Prophylactic Platelet Transfusions
Prophylactic platelet transfusion involves transfusion prior to thrombocytopenia levels generally requiring therapeutic platelet transfusion. Use of trigger levels for platelet transfusion, different dosage, and varied intervals between transfusions have been studied in patients with cancer for prevention of bleeding.
Prophylactic Octreotide
Octreotide is a medication that has physiologic effects that inhibit glucagon, insulin, splanchnic blood flow, and vasoactive peptides in the gastrointestinal tract. It has been used for treatment of watery diarrhea from tumors that secrete vasoactive intestinal peptides. Octreotide has been studied for management of chemotherapy- and radiation therapy-induced diarrhea. Octreotide is given by IV or subcutaneous injection.
Prophylactic Laxatives for Patients on Opioids
Prophylactic laxatives are the provision of laxatives prior to any symptoms of constipation to prevent or avoid constipation. This approach has been suggested for patients with cancer on opioids for pain management.
Prophylactic Colony Stimulating Factors: GCSF - GMCSF (Systemic)
Granulocyte (G-CSF) and granulocyte-macrophage stimulating factors (GM-CSF) are substances that bind to hematopoietic stem cells, activating them to profliferate and differentiate into granulocytes and macrophages – the specific cell type of interest. Colony-stimulating factors administered systemically have been evaluated and recommended for patients with cancer for the prevention of infection and febrile neutropenia. CSFs may be used for primary or secondary prophylaxis.
Prophylactic Chlorhexidine
Chlorhexidine is an antiseptic that has a broad spectrum effect against both gram-positive and -negative bacteria. Chlorhexidine gluconate oral rinse that contains glycerol, coloring, flavoring, and other compounds has been studied in patients with cancer for the prevention and treatment of mucositis. It is important to note that prophylactic use, before development of mucositis, has a different PEP category than the use of chlorhexidine in patients who already have mucositis symptoms.
Progressive Muscle Relaxation and Guided Imagery
Progressive muscle relaxation (PMR) is a technique of alternately tensing and relaxing muscles groups in sequence throughout the body. When going through muscle groups, individuals can start with the head and neck and progress to the feet, or vice versa. Similarly individuals may do one side of the body at a time, or both sides at the same time. Listening to a prerecorded script may be used to guide individuals through the process.
Progestins
Progestins are synthetic hormones that have activity that simulates progesterone, the female hormone that is elevated during pregnancy. Progestin is a type of steroid structure and is the main component of birth control medications. Progestins have been evaluated for their effect in patients with cancer for anorexia, chemotherapy-induced nausea and vomiting, hot flashes, and fatigue.
Professional Oral Care
Professional oral care involves the examination, cleaning, treatment of dental caries, management of periodontal disease, and appropriate tooth extraction by dental professionals. Provision of professional oral care during cancer treatment was studied in relation to prevention of oral mucositis.
Prochlorperazine for Breakthrough CINV
At low doses, prochlorperazine is used to control nausea and vomiting associated with radiation therapy and very low to moderately emetogenic chemotherapy. The drug can be used at high doses to control nausea and vomiting associated with highly emetogenic chemotherapy. It may be particularly effective in the management of delayed nausea and vomiting.
Probiotics
Probiotics are live microorganisms capable of colonizing the intestinal tract, altering the microflora, and exerting a positive effect on the host. The mechanism by which probiotics exert positive effects remains to be elucidated.