CANCER TREATMENT AND CARDIOVASCULAR TOXITY: PATHOGENESIS AND ACTUAL APPROACHES TO THE DIAGNOSIS OF HEART FAILURE IN CANCER PATIENTS

The field of cardio-oncology has received increasing attention in recent years. This is due to the fact that the results of a large number of clinical studies on antitumor therapy, covering issues treatments side effects, including associated cardiovascular pathology, are published. Advances in treatment have led to improved survival of patients with cancer, but have also increased clinical significance of treatment side effects. Myocardium, having high metabolic activity, responds to substrate and energy imbalance under the action of increasing malignancy and toxic effects of radio- or chemotherapy. Finding of baseline risk factors, timely identification of cardiovascular diseases, ability to predict the long-term consequences of cancer treatment-associated cardiovascular side effects lead to improving of the prognosis and quality of life, avoiding of over-diagnosis cardiovascular diseases and inappropriating violation of life-saving treatment of a malignant tumor.

Download Full-text

When Eating Becomes Torturous: Understanding Nutrition-Related Cancer Treatment Side Effects among Individuals with Cancer and Their Caregivers

Nutrients ◽

10.3390/nu14020356 ◽

2022 ◽

Vol 14 (2) ◽

pp. 356

Author(s):

Brandy-Joe Milliron ◽

Lora Packel ◽

Dan Dychtwald ◽

Cynthia Klobodu ◽

Laura Pontiggia ◽

...

Keyword(s):

Quality Of Life ◽

Side Effects ◽

Cancer Treatment ◽

Food Preferences ◽

Treatment Side Effects ◽

Food And Nutrition ◽

Loss Of Appetite ◽

Living With Cancer ◽

Depth Interviews

Individuals living with cancer often experience multiple nutrition-related side effects from cancer treatment, including changes in taste and smell, nausea, diarrhea, loss of appetite, and pain during eating. These side effects can profoundly impact nutritional status and quality of life. The purpose of this study was to explore experiences with nutrition-related cancer treatment side effects among cancer patients and their family caregivers, the way they manage such side effects, and the resulting changes in food preferences and behaviors. Structured surveys and in-depth interviews were conducted. Interviews focused on the presence and management of treatment side effects, how those changes influenced food preferences, and the extent to which they interfered with quality of life. Most patients (72%) reported treatment side effects; 61% reported that these side effects impacted their eating and drinking. Common side effects included fatigue (58%), dry mouth (30%), nausea (24%), constipation (20%) and diarrhea (20%). Six overarching qualitative themes were identified: Spiral of side effects; Pain of eating; Burden of eating; Loss of taste/change in taste; Symptom management; and Solutions. The authors conclude with implications for food and nutrition practice—moving beyond traditional recommendations of what to eat or avoid—to consider the overall patient and caregiver experience.

Download Full-text

Patients’ perspectives on radiation in health care

Annals of the ICRP ◽

10.1177/0146645320931972 ◽

2020 ◽

Vol 49 (1_suppl) ◽

pp. 154-157

Author(s):

L.A. Hunt

Keyword(s):

Health Care ◽

Radiation Therapy ◽

Side Effects ◽

Cancer Treatment ◽

Cancer Control ◽

Ongoing Research ◽

Patients With Cancer ◽

Therapy Targets ◽

Short And Long Term

As radiation therapy is needed by approximately 50% of patients with cancer there needs to be ongoing research to ensure that radiation therapy targets the tumour effectively and minimises potential side effects. Major advances in radiation therapy, due to improvements in engineering and computing, have made it more precise, reducing side effects and improving cancer control. Patients need to be informed of its risks, both short and long term, to enable them to be active participants in their cancer treatment path.

Download Full-text

Oral Integrity Related to Head and Neck Cancer Treatment

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd21.1.28 ◽

2012 ◽

Vol 21 (1) ◽

pp. 28-33

Author(s):

Annette H. May ◽

E. Danielle Hiner ◽

Elizabeth Feldman

Keyword(s):

Head And Neck Cancer ◽

Side Effects ◽

Cancer Treatment ◽

Head And Neck ◽

Neck Cancer ◽

Chronic Complications ◽

Treatment Assessment ◽

Pre Treatment

Head and neck cancer treatment can result in devastating side effects that diminish quality of life, sometimes for a lifetime. The purpose of this article is to highlight the importance of oral integrity in minimizing side effects to optimize long-term function in patients treated for head and neck cancer. We will present the value of a comprehensive pre-treatment assessment. We will describe the oral complications associated with surgery, radiation, and chemotherapy and offer approaches in management of acute and chronic complications.

Download Full-text

Cancer Care Evaluation Scale (CCES): measuring the quality of the structure and process of cancer care from the perspective of patients with cancer

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa165 ◽

2020 ◽

Vol 51 (1) ◽

pp. 92-99

Author(s):

Kento Masukawa ◽

Kazuki Sato ◽

Megumi Shimizu ◽

Tatsuya Morita ◽

Mitsunori Miyashita

Keyword(s):

Side Effects ◽

Cancer Treatment ◽

Cancer Care ◽

Intraclass Correlation ◽

Online Surveys ◽

Convenience Sample ◽

Patients With Cancer ◽

Care Evaluation ◽

Physical Care

Abstract Objective To evaluate the quality of the structure and process of cancer care from the perspective of patients with cancer, we developed a Cancer Care Evaluation Scale. Methods Two anonymous online surveys of patients with cancer in Japan were conducted using a convenience sample of 400 adult cancer outpatients. Results In total, 162 patients participated in the online surveys. Factor analysis revealed that the Cancer Care Evaluation Scale had the following 12 domains: (i) relationship with physician, (ii) relationship with nurse, (iii) physical care by physician, (iv) physical care by nurse, (v) psycho-existential care, (vi) help with decision-making for patients, (vii) coordination and consistency, (viii) environment, (ix) cost, (x) availability, (xi) care for the side effects of cancer treatment by a physician, and (xii) care for the side effects of cancer treatment by a nurse. The Cancer Care Evaluation Scale was correlated with overall care satisfaction (r = 0.75), but not with the quality of life (r = 0.40). In regard to rest–retest reliability, most items showed an intraclass correlation coefficient of 0.7 or higher. Conclusion The validity and reliability of the Cancer Care Evaluation Scale were confirmed, suggesting that this tool is useful for evaluating the quality of cancer care from the perspective of patients with cancer.

Download Full-text

The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment

npj Breast Cancer ◽

10.1038/s41523-021-00276-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Mads G. Jørgensen ◽

Navid M. Toyserkani ◽

Frederik G. Hansen ◽

Anette Bygum ◽

Jens A. Sørensen

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Treatment ◽

Breast Cancer Treatment ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact

AbstractThe impact of breast cancer-related lymphedema (BCRL) on long-term quality of life is unknown. The aim of this study was to investigate the impact of BCRL on health-related quality of life (HRQoL) up to 10 years after breast cancer treatment. This regional population-based study enrolled patients treated for breast cancer with axillary lymph node dissection between January 1st 2007 and December 31th 2017. Follow up and assessments of the included patients were conducted between January 2019 and May 2020. The study outcome was HRQoL, evaluated with the Lymphedema Functioning, Disability and Health Questionnaire, the Disabilities of the Arm, Shoulder and Hand Questionnaire and the Short Form (36) Health Survey Questionnaire. Multivariate linear logistic regression models adjusted for confounders provided mean score differences (MDs) with 95% confidence intervals in each HRQoL scale and item. This study enrolled 244 patients with BCRL and 823 patients without BCRL. Patients with BCRL had significantly poorer HRQoL than patients without BCRL in 16 out of 18 HRQoL subscales, for example, in physical function (MDs 27, 95%CI: 24; 30), mental health (MDs 24, 95%CI: 21; 27) and social role functioning (MDs 20, 95%CI: 17; 23). Age, BMI, BCRL severity, hand and dominant arm affection had only minor impact on HRQoL (MDs < 5), suggesting a high degree of inter-individual variation in coping with lymphedema. This study showed that BCRL is associated with long-term impairments in HRQoL, especially affecting the physical and psychosocial domains. Surprisingly, BCRL diagnosis rather than clinical severity drove the largest impairments in HRQoL.

Download Full-text

Rituximab-Containing Risk-Adapted Treatment Strategy in Nodular Lymphocyte Predominant Hodgkin Lymphoma: 7-Years Follow-Up

Cancers ◽

10.3390/cancers13081760 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1760

Author(s):

Novella Pugliese ◽

Marco Picardi ◽

Roberta Della Pepa ◽

Claudia Giordano ◽

Francesco Muriano ◽

...

Keyword(s):

Side Effects ◽

Hodgkin Lymphoma ◽

Prognostic Score ◽

Single Agent ◽

Response To Therapy ◽

Baseline Risk ◽

Historical Cohort ◽

Treatment Groups

Background: Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare variant of HL that accounts for 5% of all HL cases. The expression of CD20 on neoplastic lymphocytes provides a suitable target for novel treatments based on Rituximab. Due to its rarity, consolidated and widely accepted treatment guidelines are still lacking for this disease. Methods: Between 1 December 2007 and 28 February 2018, sixteen consecutive newly diagnosed adult patients with NLPHL received Rituximab (induction ± maintenance)-based therapy, according to the baseline risk of German Hodgkin Study Group prognostic score system. The treatment efficacy and safety of the Rituximab-group were compared to those of a historical cohort of 12 patients with NLPHL who received Doxorubicin, Bleomycin, Vinblastine, Dacarbazine (ABVD) chemotherapy followed by radiotherapy (RT), if needed, according to a similar baseline risk. The primary outcome was progression-free survival (PFS) and secondary outcomes were overall survival (OS) and side-effects (according to the Common Terminology Criteria for Adverse Events, v4.03). Results: After a 7-year follow-up (range, 1–11 years), PFS was 100% for patients treated with the Rituximab-containing regimen versus 66% for patients of the historical cohort (p = 0.036). Four patients in the latter group showed insufficient response to therapy. The PFS for early favorable and early unfavorable NLPHLs was similar between treatment groups, while a better PFS was recorded for advanced-stages treated with the Rituximab-containing regimen. The OS was similar for the two treatment groups. Short- and long-term side-effects were more frequently observed in the historical cohort. Grade ≥3 neutropenia was more frequent in the historical cohort compared with the Rituximab-group (58.3% vs. 18.7%, respectively; p = 0.03). Long-term non-hematological toxicities were observed more frequently in the historical cohort. Conclusion: Our results confirm the value of Rituximab in NLPHL therapy and show that Rituximab (single-agent) induction and maintenance in a limited-stage, or Rituximab with ABVD only in the presence of risk factors, give excellent results while sparing cytotoxic agent- and/or RT-related damage. Furthermore, Rituximab inclusion in advanced-stage therapeutic strategy seems to improve PFS compared to conventional chemo-radiotherapy.

Download Full-text

Cardiooncology—dealing with modern drug treatment, long-term complications, and cancer survivorship

Clinical & Experimental Metastasis ◽

10.1007/s10585-021-10106-x ◽

2021 ◽

Author(s):

Claudia de Wall ◽

Johann Bauersachs ◽

Dominik Berliner

Keyword(s):

Side Effects ◽

Checkpoint Inhibitors ◽

Heart Diseases ◽

Tumor Therapy ◽

Treatment Strategies ◽

Tumor Treatment ◽

Cardiac Side Effects ◽

Cardiovascular Side Effects ◽

Modern Drug

AbstractModern treatment strategies have improved prognosis and survival of patients with malignant diseases. The key components of tumor treatment are conventional chemotherapy, radiotherapy, targeted therapies, and immunotherapy. Cardiovascular side-effects may occur in the early phase of tumor therapy or even decades later. Therefore, knowledge and awareness of acute and long-lasting cardiac side effects of anti-cancer therapies are essential. Cardiotoxicity impairs quality of life and overall survival. The new cardiologic subspecialty ‘cardio-oncology’ deals with the different cardiovascular problems arising from tumor treatment and the relationship between cancer and heart diseases. Early detection and treatment of cardiotoxicity is of crucial importance. A detailed cardiac assessment of patients prior to administration of cardiotoxic agents, during and after treatment should be performed in all patients. The current review focusses on acute and long-term cardiotoxic side effects of classical cytotoxic and selected modern drug treatments such as immune checkpoint inhibitors and discusses strategies for the diagnosis of treatment-related adverse cardiovascular effects in cancer patients.

Download Full-text

Adrenal Insufficiency - Aetiology, Diagnosis and Treatment

Delta Medical College Journal ◽

10.3329/dmcj.v3i1.22238 ◽

2015 ◽

Vol 3 (1) ◽

pp. 36-47

Author(s):

Nazma Akter ◽

Nazmul Kabir Qureshi

Keyword(s):

Quality Of Life ◽

Adrenal Insufficiency ◽

Presenting Symptoms ◽

Life Saving ◽

Life Threatening ◽

Diagnostic Work ◽

Work Up ◽

Term Management

Adrenal insufficiency is caused by either primary adrenal failure or by hypothalamic-pituitary impairment of the corticotropic axis. Adrenal insufficiency, first codified in 1855 by Thomas Addison, remains relevant in 2014 because of its lethal nature. Though, it is a rare disease but is life threatening when overlooked. Main presenting symptoms such as fatigue, anorexia and weight loss are nonspecific, thus diagnosis is often delayed. The diagnostic work-up is well established but some pitfalls remain. The diagnosis is adequately established by the 250 ?g ACTH (adrenocorticotropic hormone) stimulation test in most cases. Glucocorticoids provide life saving treatment but long-term quality of life is impaired, perhaps because therapy is not given in a physiologic way. Dehydroepiandrosterone-replacement therapy has been introduced that could help to restore quality of life. It may be useful in pubertal girls, but not in adults. Monitoring of glucocorticoid-replacement is difficult due to lack of objective methods of assessment and is therefore largely based on clinical grounds. Thus, long-term management of patients with adrenal insufficiency remains a challenge, requiring an experienced specialist. DOI: http://dx.doi.org/10.3329/dmcj.v3i1.22238 Delta Med Col J. Jan 2015; 3(1): 36-47

Download Full-text

The New Direction of Senolytic Drug Research Should Be on Cancer Prevention, Adjuvant Therapies in Cancer and Healthy Aging in Cancer Survivors

10.21203/rs.3.rs-307731/v1 ◽

2021 ◽

Author(s):

Ozgur Tanriverdi ◽

Ummuhani Ozel Turkcu

Keyword(s):

Cardiovascular Diseases ◽

Side Effects ◽

Cellular Senescence ◽

Healthy Aging ◽

Drug Research ◽

General Information ◽

Cancer Treatments ◽

Adjuvant Therapies ◽

Anti Cancer

Abstract In cases where cellular senescence does not function properly, the use of drugs called senolytics in the prevention of chronic aging-related disorders such as cancer, diabetes and cardiovascular diseases has become a very interesting topic. There are studies showing that senolytic drugs can be used for the purpose of preventing cancer, preventing recurrence in individuals diagnosed with cancer, and delaying multimorbidity situations that may develop as long-term side effects of anti-cancer treatments. This article has been prepared with the aim of reminding general information about senolytic drugs and cellular senescence due to the fact that there are many controversial researches in the field of oncology in the future

Download Full-text

BIOBRAN MGN-3

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.01.4869 ◽

2012 ◽

Vol 20 (01) ◽

pp. 13-16

Author(s):

Ahmad Ijaz Masood ◽

RABEETA SHEIKH ◽

RANA ATIQUE ANWER

Keyword(s):

Quality Of Life ◽

Side Effects ◽

Hair Loss ◽

White Blood Cells ◽

Food Supplement ◽

Severe Nausea ◽

Treatment Side Effects ◽

Group A ◽

Group B

Objective: The aim of study was to assess the effect of Biobran in reducing of chemotherapy induced side effects in termsof tiredness, anorexia, vomiting and hair loss and quality of life in terms of weight loss. Setting: Radiotherapy Department, NishtarHospital Multan. Material and Methods: Fifty patients of breast cancer were enrolled randomly in two groups. Group-A patients weregiven 3 gram dose of Biobran MGN-3 per day one week before and one week after chemotherapy. Group-B patient were givenchemotherapy alone. Total six cycles of chemotherapy were given. No multivitamin or food supplements were given during this study.Chemotherapy induced side effects (tiredness, anorexia, and vomiting, hair loss) were assessed by questionnaire to the patients beforestart of each cycle. Weight was checked before each cycle to assess weight gain or loss. White blood cells were checked by completeblood count just before and one week after chemotherapy. Results: Between six months, 50 patients were enrolled in RadiotherapyDepartment, Nishtar Hospital Multan. There was a significant reduction in tiredness and anorexia in group-A patients. 20 (80%) patients ofgroup-A felt increase in their diet and no tiredness without any appetizer or multivitamin. But group-B patients demanded for appetizer dueto severe anorexia after chemotherapy except 3 (12%) patients who didn’t use any appetizer or food supplement. In group-A, 15 (60%)patients didn’t need any anti-emetic as compared to group-B all patient (100%) experienced severe nausea during and afterchemotherapy. Group-A patients experienced less hair fall 7 (28%) patients as compared to other group which is 25 (100%) patients.Conclusions: The study showed that, by helping to optimize the immune system, Biobran MGN-3 can not only help maximize treatmentsuccess, but also minimize treatment side effects and improve quality of life during treatment and in recovery.

Download Full-text