Badger, T.A., Segrin, C., Figueredo, A.J., Harrington, J., Sheppard, K., Passalacqua, S., . . . Bishop, M. (2011). Psychosocial interventions to improve quality of life in prostate cancer survivors and their intimate or family partners. Quality of Life Research, 20, 833–844.
To test the effectiveness of two telephone-delivered psychosocial interventions for maintaining and improving quality of life
The first intervention was by-telephone interpersonal counseling (TIP-C) delivered weekly for eight weeks to prostate cancer survivors and every other week for eight weeks to partners. The second intervention involved eight weekly health education attention condition (HEAC) sessions delivered by telephone.
Repeated-measures experimental design
Improvements in depression, negative affect, stress, fatigue, and spiritual well-being were significantly greater for survivors receiving the HEAC intervention than for those receiving the TIP-C intervention.Compared to partners in the TIP-C intervention, partners in the HEAC group showed significantly greater improvements in depression, fatigue, perceived social support from family members, social well-being, and spiritual well-being.
Both interventions in this study were effective in improving multiple dimensions of quality of life for men with prostate cancer and their partners.
Both interventions were effective, but additional research is needed. Health education may be just as effective or more effective in helping patients and caregivers than individualized counseling.
Badger, T. A., Segrin, C., Figueredo, A. J., Harrington, J., Sheppard, K., Passalacqua, S., . . . Bishop, M. (2011). Psychosocial interventions to improve quality of life in prostate cancer survivors and their intimate or family partners. Quality of Life Research, 20, 833–844.
To test the effectiveness of two telephone-delivered psychosocial interventions for maintaining and improving quality of life (QOL).
The first intervention was a telephone interpersonal counseling (TIP-C) intervention delivered weekly for eight weeks to prostate cancer survivors and every other week, for four times, to partners. The second intervention included eight weekly health education attention conditions (HEACs) delivered by telephone.
The study used a repeated measures experimental design.
Improvements in depression, negative affect, stress, fatigue, and spiritual well-being were significantly higher for survivors in the HEAC intervention than in the TIP-C intervention. Partners in the HEAC intervention showed significantly greater improvements in depression, fatigue, social support from family members, social well-being, and spiritual well-being compared to partners in the TIP-C intervention.
Both interventions were effective in improving multiple dimensions of QOL for men with prostate cancer and their partners.
The study had a small sample size, with less than 100 participants.
Both interventions were effective, but further research is needed.
Badger, T., Segrin, C., Dorros, S.M., Meek, P., & Lopez, A.M. (2007). Depression and anxiety in women with breast cancer and their partners. Nursing Research, 56, 44–53.
This intervention provided telephone-delivered psychosocial interventions.
One group received six weeks of telephone-delivered counseling (TIP-C) sessions based on interpersonal psychotherapy/counseling principles, covering the following topics.
These phone calls averaged 34 minutes.
A second group received six weeks of telephone-delivered, self-managed exercise protocol information. The exercise protocol consisted of engaging in regular, low-impact exercise (e.g., walking for a prescribed number of minutes at least four times per week). These phone calls averaged 11 minutes.
A third group received six weeks of attention control (AC) printed information about breast cancer with brief weekly phone calls averaging seven minutes. This group did not receive counseling or encouragement to exercise.
Data were collected at baseline (T1), one week after the final call (T2), and one month after the final call (T3).
The study used an experimental design: three-wave repeated measures with a between-subjects factor (treatment group).
Both telephone counseling and exercise conditions helped to significantly reduce anxiety in women and their partners (p < 0.001). The AC group did not evidence the same improvement in decreased anxiety, and their partners’ anxiety scores increased. The authors reported mixed-model ANOVA significant effect for time (p = 0.001), no significant main effect for treatment group, and significant group x time interaction (p = 0.01).
The intervention required special training needs of a psychiatric nurse counselor with oncology expertise to deliver the telephone counseling sessions. These 34-minute (on average) phone calls per weekly session (x 2—one per patient and one per partner) required more than one hour per week per couple of time to deliver the intervention.
Badger, T., Segrin, C., Dorros, S.M., Meek, P., & Lopez, A.M. (2007). Depression and anxiety in women with breast cancer and their partners. Nursing Research, 56, 44–53.
This intervention provided telephone-delivered psychosocial interventions. One group received six weeks of telephone-delivered counseling (TIP-C) sessions based on interpersonal psychotherapy/counseling principles, covering the following topics.
The phone calls averaged 34 minutes. Another group received six weeks of telephone-delivered, self-managed exercise protocol information. The exercise protocol consisted of engaging in regular, low-impact exercise (e.g., walking for a prescribed number of minutes at least four times per week). These phone calls averaged 11 minutes. The third group received six weeks of attention control (AC) printed information about breast cancer with brief weekly phone calls averaging 7 minutes. This group did not receive counseling or encouragement to exercise.
A convenience sample was used.
Data were collected at baseline (T1), one week after final call (T2), and one month after final call (T3).
The study used a three-wave repeated measures design with a between-subjects factor (treatment group).
Results showed mixed-model ANOVA significant effect for time (p = 0.001), no significant main effect for treatment group, and significant group x time interaction (p = 0.01).
Both telephone counseling and exercise conditions helped to reduce anxiety in women and their partners, with significant differences (p < 0.001). The AC group did not evidence the same improvement in decreased anxiety, and their partners’ anxiety scores increased.
Baden, L.R., Swaminathan, S., Angarone, M., Blouin, G., Camins, B.C., Casper, C., . . . Smith, C. (2016). Prevention and treatment of cancer-related infections, version 2.2016. Journal of the National Comprehensive Cancer Network, 14, 882–913. Retrieved from http://www.jnccn.org/content/14/7/882.full.pdf
RESOURCE TYPE: Evidence-based guideline
PHASE OF CARE: Active antitumor treatment
An initial search resulted in 1,162 citations, which were delimited to 277 references that contributed to these guidelines. High-level evidence findings were included as well as a review of lower-level evidence by panel members in areas where high-level evidence was lacking.
Algorithms were established for the use of antifungal and antiviral therapies and the use of vaccinations, specifically therapeutic drug monitoring of azoles; enhanced recommendations for HBV, HCV, and HIV; and vaccination utilization (outlined by disease/therapies and level of risk, p. 884–890). Overall, infection control should include prophylactic anti-infective therapies, per protocol per case, as well as ensure standards of care (e.g., hand hygiene). Considerations for susceptibility and resistance are paramount.
Assessment of patient diagnosis, treatment, and preexisting comorbidities (e.g., HSV, HIV, CMV) can guide proper prophylactic anti-infective agents and vaccines. Together with following standards of practice (e.g., hand hygiene), nurses can optimize infection control.
Badar, T., Cortes, J., Borthakur, G., O'Brien, S., Wierda, W., Garcia-Manero, G., . . . Mattiuzzi, G. (2015). Phase II, open label, randomized comparative trial of ondansetron alone versus the combination of ondansetron and aprepitant for the prevention of nausea and vomiting in patients with hematologic malignancies receiving regimens containing high-dose cytarabine. BioMed Research International, 2015, 497597.
To compare the effectiveness of antiemetic regimens including ondansetron with and without aprepitant to prevent chemotherpy-induced nausea and vomiting (CINV)
Patients were randomized to receive (a) an antiemetic regimen consisting of ondansetron 8 mg IV 30 minutes before chemotherapy followed by 24 mg IV in a continuous infusion daily till 6–12 hours after the last dose of chemotherapy or (b) the same ondansetron regimen with the addition of oral aprepitant 125 mg 6–12 hours before chemotherapy and 80 mg daily till one day after the last dose of chemotherapy. Data were collected for six days following chemotherapy administration.
Randomized, controlled trial
There were no statistically significant differences in the prevention of CINV or use of rescue medications between the two arms.
There was no difference in CINV prevention between antiemetic regimens of ondansetron with or without aprepitant.
There was no significant difference between antiemetic regimens of ondansetron with or without aprepitant in the prevention of CINV. There may not be a benefit to adding aprepitant to standard antiemetic therapy in this population of patients.
Badalamenti, G., Incorvaia, L., Provenzano, S., Bronte, G., Leto, G., Fulfaro, F., & Maltese, G. (2013). Lenograstim in preventing chemotherapy-induced febrile neutropenia in patients with soft tissue sarcoma. Anticancer Research, 33, 679–684.
The purpose of the study was to evaluate incidence of febrile neutropenia and grade 4 neutropenia after receiving lenograstim prophylaxis.
All patients received G-CSF prophylaxis with 263 mcg from days 5–9 in patients receiving three cycles of epirubicin and ifosamide for soft tissue sarcoma. Patients were observed for three cycles. Blood counts were done on days 8,15, and 22.
Active antitumor treatment
Observational
There were no episodes of febrile neutropenia. Grade 4 neutropenia was seen in 17% of patients—58% on day 8, 29% on day 15, and 13% on day 22. No treatment delays or dose reductions were required.
G-CSF as given here was effective in preventing the risk of febrile neutropenia and grade 4 neutropenia in patients receiving chemotherapy associated with high risk for these adverse events.
Prophylactic G-CSF reduced risk of febrile neutropenia and grade 4 neutropenia in patients at risk for these problems during chemotherapy for soft tissue sarcoma. The most appropriate timing of prophylactic colony-stimulating factor is not clear. The timing studied here appeared to be effective.
Bach, H.V., Kim, J., Myung, S.K., & Cho, Y.A. (2016). Efficacy of ginseng supplements on fatigue and physical performance: A meta-analysis. Journal of Korean Medical Science, 31, 1879–1886.
STUDY PURPOSE: To investigate the effectiveness of ginseng supplements for reduction of fatigue and enhancement of physical performance
TYPE OF STUDY: Meta-analysis and systematic review
PHASE OF CARE: Not specified or not applicable
Ginseng supplements were associated with an overall standard mean difference of 0.34 (95% confidence interval [0.16, 0.52]) for fatigue reduction; however, duration of use was only six weeks or less, and doses of less than 1000 mg/day showed no effect. No effect was seen for physical performance.
Ginseng may be helpful for fatigue reduction; however, this analysis included few studies and only one study on individuals with cancer. This analysis provides insufficient evidence to draw firm conclusions.
Limited evidence exists to show the efficacy of ginseng supplements overall for fatigue reduction, and evidence here does not show any improvement in physical performance with ginseng.
Bacelar Arruda, M.A., Garcia, M.A., and Santos Garcia, J.B. (2016). Evaluation of the effects of music and poetry in oncologic pain relief: A randomized clinical trial. Journal of Palliative Medicine, 19, 943–948.
To evaluate the effects of listening to music and poetry on pain, depression, and hope
Patients were randomly selected for inclusion and then randomly assigned to listen to instrumental music or poetry readings on a MP3 players or to a control group. Therapies were offered for three days and for 30 minutes at a time. Study measurements were obtained before and after the intervention on day 1 and again on the last day. Listening was monitored. The daily variations in pain of the music and poetry group were compared to those of the control group.
Randomized, parallel-group, prospective trial
Listening to music was associated with improvement in pain (p < 0.001) and depression (p = 0.004). Listening to poetry was associated with improvement in pain (p < 0.001), depression (p = 0.001), and hope (p = 0.009). Individuals with either intervention had improvement in pain compared to the controls (p < 0.001), but no difference was observed in other outcomes.
Listening to music or poetry reading may help in the management of pain and depressive symptoms.
Listening to music or poetry may be beneficial to patients in the management of pain and dealing with depressive symptoms. Flaws in this study limit the strength of these findings; however, these are low-risk and low-cost interventions that might be beneficial. The type of music and poetry would likely affect the results for various patients.
Babu, G., Saldanha, S.C., Kuntegowdanahalli Chinnagiriyappa, L., Jacob, L.A., Mallekavu, S.B., Dasappa, L., . . . Arroju, V. (2016). The efficacy, safety, and cost benefit of olanzapine versus aprepitant in highly emetogenic chemotherapy: A pilot study from South India. Chemotherapy Research and Practice, 2016, 3439707.
To compare the efficacy, safety, and cost of olanzapine-based triplet antiemetics compared to the use of aprepitant as part of antiemetics in chemotherapy-naïve patients receiving highly emetogenic chemotherapy
The olanzapine group received 10 mg olanzapine orally (PO), 0.25 mg palonosetron intravenously (IV), and 20 mg dexamethasone IV on day 1; and then 5 mg olanzapine PO and 4 mg dexamethasone PO on days 2–4. The aprepitant group was given 125 mg aprepitant PO, 0.25 mg palonosetron IV, and 12 mg dexamethasone IV on day 1; 80 mg aprepitant PO on days 2 and 3; and 4 mg dexamethasone PO on days 2–4. Patients were asked to record the intensity of nausea, the use of rescue medication, and vomiting daily in a diary. Patients were contacted daily for reminders to record symptoms.
PHASE OF CARE: Active antitumor treatment
No significant differences existed between groups in complete response rates or nausea severity. No grade 3 or 4 toxicities existed. Adverse events associated with olanzapine were sedation and dizziness in less than 10% of patients.
Olanzapine-based triplet antiemetic therapy was as effective as aprepitant-based triplet antiemetics in this study.
Findings suggest that the use of olanzapine in substitution for an NK1 in a triplet antiemetic regimen was effective. The study is limited by its lack of random assignment to study groups, but the groups were well matched on most demographic and other treatment variables. Olanzapine is much less expensive than an NK1 and may be a good alternative for patients who have limited financial resources or insurance coverage for antiemetics.