Mak, S.S., Molassiotis, A., Wan, W.-M., Lee, I.Y.M., & Chan, E.S.J. (2000). The effects of hydrocolloid dressing and gentian violet on radiation-induced moist desquamation wound healing. Cancer Nursing, 23, 220–229.
To examine effectiveness of hydrocolloid dressing in the management of moist desquamation after radiation therapy is complete
Patients with moist desquamation were randomly assigned to one of two arms: hydrocolloid dressing (experimental group) or gentian violet (GV) (control group). Chemotherapy was used in stratifying patients for subgroup analysis.
The study took place at a hospital authority of Hong Kong.
The study used a randomized controlled trial design.
GV was more effective in healing of moist desquamation but hydrocolloid was more comforting and pleasing.
Majithia, N., Smith, T.J., Coyne, P.J., Abdi, S., Pachman, D.R., Lachance, D., . . . O’Neill, C. (2016). Scrambler therapy for the management of chronic pain. Supportive Care in Cancer, 24, 2807–2814.
STUDY PURPOSE: To evaluate what is known about mechanisms of scramble therapy and investigate preliminary evidence regarding efficacy
TYPE OF STUDY: General review/semi-systematic review
PHASE OF CARE: Not specified or not applicable
Most reports showed positive results for pain reduction for various pain syndromes. One double-blind, randomized trial showed no difference between controls and those receiving scrambler therapy for chemotherapy-related peripheral neuropathy.
Scramble therapy may have benefit for management of chronic pain and symptoms of peripheral neuropathy; however, current evidence is limited and weak.
Scrambler therapy, a neuromodulator approach to pain relief, may have some benefit in the management of chronic pain and peripheral neuropathy; however, current evidence is limited, and study designs have high risk of bias. Given the promising findings with scrambler therapy, additional well-designed research is warranted.
Maiya, G., Sagar, M., & Fernandes, D. (2006). Effect of low level helium-neon (He-Ne) laser therapy in the prevention and treatment of radiation induced mucositis in head and neck cancer patients. Indian Journal of Medical Research, 124(4), 399–402.
He-Ne wavelength 632.8 nm and output of 10 mW was administered for three minutes five days a week until completion of radiation.
Control group received oral analgesics, anesthetics, 0.9% saline, and ovidine wash.
Physician was blinded to the type of treatment.
Patients with cancer of the oral cavity stages 2–4 receiving radiation 66 Gy in 33 fractions over six weeks
Computer randomization; 25 patients receiving laser treatment, 25 patients in the control group
Mean age of study group was 54 years (+/– 1 year); mean age of the control group was 53 years (+/–1 year).
Ratio of men to women was 2:1.
WHO mucosiis
VAS for pain
Recorded weekly
At the end of week 6 of RT, pain rank in the study group significantly decreased (p < 0.001) as compared to the control group (13 versus 38).
Mean pain score in the study group was 2.6 (+/– 0.64); the control group score was 6.68 (+/– 1.44) (p < 0.001).
At the end of radiation, mucositis grade in the study group was 1.72 (+/– 0.67); the grade was 3.32 (+/–0.09) in the control group (p < 0.001).
18 patients in the study group had grade 1, and 7 had grade 2 mucositis;
14 patients in the control group had grade 3, and 11 had grade 4.
Small sample size, but findings were significant at the end of radiation.
Did not report data during treatment
Maiti, P.K., Ray, A., Mitra, T.N., Jana, U., Bhattacharya, J., & Ganguly, S. (2012). The effect of honey on mucositis induced by chemoradiation in head and neck cancer. Journal of the Indian Medical Association, 110, 453–456.
To evaluate the use of natural honey for treatment of radiation mucositis
Patients were randomly assigned to the honey treatment or control group. Patients in the intervention group were instructed to take 20 ml of honey 15 minutes before radiation therapy, 15 minutes after radiation therapy, and at bedtime. On days when they had no radiation treatment, they were to take the same amount of honey 3 times per day. Patients were evaluated at baseline, weekly during treatment, and at 3 and 6 weeks after completion of radiation therapy.
The study was conducted at a single outpatient site in India.
Patients were undergoing the active antitumor treatment phase of care.
This was a randomized controlled trial.
The authors reported that honey delayed the onset of severe mucositis in about 80% of the intervention group, while 63% of the control group developed severe mucositis. Grade 3 mucositis developed in 11 patients in the control group and 5 patients in the study group. No statistical analysis was done.
This study suggests that honey may help to delay the onset of mucositis in patients with head and neck cancer during radiation therapy; however, multiple limitations in this report make it impossible to draw firm conclusions.
Findings as reported from this study are inconclusive regarding any effect of honey on the development of mucositis.
Maione, L., Vinci, V., Caviggioli, F., Klinger, F., Banzatti, B., Catania, B., . . . Klinger, M. (2014). Autologous fat graft in postmastectomy pain syndrome following breast conservative surgery and radiotherapy. Aesthetic Plastic Surgery, 38, 528–532.
To evaluate the effectiveness of autologous fat grafting to control pain in patients with persistent postmastectomy pain syndrome (PMPS)
Patients who received lumpectomies and radiation therapy and had severe scar retraction, radiodystrophy, and chronic pain met the definition of PMPS and were considered for the study. Patients who had fat grafting underwent liposuction of the subumbilical area, and the obtained fat was processed and purified. The fat was then injected into the scar area. Study data were obtained at baseline and at one year after the procedure. Patients who had the fat graft procedure were compared to patients who did not receive the procedure.
Prospective trial
Among those who had the fat graft procedure, there was a mean reduction of 3.1 points for pain compared to a mean reduction of 0.9 points in the comparison group (p ≤ 0.005).
Autologous fat grafting may have reduced PMPS.
Persistent pain as a consequence of surgical treatment for breast cancer is a clinical problem for which the general treatment is pain medication. Nurses need to be aware of this syndrome and educate patients about alternative approaches that may be available for management. Additional well-designed research regarding the efficacy of fat grafting for this population is needed.
Maiche, A.G., Grohn, P., & Maki-Hokkonen, H. (1991). Effect of chamomile cream and almond ointment on acute radiation skin reaction. Acta Oncologica (Stockholm, Sweden), 30(3), 395–396.
To evaluate the tolerability and activity of Kamillosan (chamomile cream) as compared to almond ointment in patients receiving radiation therapy
Patients were assigned to use one product above and the other product below their scar. The physician who evaluated the skin was blinded to which product was used on which side of the scar. The skin product was applied twice a day with the first 30 minutes before external beam radiation therapy and again at bed time. Reactions were noted after every 10 Gy and at two weeks and three months following completion.
The study took place at Helsinki University Central Hospital in Helsinki, Finland.
The study used a quasi-experimental single-blinded design. Patients were used as their own controls
Adverse skin effects were graded on a four-point rating scale, with 0 being no change, 1 light erythema, 2 dark erythema, and 3 moist desquamation. Subjective evaluation was also performed, including symptoms such as pain and itching.
Skin changes seemed to appear later in the Kamillosan group; however, a higher proportion of the Kamillosan group developed grade 3 reactions. Overall, differences between groups were not significant. The subjective symptoms, such as itching and pain, were equally uncommon in the two groups. Most patients preferred Kamillosan because of convenience and hygienic preference.
Neither of the two agents prevented a skin reaction and every patient developed grade 1 erythema.
Maiche, A., Isokangas, O.P., & Gröhn, P. (1994). Skin protection by sucralfate cream during electron beam therapy. Acta Oncologica, 33, 201–203.
To compare the efficacy of sucralfate cream to a control base cream in women receiving postoperative electron beam therapy to their chest wall
Patients were randomized to apply sucralfate containing 7% micronized sucrose sulfate or equivalent base cream on either side of the scar.
N = 44
AGE RANGE = 33–84 years
MEAN AGE = 60 years
FEMALES: 100%
KEY DISEASE CHARACTERISTICS: Breast cancer of the chest wall
OTHER KEY SAMPLE CHARACTERISTICS: 6 MeV electron beam total dose 50 Gy—10 Gy weekly in five fractions. Surface area varied from 11 cm × 11cm–20 cm × 20 cm. The scar was situated horizontally in the middle of the portal image.
Grade 1 and 2 reactions appeared later on the areas treated with sucralfate cream. Grade 2 reactions in the entire sample were observed more often at four weeks (p = 0.01) and at five weeks (p > 0.01 but < 0.05). Recovery time of radiation-induced reactions was faster and, after finishing radiation therapy, the grade of skin reaction remained lower with the sucralfate cream than the base cream (p = 0.05).
Sucralfate may be of benefit in reducing severity of radiation dermatitis.
Mahigir, F., Khanehkeshi, A., & Karimi, A. (2012). Psychological treatment for pain among cancer patients by rational-emotive behavior therapy—efficacy in both India and Iran. Asian Pacific Journal of Cancer Prevention, 13, 4561–4565.
To find out the influence of rational emotive behavior therapy (REBT) on pain intensity among patients with cancer in India and Iran
The intervention included eight two-hour sessions of REBT characterized as cognitive techniques, imagery techniques, and behavioral techniques. The intervention was given to the experimental group for 45 days (10 sessions), and at the end of the intervention, pain of patients was evaluated again. Empathy, warmth, respect, relationship building, and family dynamics were covered in the first session; personal experience assessment was covered in the second session; counseling and REBT approach were covered in the third session; REBT was covered in the fourth through seventh sessions; and coping with stress was covered in the final session. Workbooks, worksheets, and practice exercises were included in the program. What the intervention actually entailed is not clear.
Because of errors in the tables, interpreting the findings is difficult. Data in the table are transposed from the information included in the narrative text; this makes interpretation of the information uncertain. The overall reliability of the data is in question.
The authors have asserted that an intervention resulted in reduction in pain perception, as measured by the McGill Pain Questionnaire, in an experimental group receiving REBT when compared with a control group. However, discrepancies in the article make interpretation difficult.
Nurses are well aware that psychoeducational interventions can affect pain control. This study aims to support that contention. This study does not provide additional strong support in this area because of multiple study limitations.
Maher, J., Refshauge, K., Ward, L., Paterson, R., & Kilbreath, S. (2012). Change in extracellular fluid and arm volumes as a consequence of a single session of lymphatic massage followed by rest with or without compression. Supportive Care in Cancer, 20, 3079–3086.
To evaluate the effects of massage and compression in women with and without arm lymphedema secondary to breast cancer
Women with clinically diagnosed lymphedema secondary to breast cancer and a convenience sample of women without breast cancer or lymphedema were recruited. Women who wore a compression garment removed it two hours before measurement and massage. Measurements were taken prior to, mid way through, and at the completion of massage. Women received a therapeutic massage for one hour using the Foldi method of lymphatic drainage provided by a single trained therapist.
This was a single-site study conducted in the outpatient setting in Australia.
The study used a pre/post design.
Perometry and bioimpedance techniques were used.
No statistically or clinically significant effect was found between the use of massage and limb volume with either study group.
A single session of lymphatic massage did not reduce lymphedema.
The sample size was small, with fewer than 30 participants.
Findings suggest that a single session of lymphatic massage does not have any effect on arm volume in women with or without lymphedema.
Mahendran, R., Lim, H.A., Tan, J.Y.S., Hui, Y.N., Chua, J., Siew, E.L., . . . Kua, E.H. (2017). Evaluation of a brief pilot psychoeducational support group intervention for family caregivers of cancer patients: A quasi-experimental mixed-methods study. Health and Quality of Life Outcomes, 15, 1–8.
To evaluate the effects of a psychoeducational program (COPE) on caregivers of patients with cancer
The COPE (Caregivers of Cancer Outpatients' Psycho-Education Support Group Therapy) intervention was provided to caregivers during four weeks. The program included didactic content and supportive interventions in group sessions. Study measures were obtained before and after the intervention. A subgroup was invited to participate in semistructured interviews. Caregivers were placed in one of two groups, one of which was wait-listed and used as a control in the analysis.
PHASE OF CARE: Multiple phases of care
Nonrandomized, prospective, parallel group
No significant differences existed between study groups in postintervention caregiver quality of life overall or burden subscale scores. Those in the wait-list control group had much better quality of life scores at baseline.
The intervention studied here did not demonstrate an effect on caregiver burden or quality of life.
The specific psychoeducational program examined here did not demonstrate an effect on caregivers. Several limitations existed.