Mar Fan, H. G., Clemons, M., Xu, W., Chemerynsky, I., Breunis, H., Braganza, S., & Tannock, I. F. (2008). A randomised, placebo-controlled, double-blind trial of the effects of d-methylphenidate on fatigue and cognitive dysfunction in women undergoing adjuvant chemotherapy for breast cancer. Supportive Care in Cancer, 16, 577–583.
To investigate the effects of d-methylphenidate (d-MPH) on fatigue and cognitive function in women undergoing adjuvant chemotherapy for early breast cancer.
Patients were given 5 mg of placebo for the first chemotherapy cycle to assess for compliance and were then randomized to either d-MPH 5 mg twice daily (BID) or matched placebo. The dosage increased to 10 mg BID after one week and was taken in the morning and at noon.
The study was a randomized, controlled trial with a placebo arm.
All were measured at baseline, end of chemotherapy, and at six-month follow-up.
The difference between groups was not significant in cognitive function or fatigue.
The findings do not support the effectiveness of d-MPH at the doses given here in reducing fatigue during active treatment for breast cancer.
D-MPH cannot be suggested as an intervention to relieve cancer-related fatigue or cognitive functioning.
Marx, W.M., Teleni, L., McCarthy, A.L., Vitetta, L., McKavanagh, D., Thomson, D., & Isenring, E. (2013). Ginger (Zingiber officinale) and chemotherapy-induced nausea and vomiting: A systematic literature review. Nutrition Reviews, 71, 245-254.
To review the current published research from randomized controlled trials (RCTs) and crossover trials evaluating the efficacy of ginger for prevention of chemotherapy-induced nausea and vomiting (CINV)
Databases searched were PubMed, CINAHL, and Cochrane library.
Search keywords were ginger, cancer , chemotherapy, nausea, emesis, vomiting, and CINV.
Studies were included in the review if they
Study exclusions were not reported.
At best, findings show mixed results for use of ginger. Overall body of evidence was rated as “C’ in which “D” was the lowest possible level.
This review does not support the use of ginger for CINV prevention.
Maru, A., Gangadharan, V.P., Desai, C.J., Mohapatra, R.K., & Carides, A.D. (2013). A phase 3, randomized, double-blind study of single-dose fosaprepitant for prevention of cisplatin-induced nausea and vomiting: Results of an Indian population subanalysis. Indian Journal of Cancer, 50, 285–291.
To compare the safety and efficacy of fosaprepitant with the safety and efficacy of aprepitant
Patients on cisplatin-based chemotherapy were randomly assigned to receive a single IV dose of fosaprepitant or a three-day dosing regimen of aprepitant. All also were given a dexamethasone regimen and ondansetron on day 1. Both groups could receive rescue therapy. Patients recorded nausea and vomiting episodes for the first 120 hours after chemotherapy.
No significant differences occurred between groups in complete response (CR) during the acute phase. In the delayed phase, 77.7% of patients on fosaprepitant had CR compared to 73.9% in the aprepitant group. This difference was not statistically significant. No differences existed in need for rescue medication. None of the patients experienced infusion site reactions with fosaprepitant.
The findings showed essentially equivalent efficacy of single dose fosaprepitant and a three-day aprepitant regimen for the prevention of chemotherapy-induced nausea and vomiting (CINV) with highly emetogenic chemotherapy.
A single dose of fosaprepitant can provide the same essential prevention of CINV as a multiday aprepitant regimen as part of triple-drug therapy. Infusion site reactions have been described with fosaprepitant but were not shown in this particular analysis. Selection of the type of NK1 use can be planned according to individual patient situations.
Martire, L.M., Lustig, A.P., Schulz, R., Miller, G.E., & Helgeson, V.S. (2004). Is it beneficial to involve a family member? A meta-analysis of psychosocial interventions for chronic illness. Health Psychology, 23, 599–611.
MEDLINE, PsycInfo, CancerLit, CINAHL, American College of Physicians Journal Club, Cochrane Controlled Trials Register, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effectiveness were searched using key words in groups (a) patient, ill, illness or health, (b) family, caregiver, caregiving, marriage, marital, spouse, spousal, couple, or partner, and (c) treatment, intervention, or support. ERIC, Social Work Abstracts, Expanded Academic ASAP, Academic Search Elite, PubMed, ISI Web of Knowledge and Web of Science, Economic and Social Research Council, Inter-University Consortium for Political and Social Research, and Physician Data Query/National Cancer Institute, as well as tables of contents of all Elsevier Publications medical journals, were searched using the key words family, caregiving or caregiver, and intervention or treatment.
Overall, evidence suggested that interventions reduced depressive symptoms in family members when the intervention focused on illnesses other than dementia. Family interventions targeted to patients and family members (as a dyad) or to family members alone were effective in reducing caregiver burden. Interventions offered to spouses alone or to a combination of family members were effective in reducing caregiver burden. Interventions had a stronger effect in reducing burden, depression, and anxiety when relationship issues between patients and caregivers were addressed.
No evidence was found that psychosocial interventions relieved anxiety in family members (uniform across studies).
A family intervention demonstrated the strongest evidence for improving family burden and was uniform across studies for spouses and for mixed groups of family members.
Only five studies included cancer populations.
Martin, M.L., Hernandez, M.A., Avendano, C., Rodriguez, F., & Martinez, H. (2011). Manual lymphatic drainage therapy in patients with breast cancer related lymphoedema. BMC Cancer, 11, 94.
To determine the effectiveness of manual lymph drainage (MLD) in reducing lymphedema in patients with breast cancer
Participants were randomly assigned to a control group and an experimental group. The control group received standard lymphedema treatment as well as a month of ambulatory treatment, daily bandaging from hand to shoulder for the first four weeks (removed at night), compression garments, and patient education regarding prevention guidelines and exercises to perform at home. The experimental group received the standard treatment plus MLD. MLD was performed before the bandaging occurred.
The study took place at a rehabilitation facility in Brazil.
Patients were undergoing active lymphedema treatment.
The study used a randomized controlled trial design.
At 12 months the incidence of lymphedema in the intervention group was very similar to the control group: 24% and 19%, respectively. This difference is not considered statistically significant. There were no incidence differences at three and six months. There was also no difference in the time taken to develop lymphedema, secondary outcome measures of arm circumference, health-related quality of life, and patient reports.
Because of the lack of statistically significant changes in lymphedema incidence between control and intervention groups, it can be concluded that MLD is not effective in preventing lymphedema in the first year post-operatively in patients with breast cancer.
The study had a small sample size, with less than 100 participants.
The study indicates that MLD does not provide a statistically significant improvement in limb volume in patients with lymphedema. One of the greatest limitations of the study is the sample size. If the results of a repeated randomized controlled trial with a larger sample size yields similar results, MLD should not be taught to lymphedema patients because studies suggest it is unnecessary and ineffective.
Martinez-Zapata, M.J., Roque, M., Alonso-Coello, P., & Catala, E. (2006). Calcitonin for metastatic bone pain. Cochrane Database of Systematic Reviews, 3, CD003223.
Databases searched were MEDLINE (1966–2005), EMBASE (1974–2005), Cochrane Central Register of Controlled Trials (issue 2, 2005), and specialized registers of the Cochrane Cancer Network and the Cochrane Pain, Palliative and Supportive Care Group. Also searched were metaRegister of Controlled Trials, U.S. National Institutes of Health register, register of the Center for Clinical Trials and Evidence-Based Healthcare, and register of the European Organization for Research and Treatment of Cancer.
Registers of trials in progress also were assessed.
Studies were included in the review if they
Studies where bisphosphonates were administered before patients were randomized to different treatment arms and studies where the efficacy of calcitonin in treating pain was measured over a short period (less than four weeks) were excluded.
The review included two randomized, double-blind clinical trials of patients with metastatic bone pain for a total of 90 patients. The first study compared calcitonin (100 IU administered subcutaneously each day for 28 days) versus placebo administered to a group of 40 women with breast cancer and pain from bone metastasis. The second study compared calcitonin (100 IU administered subcutaneously each day for three months) versus placebo in 50 women with breast cancer and painful bone metastases.
Of the two studies selected (90 patients), all patients had metastatic bone pain caused by any primary tumor, diagnosed by computed tomography, bone gammagraphy, nuclear magnetic resonance, or other radiographic process.
The limited available evidence does not support the use of calcitonin to control pain from bone metastases.
Calcitonin has been assessed in studies with small sample sizes and too short-term evaluations.
More double-blind, parallel clinical trials using long-term evaluations are needed.
Martinez, K.A., Aslakson, R.A., Wilson, R.F., Apostol, C.C., Fawole, O.A., Lau, B.D., . . . Dy, S.M. (2014). A systematic review of health care interventions for pain in patients with advanced cancer. American Journal of Hospice and Palliative Care, 31, 79–86.
STUDY PURPOSE: To evaluate the effectiveness of healthcare interventions targeting pain in patients with cancer
TYPE OF STUDY: Systematic review
DATABASES USED: PubMed, CINAHL, PsycINFO, DARE, and Cochrane Collaboration; reference lists were used to identify additional studies.
KEYWORDS: Search terms and strategy specifics are in an online appendix to this article.
INCLUSION CRITERIA: Random or nonrandom trials with a control group. Patient-centered and institutional change interventions were included in the definition of healthcare interventions. Pain was included as an outcome.
EXCLUSION CRITERIA: Not specified
TOTAL REFERENCES RETRIEVED = 1,3014
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: GRADE system of quality evaluation; risk of bias was high in seven studies and moderate in another seven studies.
APPLICATIONS: Palliative care
Of the studies, 89% examined patient educational activities. Two focused on provider-level interventions. Fifty-five percent of studies (11 studies) that measured knowledge and barriers found significant improvement in barriers to pain management. Five studies measured pain knowledge–two of these showed improvement. Forty-seven percent of the 19 studies showed significant improvement in pain outcomes compared to the control group. Findings varied by the type of intervention used, and results suggest that the use of multiple educational modalities may be more effective. The number of patient encounters in studies varied widely.
Psychoeducational interventions significantly can reduce barriers to pain management, improve pain knowledge, and improve pain outcomes.
Psychoeducational interventions can reduce patient barriers to pain management, improve relevant knowledge, and have a positive impact on pain. Multimodal interventions combining various educational media and follow-up appear to be more effective than alternatives. Data are limited to show effects of institutional, provider-focused interventions, but results in this area are promising. A combination of provider- and patient-focused interventions should be evaluated.
Martinez, J.M., Leite, L., França, D., Capela, R., Viterbo, L., Varajão, N., . . . Santo, A. (2015). Bundle approach to reduce bloodstream infections in neutropenic hematologic patients with a long-term central venous catheter. Acta Medica Portuguesa, 28, 474–479.
To use a bundle approach to reduce central line–associated bloodstream infections (CLABSI) in patients with hematologic malignancies and neutropenia with long-term central venous catheters (CVC)
Between 2010 and 2012, a bundle of interventions was introduced and outcomes were compared with the results from six months prior to the intervention. Interventions were the use of a different catheter (a neutral pressure mechanical valve connector versus a positive pressure mechanical valve connector), changing needless connectors twice weekly instead of weekly, and the replacement of a chlorhexidine solution to clean needless connectors rather than a solution with 70% alcohol. If blood cultures were obtained, patients were put on broad spectrum antibiotics. All patients were receiving prophylactic co-trimoxazole, itraconazole, and environmental neutropenic precautions.
Blood cultures were obtained for the presence of a fever for more than one hour or other signs of infection from peripheral veins and CVC lines.
With the intervention, a 71% reduction in both CLABSIs (risk ratio [RR] = 0.29, p < 0.014) and overall bloodstream infections (RR = 0.28, p < 0.001) occurred. The reduction of gram-positive bacteria was most pronounced.
The institutional protocol changes related to catheter selection and IV access system care were associated with a reduction in CLABSIs.
The changes implemented here were associated with the reduced incidence of CLABSIs within 72 hours. The authors suggested that changing from a positive pressure valve catheter to a neutral pressure type catheter may have been most relevant, as positive pressure valves tend to develop a biofilm and cannot be cleaned well with routine flushing.
Martin-Hirsch, P.P.L., and Bryant, A. (2013). Interventions for preventing blood loss during the treatment of cervical intraepithelial neoplasia. Cochrane Database of Systematic Reviews, 2013, CD001421.
STUDY PURPOSE: To assess safety and efficacy of interventions used to prevent blood loss during treatment of cervical intraepithelial neoplasia (CIN)
TYPE OF STUDY: Meta-analysis and systematic review
PHASE OF CARE: Active antitumor treatment
Vasopressin, TA, and vaginal packs with Monsel’s solution appear to be helpful in reducing blood loss in women with CIN undergoing surgical procedures. Findings are limited because few studies exist comparing specific interventions.
This review contains limited evidence; however, findings suggest that use of vasopressin, TA, and vaginal packs with Monsel’s solution may be helpful to reduce various types of procedure-related bleeding in women with CIN.
Martin, A.C., & Keats, M.R. (2014). The impact of yoga on quality of life and psychological distress in caregivers for patients with cancer. Oncology Nursing Forum, 41, 257–264.
To evaluate the effects of a six-week yoga intervention on caregivers’ overall quality of life and psychological distress
Caregivers participated in a particular type of yoga called vinyasa yoga (VY) for 150 minutes per week, which was conducted in two 75-minute sessions for six weeks. Each VY session included breathing exercises, meditation, poses, and a particular subtype of VY called savasana that promotes relaxation and relieves stress.
The overall attendance rate was 65%. Participants had a mean baseline distress score of 6.5 out of 10. A significant difference was seen in TMD scores from baseline to post-intervention (p = 0.002). Although no significant difference was seen in the physical component score of SF-36 from baseline to post-intervention, a significant difference was seen in the mental component scores of SF-36 from baseline to post-intervention (p = 0.018). The effect in the intended outcome for TMD scores and MCS was large.
Cancer caregivers may benefit mentally with reduction in psychological distress from VY.
VY seems to be a cost-effective approach to improve the quality of life and psychological distress in cancer caregivers. Nurses can encourage caregivers to participate in VY programs. RCTs with larger sample size are needed to find the true effect of yoga on cancer caregivers in terms of reducing psychological distress and improving quality of life.