Caregiver burden among family members of patients diagnosed with cancer in Jimma medical center oncology unit, south west Ethiopia.

Background Cancer is a type of disease defined by uncontrolled growth and spread of abnormal cells, which can result in death. Globally, around 25 million people are surviving with it. The burden of cancer is growing in developing countries and it frequently comprises patient’s vitality. In addition, it has emotional, economical, physical and psychological burden on family, friends, significant others, community and other social resource. Objective To assess caregiver burden of cancer patients in Jimma medical center oncology unit, South west Ethiopia. Method An institutional based cross-sectional study design was employed. The study was done on 141 respondents using simple random sampling. A pretested semi structured interviewer administered questionnaire was used to collect the data. The collected data was entered in to EPI data version 3.1 then transferred to SPSS version 23 for data analysis. Multivariable logistic regression model was fitted, Adjusted Odds Ratio (AOR) at 95% confidence interval and p-value <0.05 were estimated to determine statistically association between predictors and outcome variables. Results The data were collected from the total of 141 respondents with 100% response rate. The mean ±SD age of cancer patients and care givers were 46.4 ±12.406 and 32 ± 11.23 years, respectively. The general level of caregiver burden in this study was mild to moderate (71.6%) with ZBI total score of 30 and by using CBI114 (80.9%) had some burden. Caregivers whose their age is greater than 40 years were 4.01 times more likely have high burden than those age between 20-40 old age [AOR=4.01, 95%CI (1.58, 10.17)]. Conclusion The study disclosed a moderate level of caregiver burden among family caregivers.

What Do Oncology Patients Know and Think About Apitherapy?

Purpose In clinical practice, the use of apitherapy products in the treatment of oncology patients is not very common. For this reason, it is extremely important for cancer patients to have accurate information about apitherapy and to use these products in a controlled manner. This study was conducted to determine the knowledge level of oncology patients about apitherapy, their use of apitherapy products and their opinions about these products.Methods This descriptive research was carried out between January 2019 and January 2020 at the oncology unit of a university hospital. Power analysis was used to determine the sample size of the study, and a total of 87 patients constituted the sample of the research with a confidence interval of 85%. A questionnaire consisting of questions investigating the sociodemographic characteristics of the patients and their knowledge, opinions and practices about apitherapy was used to collect the data. The data were analyzed using descriptive statistics and the SPSS 21 package program. Results The level of knowledge of the patients about apitherapy is quite low (41.4%) and they received the information they gained from their family/friends (63.9%). The rate of use of apitherapy products by patients is low (27.6%) and the most frequently used product is honey (37.4%). Patients think that more scientific evidence is needed for the use of apitherapy methods in cancer patients (83.9%).Conclusions Healthcare professionals should conduct more scientific research on the use of apitherapy products in cancer treatment and inform patients about the usage areas and risks of apitherapy.

A-10-Year Review on Survival Rate and Prognostic Factors of Ewing Family Tumour in Children at Hospital Universiti Sains Malaysia

Introduction: Ewing Family Tumour (EFT) is a group of rare malignant and aggressive tumour, with a considerably improved prognosis. However, there is lack of study on the outcome of children with EFT in Malaysia. Objectives: The study aimed to evaluate the Overall Survival (OS) rate, Event Free Survival (EFS) rate and identify the prognostic factors that determined the EFT outcome at Hospital Universiti Sains Malaysia (USM). Methodology: A retrospective record review of children aged 0-18 years with EFT was done. Patients were identified from the registration data in the Oncology Unit and Record Office of Hospital USM. For patients with untraceable information or deceased, a letter was sent to State Registry to obtain the outcome of the patient. The association between demographics and patients’ clinical factors was determined using the Cox regression. Survival curves were estimated by the Kaplan-Meier method and were compared using the Log-rank test. Results: There were 51 patients identified but 29 of them were eligible for the study. The mean duration of follow-up was 21 months. The OS rate at 1, 2, 3 and 5 years were 62.1%, 44.8%, 30.2% and 21.6% respectively. The EFS rate at 1, 2, 3 and 5 years were 41.9%, 26.7%, 17.8% and 0% respectively. Multivariate Cox regression analysis showed that the presence of surgical intervention (p = 0.030) and major complications (p = 0.045) were the significant prognostic factors to the survival of EFT. Conclusion: The survival rate of EFT among our patients was comparable to other developing countries, with surgical intervention and the presence of major complications as independent prognostic factors.

The effect of progressive muscle relaxation training on chemotherapy-induced nausea, vomiting and anxiety in Egyptian breast cancer women: A randomized controlled trial

Background and objective: This study was conducted to examine the effect of progressive muscle relaxation training (PMRT) in combination with antiemetic drugs on chemotherapy-associated nausea, vomiting and anxiety in breast cancer women receiving chemotherapy.Methods: A randomized controlled trial design was conducted on 74 patients divided into control (n = 37) and PMRT group (n = 37). The study was conducted at Oncology Center affiliated to Mansoura University, Egypt. The intervention included daily PMRT practice for seven days two hours before chemotherapy. The patients exercised in the oncology unit with the researcher, and individually applied the exercises at home. The data was collected using Rhodes index of nausea-vomiting and retching used daily after chemotherapy for seven days and Zung self-rating anxiety scale used before chemotherapy and at the seventh and 14th days after chemotherapy.Results: A significant decrease in the frequency, severity, and duration of vomiting, nausea, retching and anxiety in PMRT group than in the control group (p < .0001). Conclusions: Progressive muscle relaxation combined with antiemetics was effective in reducing vomiting, nausea, and retching, as well as improving anxiety level induced by chemotherapy.

The Utility of Multi-dimensional Symptom Assessment Scales for Children Treated in a Tertiary Paediatric Oncology Unit: a Prospective Survey-based Study

Background: Children undergoing cancer-directed treatment experience distressing symptoms. Multi-dimensional patient-reported symptom assessment scales have been validated in children with cancer, but are not routinely used in clinical practice.Aim: To describe the symptom prevalence and burden for children receiving treatment in a paediatric oncology unit, as described by both children where possible, and their parents.Methods: Prospective survey-based study during which the Memorial Symptom Assessment Scale was administered to children and parents. Participants were offered the opportunity to complete the survey on multiple occasions. Demographic and clinical data were obtained from electronic medical records. Institutional ethics approval was granted (HREC37022A).Results: Forty-one children were recruited, aged 8 months to 18 years and 54% were female. In total, 54 parent surveys and 29 child surveys were completed. The vast majority of surveys (81%) were completed in the inpatient setting, and more than half within 10 days of chemotherapy. Haematological malignancies predominated. There was a median of 4.8 months between diagnosis and recruitment. Eleven children died after the study closed; no patients died during the study period. Children aged 10 – 18 reported an average of 15 symptoms. Symptom prevalence did not always correlate with distress.Conclusions: Exploration of the impact of a symptom, and not just its presence, is vital for patient-centred care and can be achieved using multi-dimensional symptom scales. Both the child and caregiver’s voices should be obtained where possible. Further studies are needed to explore how these scales can be used to identify distress and guide supportive care delivery.

Accurate Triage of Oncological Patients for Safely Continuing Cancer Therapy During the SARS-CoV-2 Pandemic

ObjectiveTo evaluate the efficacy of clinical triage of oncological patients for safe continuation of cancer therapy implemented during the first SARS-CoV-2 outbreak.MethodsBetween 25 February and 21 April 2020, patients attending the Medical Oncology Unit, Spedali Civili Hospital, Brescia (Italy) for cancer therapy underwent triage to identify those with no signs and symptoms suspicious for SARS-CoV-2 infection in which antineoplastic treatment could be continued as scheduled. Triage questions investigated common symptoms (e.g., fever, cough, dyspnea, anosmia, dysgeusia, headache, nasal congestion, conjunctival congestion, sore throat, diarrhea, nausea and vomiting); body temperature and pulse oximetry were also recorded. All patients were followed-up for overt SARS-CoV-2 through to 18th May 2020.ResultsOverall, 1180 patients (median age 65 years) underwent triage during the study period. The most frequent primary malignances were breast (32%), gastrointestinal (18%), and lung (16.5%) cancer. Thirty-one (2.5%) presented with clinically evident SARS-CoV-2 infection and tested positive on nasopharyngeal swab testing and/or radiological imaging. Triage identified 69 (6%) grey zone patients with symptoms suspicious for SARS-CoV-2; 5 (7.2%) subsequently developed symptomatic disease. Neither the symptomatic nor the grey zone patients received their scheduled treatment; instead, they were referred for hospitalization or home quarantine.ConclusionTriage of oncological patients at our Unit provided for safe continuation of scheduled cancer treatment in 91.5% of patients during the initial SARS-CoV-2 outbreak.