Chiu, H.Y., Huang, H.C., Chen, P.Y., Hou, W.H., & Tsai, P.S. (2015). Walking improves sleep in individuals with cancer: A meta-analysis of randomized, controlled trials. Oncology Nursing Forum, 42, E54–E62.
PHASE OF CARE: Multiple phases of care
Overall, the effect size for walking on sleep disturbance was -0.52 (Hedges' g: 95%; CI -0.79, -0.25). There was significant overall heterogeneity among the studies. Multiple subgroup analyses were conducted to explore factors that may contribute to the heterogeneity. The effect size was not associated with age, gender, the duration of the intervention, or adherence rate. An analysis demonstrated no evidence of publication bias. Studies were done before, during, or after treatment for cancer, and the overall effect sizes did not differ according to the timing of the intervention. All studies used walking of moderate intensity, and most studies were done in women with breast cancer. Some studies included additional exercise interventions such as strength training, and some also included psychoeducational interventions.
Walking exercise appears to improve sleep in patients with cancer.
There was a relatively small number of studies included with high heterogeneity. Twelve studies were excluded because they did not report sufficient data to compute an effect size or they did not use a self-reported sleep outcome. These excluded studies, which have been summarized in other PEP® summaries, did not demonstrate the effectiveness of exercise. This suggests that effectiveness may be overestimated in this analysis.
This analysis provides some support for moderate intensity walking exercise to improve sleep. The findings need to be viewed with caution because of the high heterogeneity of the studies and the contrary findings that were excluded from this analysis. However, walking is a safe activity for patients, and it can be suggested to patients as an approach that may improve sleep. It also could be incorporated into multicomponent approaches to address sleep-wake disturbances.
Chiu, H.Y., Hsieh, Y.J., & Tsai, P.S. (2016). Systematic review and meta-analysis of acupuncture to reduce cancer-related pain. European Journal of Cancer Care. Advance online publication.
STUDY PURPOSE: To evaluate the effects of acupuncture in reducing cancer-related pain associated with treatment types
TYPE OF STUDY: Meta-analysis and systematic review
PHASE OF CARE: Multiple phases of care
APPLICATIONS: Palliative care
Eleven trials focused on radiation-induced pain, and five focused on surgery-induced pain. The majority of trials (17) focused on general cancer-related pain. Overall analysis showed that acupuncture reduced cancer-related pain with a small effect size (-0.45, 95% CI [-0.63, -0.26]). There was high and significant heterogeneity. In the 17 trials regarding cancer-related pain, the weighted mean effect size was -0.71 (95% CI [-0.94, -0.48]), without significant heterogeneity. Among trials examining radiation-related pain, no effect was found. For surgical-related pain, mean effect size for five randomized, controlled trials was -0.4 (95% CI [-0.69, -0.1]) with high heterogeneity. For patients receiving hormonal therapy, no significant effect was seen.
Acupuncture may be helpful in reducing chronic cancer pain and pain associated with surgical procedures.
Evidence regarding efficacy of acupuncture for pain is limited; however, findings from this meta-analysis suggest that it may be helpful for chronic and acute pain in patients with cancer. Effect sizes were small.
Chitapanarux, I., Chitapanarux, T., Traisathit, P., Kudumpee, S., Tharavichitkul, E., & Lorvidhaya, V. (2010). Randomized controlled trial of live lactobacillus acidophilus plus bifidobacterium bifidum in prophylaxis of diarrhea during radiotherapy in cervical cancer patients. Radiation Oncology, 5, 31.
To determine if the combination of Lactobacillus acidophilus plus Bifidobacterium bifidum is effective in preventing diarrhea in patients with locally advanced cervical cancer receiving radiation therapy
Patients were randomized to receive either L. acidophilus plus Bifidobacterium bifidum or placebo capsules. Beginning 7 days before and continuing throughout the entire time of receiving radiotherapy, participants took 2 capsules, 2 times each day before breakfast and dinner. Patients needing antidiarrheal medication were given loperamide (2 mg).
The study was conducted in Thailand.
All patients were undergoing the active treatment phase of care.
This was a prospective, randomized, double-blind, placebo-controlled study.
The National Cancer Institute Common Toxicity Criteria, version 2, was used.
The prophylactic use of the combination of live L. acidophilus plus Bifidobacterium bifidum was shown to be effective in decreasing the severity of diarrhea.
The prophylactic use of L. acidophilus plus Bifidobacterium bifidum may decrease the severity of diarrhea, improve stool consistency, and reduce the need for antidiarrheal medication in patients with locally advanced cervical cancer undergoing pelvic radiation with concomitant weekly cisplatin. Further studies need to be done with larger samples.
Chipperfield, K., Brooker, J., Fletcher, J., & Burney, S. (2013). The impact of physical activity on psychosocial outcomes in men receiving androgen deprivation therapy for prostate cancer: A systematic review. Health Psychology.
To evaluate the effectiveness of physical activity on depression and anxiety symptoms, cognitive function, and quality of life in patients receiving androgen deprivation therapy (ADT) for prostate cancer
TYPE OF STUDY: Systematic review
DATABASES USED: MEDLINE, PsycINFO, EMBASE, Informit, Scopus, Cochrane Library, CINAHL
KEYWORDS: Prostate neoplasm, prostate cancer, prostate carcinoma, prostate adenocarcinoma, androgen deprivation therapy, androgen ablation, androgen suppression, hormone therapy, androgen antagonist, androgen agonist, gonadotropin, luteinizing hormone-releasing hormone, antiandrogen, orchidectomy, surgical castration, chemical castration, physical activity, physical exercise, exercise, sport therapy, sport, endurance, aerobic training, resistance training, cardiac training, aerobic activity, resistance activity, and motor activity
INCLUSION CRITERIA: Physical activity interventions, exercise interventions, and supervised and nonsupervised interventions. Participants who were patients with prostate cancer receiving ADT only (or separate results according to cancer and treatment type). All study designs. Pilot studies (no sample size limitations). Published in English.
EXCLUSION CRITERIA: Studies with the additional interventions of psychotherapy or nutritional consultation. Studies about physical activity behavior or motivation. Studies involving outcomes other than depression, anxiety, quality of life, or cognitive function. Studies involving the impact of physical activity on patients with prostate cancer undergoing forms of treatment other than ADT.
TOTAL REFERENCES RETRIEVED: N = 867
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Reviewed studies for inclusion and exclusion criteria. No appraisal or scoring system used.
PHASE OF CARE: Multiple phases of care
Existing data suggest that physical activity improved quality of life. The existing evidence, however, is not sufficiently robust to determine the adequacy of physical activity as an intervention to improve depression, anxiety, and cognitive function outcomes. One study examined impact on depression and found no significant effect.
Preliminary findings support physical activity to improve quality of life in men receiving ADT for prostate cancer.
Evidence suggests that clinical exercise in the form of resistance and combined aerobic and resistance training programs may be important for the health status and rehabilitation of patients with prostate cancer.
Chih, M.Y., DuBenske, L.L., Hawkins, R.P., Brown, R.L., Dinauer, S.K., Cleary, J.F., & Gustafson, D.H. (2013). Communicating advanced cancer patients' symptoms via the Internet: A pooled analysis of two randomized trials examining caregiver preparedness, physical burden, and negative mood. Palliative Medicine, 27, 533–543.
To examine the effects of an online symptom reporting system on caregiver negative mood, preparedness, and perceptions of physical burden
Following recruitment, patients were randomized to either the Comprehensive Health Enhancement Support System (CHESS) only intervention or CHESS plus clinician report (CR). The CHESS only group of patient-caregiver dyads accessed the CHESS website for coaching, information, and communication resources for advanced-stage cancer care. At baseline and weekly, dyads “checked in” to CHESS to report needs and symptoms informed by the Edmonton Symptom Assessment System (ESAS) and Eastern Cooperative Oncology Group Performance Status. “Checking in” allowed symptom tracking to evaluate patient improvement or decline. Caregivers also reported preparedness and caregiving burden and could pose questions for future clinical visits. The CHESS plus CR group would access the CHESS website as well as have access to the ePRO system (CR) that delivered dyadic tracking information and alerts to clinicians when the patient or caregiver met certain criteria of concern. The ePRO system would support clinicians’ timely response to improve caregiver management of patient symptoms and lessen burden. Intervention technical support was provided to both groups. CHESS intervention access varied from 12–24 months based on patient diagnosis, and caregivers sequentially were assessed following the intervention.
Caregivers in the CHESS plus CR group reported more positive moods than those in the CHESS alone group at 6 months (p = 0.009) and 12 months (p = 0.004). However, the two groups did not differ significantly on caregiver preparedness or physical burden at 6- and 12-month assessment.
Online delivery of information, communication, and coaching resources, combined with a format that supports patient and caregiver reporting of symptoms to facilitate clinician-caregiver timely communication, has the potential to improve caregiver mood and minimize distress of patients with advanced-stage cancer.
Advances in technology offer opportunities for oncology clinicians to partner with patients and their caregivers to promote patient and caregiver health during the cancer trajectory. Issues such as clinician heavy workload and continued clinical focus on patient needs challenge oncology clinicians in redefining workplace approaches to improve outcomes for patients and their caregivers.
Chien, C.H., Liu, K.L., Chien, H.T., & Liu, H.E. (2013). The effects of psychosocial strategies on anxiety and depression of patients diagnosed with prostate cancer: A systematic review. International Journal of Nursing Studies.
To evaluate, by means of meta-analysis and systematic review, evidence regarding the effectiveness of psychosocial interventions for anxiety and depression in patients with prostate cancer
Databases searched were PubMed, CINAHL, PsycINFO, Cochrane Collaboration, and two Chinese databases.
A study was included in the review if it
A study was excluded if it focused on disease other than prostate cancer and lacked intergroup comparison.
Patients were undergoing multiple phases of care.
Findings suggest that psychosocial interventions can be helpful in reducing anxiety and depression, at various time points in the cancer trajectory, for men who are newly diagnosed with prostate cancer. Positive effects were generally short-term only.
Findings of this analysis suggest that various types of psychosocial interventions can help reduce anxiety and depression in men with prostate cancer. Effects shown tended to be short-lived. Nurses can help reduce anxiety and depression among patients with prostate cancer by using psychosocial types of strategies. Information about ways to sustain this effect is limited, and the analysis does not identify the types of approaches that are the most helpful. Further exploration of longer-term sustainable effects and associated dosage and intervention frequency is needed. Given the relatively low level of quality of research in this area, more well-designed studies are needed.
Chiarioni, G., Whitehead, W.E., Pezza, V., Morelli, A., & Bassotti, G. (2006). Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia. Gastroenterology, 130, 657–664.
To assess long-term (24-month) efficacy of biofeedback versus laxatives and bowel education.
Biofeedback training was provided in five 30-minute classes over five weeks. Similarly, laxative plus bowel education was provided in five 30-minute bowel training classes over five weeks. Those patients also took 14.6 to 22.9 g/kg of polyethylene glycol for the first six months; after six months, patients took the dose BID.
Tertiary gastroenterology clinic in Verona, Italy
This was a randomized, controlled trial.
Biofeedback should be the treatment of choice for PFD-induced constipation.
Chiarioni, G., Salandini, L., & Whitehead, W.E. (2005). Biofeedback benefits only patients with outlet dysfunction, not patients with isolated slow transit constipation. Gastroenterology, 129, 86–97.
To compare the efficacy of biofeedback in pelvic function dyssynergia–induced constipation (PFD) versus slow transit constipation (STC).
All subjects received five weekly biofeedback lessons and were assessed at 1, 6, 12, and 24 months.
Gastroenterology Clinic of the Division of Gastrointestinal Rehabilitation of the University of Verona in Valeggio sul Mincio, Italy
This was a quasi-experimental study.
At six months, greater improvements were seen in patients with PFD compared to those with STC: 71% versus 8% reported improved satisfaction (p = 0.001), and 76% versus 8% reported three or more bowel movements per week (p ≤ 0.001).
Patients with PFD received greater benefit from biofeedback than those with STC.
Chi, K.H., Chiou, T.J., Li, C.P., Chen, S.Y., & Chao, Y. (2014). MS-20, A chemotherapeutical adjuvant, reduces chemo-associated fatigue and appetite loss in cancer patients. Nutrition and Cancer, 66, 1211–1219.
To examine the effects of MS-20, a fermented soybean extract, on quality of life, fatigue, and appetite for patients with cancer receiving chemotherapy (Immunologic and antioxidant profiles were also examined.)
MS 20 was taken orally on an empty stomach at a dose of 5 mL in the morning and 3 mL in the afternoon diluted in 100 mL of warm water. Patients were randomly assigned to receive MS 20 during either the first or second chemotherapy cycle after a one to two-week washout period. The study duration was eight weeks. Patients were evaluated at weekly office visits.
Randomized, unblended, crossover trial
Physical functioning scores were significantly better during treatment with MS 20 (p = .023). VAS scores for fatigue and appetite loss improved significantly while taking MS 20 (p < .001); however, fatigue and appetite loss scales on the EORTC questionnaire showed no significant difference between study conditions. There were no measurable effects on immunological parameters examined in the study.
Findings were mixed regarding the effect of MS 20 on fatigue and appetite loss.
This study provides some mixed findings regarding the effect of MS 20, a fermented soybean extract, on fatigue and anorexia in patients during chemotherapy.
Chew, C., Ritchie, M., O'Dwyer, P. J., & Edwards, R. (2011). A prospective study of percutaneous vertebroplasty in patients with myeloma and spinal metastases. Clinical Radiology, 66, 1193–1196.
To assess the outcome and complication rate of percutaneous vertebroplasty in a large cohort of consecutive patients with myeloma and spinal metastasis treated over a nine-year period
Patients with cancer who were experiencing intractable pain from metastasis and vertebral collapse and were unresponsive to oral analgesia underwent percutaneous vertebroplasty. Pain and function were measured prior to and six weeks after the procedure.
This was a single-site study conducted in the United Kingdom.
This was a prospective, intervention trial.
Vertebroplasty can be considered as a possible option for patients with myeloma or spinal metastasis to help with intractable pain and physical disability.