactam allergy (85% vs 70%, P = .015). Among reported β-lactam allergy patients, those without a documented reaction were less likely to receive optimal therapy (47% vs 79 %, P = .042). Reported β-lactam allergy was not associated with clinical response ( P = .61) or MSSA-related mortality ( P = .83). When adjusting for immunosuppression, variables independently associated with optimal therapy were β-lactam allergy (adjusted odds ratio [adjOR], 0.3; 95% confidence interval [CI], 0.1-0.6) and infectious diseases consultation (adjOR, 6.1; 95%CI, 2.7-13.9). Optimal antibiotic use was associated with decreased all-cause 90-day mortality (adjOR, 0.23; 95%CI, 0.09-0.54). Conclusions: Patients with reported β-lactam allergies, particularly those without a documented reaction, were less likely to receive optimal antibiotics for MSSA BSI. Patient outcomes may be improved with enhanced quality of allergy history and routine infectious disease consultation.

scholarly journals Effects of midfoot joint mobilization on perceived ankle-foot function in chronic ankle instability. A crossover clinical trial

2021 ◽  
Author(s):  
Abbis Jaffri ◽  
John J. Fraser ◽  
Rachel M. Koldenhoven ◽  
Jay Hertel
Keyword(s):  
Ankle Instability ◽  
Dynamic Balance ◽  
Chronic Ankle Instability ◽  
Post Treatment ◽  
Home Exercise ◽  
Pain Patient ◽  
Joint Mobility ◽  
Joint Mobilization ◽  
Patient Reported ◽  
To Receive

AbstractBackgroundChronic ankle instability (CAI) is a complex clinical entity that commonly includes ankle-foot impairment.ObjectiveTo investigate the effects of midfoot joint mobilizations and a one-week home exercise program (HEP) compared to a sham intervention and HEP on pain, patient-reported outcomes (PROs), ankle-foot joint mobility, and neuromotor function in young adults with CAI.MethodsTwenty participants with CAI were instructed in a stretching, strengthening, and balance HEP and were randomized a priori to receive midfoot joint mobilizations (forefoot supination, cuboid glide and plantar 1st tarsometatarsal) or a sham laying-of-hands. Changes in foot morphology, joint mobility, strength, dynamic balance, and PROs assessing pain, physical, and psychological function were assessed pre-to-post treatment and one-week following. Participants crossed-over to receive the alternate treatment and were assessed pre-to-post treatment and one-week following. Linear modelling was used to assess changes in outcomes.ResultsParticipants who received midfoot mobilization demonstrated significantly greater perceived improvement immediately posttreatment in the single assessment numeric evaluation (Sham: 5.0±10.2%; Mobilization: 43.9±26.2%; β: 6.8 p<0.001, Adj R2:0.17) and Global Rating of Change (Sham: −0.1±1.1; Mobilization: 1.1±3.0; β: 1.8 p=0.01, Adj R2:0.12). Following the mobilization intervention, participants demonstrated greater improved rearfoot inversion mobility (Sham: 4.4±8.4°; Mobilization: −1.6±6.1°; β: −6.37, p=0.01, Adj R2:0.19), plantarflexion mobility (Sham: 2.7°±6.4; Mobilization: −1.7°±4.3; β: −4.36, p=0.02, Adj R2:0.07), and posteromedial dynamic balance (Sham: 2.4±5.9%; Mobilization: 6.0±5.4%; β: 3.88, p=0.04, Adj R2:0.10) compared to controls at 1-week post-treatment.ConclusionParticipants with CAI who received midfoot joint mobilization had greater perceived improvement and physical signs that may benefit this clinical population.

Associations Between Treatment Restrictions, Patient-Reported Treatment Burden and Adherence to Tyrosine-Kinase Inhibitor Therapy Among Chronic Myeloid Leukemia Patients in the United States and Europe

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2077-2077
Author(s):  
Shaloo Gupta ◽  
Amir Goren ◽  
Timothy W Victor ◽  
Jonathan Chapnick ◽  
Stephanie Hawthorne ◽  
...  
Keyword(s):  
Research Funding ◽  
Kinase Inhibitor ◽  
The United States ◽  
Current Treatment ◽  
Treatment Regimens ◽  
Dietary Restrictions ◽  
Patient Reported ◽  
Tki Treatment ◽  
The Impact ◽  
Treatment Restrictions

Abstract Abstract 2077 Background: The availability of the tyrosine-kinase inhibitor (TKI), imatinib, and later introduction of second generation TKIs, dasatinib and nilotinib, have not only improved the clinical outcomes of patients with chronic myeloid leukemia (CML), but have also provided multiple therapeutic options for CML patients. Despite the widespread use of these oral therapies, little is known about the impact of different treatment regimens on overall treatment burden and adherence among CML patients. Objective: The objective of this cross-sectional survey conducted in the United States (US) and Europe (EUR) was to assess the overall CML disease management and treatment experience from the patient's perspective. This analysis evaluates the impact of dosing and dietary restrictions on patient-reported adherence and difficulty following oral TKI treatment regimens. Methods: This study included patients identified from the National Health and Wellness Survey and Lightspeed Research Chronic Illness Panel aged ≥18 years from the US and EUR (United Kingdom, Spain, France, Italy, and Germany) who had a diagnosis of CML, were in chronic phase, and were currently on TKI treatment or on a drug holiday. Patients completed a web based self-administered questionnaire. Relevant measures of treatment restrictions, including dietary restrictions (while fasting, with food, without certain foods, with water, at specific time intervals, or without certain non-CML meds) and dosing regimens (once a day, twice a day, two or more pills at one time, or at specific times of day) were compared across TKIs. Outcomes included CML treatment adherence (TKI dose was missed/skipped or taken less than prescribed over the past 4 weeks) and treatment difficulty (patient-reported difficulty in following treatment regimens - Yes/No). A composite score of overall dietary restrictions was constructed for each patient to assess associations with patient-reported treatment difficulty and adherence using a structural equation model (SEM). Results: A total of 303 respondents participated in the study (50% from US), of which 68.6% reported current treatment as imatinib, 12.5% dasatinib and 16.2%nilotinib (2.7% reported other). Mean age was 51.5 years (standard deviation [SD] = 13.6), 46.2% were male, and mean time since diagnosis was 4.8 years (SD = 4.5), with 12.3% of patients within 12 months of diagnosis. The majority of patients reported being adherent to their CML treatment, with 25.4% stating missed doses within the past 4 weeks. Approximately 30% reported difficulty in following treatment regimens; treatment difficulty was substantially higher among nilotinib (63.3%) than among dasatinib (3.7%) or imatinib (22.9%) treated patients (p<0.0001). Overall dietary restriction scores (ranging from -1.33 to 1.60, with positive values indicating greater restrictiveness) were low among dasatinib (mean score= −0.31) and imatinib users (-0.06), whereas overall scores were significantly higher among nilotinib users (mean= 0.61; p<0.0001). Although dietary restrictions were not significantly associated with self-reported adherence (p=0.24), results of the SEM model indicated that higher overall dietary restriction scores were associated with significantly greater difficulty in taking medication as required (beta=0.28, p<0.001). Conclusions: Dietary restrictions were strongly associated with patients reporting difficulty with current treatment regimens. Patients receiving dasatinib and imatinib reported fewer dietary and dosing restrictions than did patients receiving nilotinib. Choosing a regimen that requires fewer overall dosing restrictions may be an important consideration for treatment choice in CML patients. Disclosures: Gupta: Bristol-Myers Squibb: Research Funding. Goren:Bristol-Myers Squibb: Research Funding. Victor:Bristol-Myers Squibb: Research Funding. Chapnick:Bristol-Myers Squibb: Research Funding. Hawthorne:Bristol-Myers Squibb: Research Funding. Hirji:BMS: Employment. Olavarría:Bristol-Myers Squibb: Consultancy. Moadel:Bristol-Myers Squibb: Consultancy. Lemoine:Bristol-Myers Squibb: Consultancy. Davis:Bristol-Myers Squibb: Employment.

Functional impact of sequelae in drug-susceptible and multidrug-resistant tuberculosis

2020 ◽  
Vol 24 (7) ◽  
pp. 700-705 ◽  
Author(s):  
M. Muñoz-Torrico ◽  
S. Cid-Juárez ◽  
L. Gochicoa-Rangel ◽  
L. Torre-Bouscolet ◽  
M. A. Salazar-Lezama ◽  
...  
Keyword(s):  
Lung Function ◽  
Multidrug Resistant ◽  
Forced Expiratory Volume ◽  
Post Treatment ◽  
World Health ◽  
Functional Evaluation ◽  
Bronchodilator Response ◽  
Treatment Regimens ◽  
Tb Treatment ◽  
The Impact

BACKGROUND: Evidence on the impact of tuberculosis (TB) treatment on lung function is scarce. The aim of this study was to evaluate post-treatment sequelae in drug-susceptible and drug-resistant-TB (DR-TB) cases in Mexico and Italy.METHODS: At the end of TB treatment the patients underwent complete clinical assessment, functional evaluation of respiratory mechanics, gas exchange and a 6-minute walking test. Treatment regimens (and definitions) recommended by the World Health Organization were used throughout.RESULTS: Of 61 patients, 65.6% had functional impairment, with obstruction in 24/61 patients (39.4%), and 78% with no bronchodilator response. These effects were more prevalent among DR-TB cases (forced expiratory volume in 1 s/forced vital capacity [FEV1/FVC] < lower limit of normality, 14/24 vs. 10/34; P = 0.075). DR-TB patients showed moderately severe (FEV1 < 60%) and severe obstruction (FEV1 < 50%) (P = 0.008). Pre- and post-bronchodilator FEV1 and FEV1/FVC (% of predicted) were significantly lower among DR-TB cases. Plethysmography abnormalities (restriction, hyperinflation and/or air trapping) were more frequent among DR-TB cases (P = 0.001), along with abnormal carbon monoxide diffusing capacity (DLCO) (P = 0.003).CONCLUSION: The majority of TB patients suffer the consequences of post-treatment sequelae (of differing levels), which compromise quality of life, exercise tolerance and long-term prognosis. It is therefore important that lung function is comprehensively evaluated post-treatment to identify patient needs for future medication and pulmonary rehabilitation.

Review of the impact of NNRTI-based HIV treatment regimens on patient-reported disease burden

AIDS Care ◽  
2013 ◽  
Vol 26 (4) ◽  
pp. 466-475 ◽  
Author(s):  
Kit N. Simpson ◽  
Kristin A. Hanson ◽  
Gale Harding ◽  
Seema Haider ◽  
Margaret Tawadrous ◽  
...  
Keyword(s):  
Disease Burden ◽  
Hiv Treatment ◽  
Treatment Regimens ◽  
Patient Reported ◽  
The Impact

The effects of chemotherapy-induced alopecia on cancer patients’ distress

2021 ◽  
Keyword(s):  
Cancer Patients ◽  
Hair Loss ◽  
Economic Status ◽  
Scientific Evidence ◽  
Cross Sectional Study ◽  
Scalp Cooling ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
The Individual ◽  
Distress Scale

Background: Hair is a human characteristic, which has an important role in presenting the individual gender, race, nation, social interaction as well as mental and physical health status. Chemotherapy-induced alopecia (CIA), which has an incidence of 65%, is known to be one of the most psychological shocks among cancer patients. Chemotherapy-induced Alopecia Distress Scale (CADS) created by a group of Korean scientists is a new tool developed to evaluate alopecia’s effects on patients’ mentality. It is necessary to investigate the effects of alopecia on cancer patients and to understand the demands of patients in coping with CIA. However, to our knowledge, this is a topic that is still lacking objective and scientific evidence in Hue, Vietnam. Therefore, we conducted the study to describe the alopecia characteristics of patients treated with chemotherapy, and to identify the distress level of cancer patients using CADS and the preference of patients to deal with the alopecia. Methods: A cross-sectional study was conducted on 56 cancer patients undergoing chemotherapy at the Oncology department of Hue University of Medicine and Pharmacy Hospital from 01/12/2020 to 25/03/2021. The hair loss grade was assessed by CTCAE and the level of distress was evaluated by CADS. Statistical analysis was performed in Microsoft Excel 2016 and the R 3.6.0 program. Results: The mean age of patients in our study was 56.48 ± 10.244. Of all 56 patients, the majority of participants were female (69.6%), married (82.1%), and had above-average economic status (67.9%). Breast cancer patients accounted for the highest percentage with 39.3%. Most of the patients were in grade III (32.1%) and grade IV (39.3%). Our study revealed that 82.1% of patients having hair loss at grade 2 according to CTCAE 5.0. Evaluating by CADS showed that 87.5% of participants experienced low distress. Hat/ headscarf and wig were the most popular coping strategy against the CIA (66.1% and 35.7%, respectively). Scalp cooling is a new method that can prevent the CIA effectively. A proportion of 41.1% was willing to try the scalp cooling systems. Conclusions: Alopecia grade 2 accounted for the majority of patients in our study (82.1%). This was a symptom that should be concerned, however, our study revealed that the alopecia’s effects were not so serious among patients in the study. Most of the patients did not worry about chemotherapy - induced alopecia (89.3%), and 87.5% of participants experienced low distress, while there was still a proportion of 12.5% with higher distress. To cope against alopecia, many feasible coping strategies have been used by patients, including hat/ headscarf or wig.

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