Kefir is a natural probiotic produced from the fermentation of milk with kefir grains, which contain yeast and bacteria, similar to the bacteria found in yogurt. Kefir was studied in patients with cancer to assess its effects for various symptoms and impact on overall quality of life.
Iseganan is an analog of a peptide with broad-spectrum antimicrobial activity under development for the prevention of oral mucositis from chemotherapy and radiation therapy.
Irsogladine maleate is a synthetic drug that has antiviral activity and appears to have some mucosal protective effects. Oral rinsing with dissolved irsogladine maleate was studied for its effect on oral mucositis.
Immunoglobulin is an antibody in the immune system that identifies and neutralizes foreign items such as bacteria and viruses. It is part of the humoral immune system. Prophylactic IV administration of immunoglobulin (IVIG) has been examined in patients with cancer for prevention of infection. In general, consideration of IVIG is only suggested by NCCN guidelines for patients with significant hypogammaglobulinemia.
Fentanyl is an opioid analgesic drug. The delivery of fentanyl intravenously has been evaluated for its effectiveness in the management of acute pain.
Dexmedetomidine is an alpha-2 adrenoceptor agonist that has sympatholytic, sedative, and and analgesic effects. It has been used in postoperative sedation and analgesia, and it appears to have opioid-sparing effects in analgesia. Dexmedetomidine in combination with morphine, delivered intrathecally, was examined for its effects on refractory pain in patients with advanced cancer.
Intraspinal analgesia includes various approaches for medication administration directly into the spinal canal to diffuse throughout the spinal fluid, including intrathecal injections and implanted devices such as reservoirs or pumps. Intraspinal analgesics have been used for the prevention of procedure-related acute pain. These approaches have been evaluated for their efficacy in the management of intractable pain in patients with cancer. The risk of infection with the long-term use and functioning of indwelling devices and catheters requires consideration.
Dexmedetomidine is an alpha-2 adrenoceptor agonist that has sympatholytic, sedative, and analgesic effects. It has been used in postoperative sedation and analgesia, and appears to have opioid-sparing effects in analgesia. Administration of dexmedetomidine during surgery has been examined for its effect on postoperative pain from bladder spasms in patients undergoing cancer-related surgery.
Sufentanil is a strong synthetic opioid analgesic that has been used as an anesthetic agent. Research has evaluated the effects of an intranasal formulation of sufentanil as a treatment for cancer-related breakthrough pain. At the time of this writing, this formulation is not yet FDA-approved for use in the United States. Sufentanil for injection is also available.
Intensity modulated radiation therapy (IMRT) combines tumor imaging techniques with special linear accelerators that can deliver hundreds of thin beams of radiation from any angle. Information fed into the linear accelerator allows it to revolve around the patient, delivering radiation in a three-dimensional pattern that corresponds to the exact tumor location.