Quality of Life and Neuropathic Pain in Hospitalized Cancer Patients: A Comparative Analysis of Patients in Palliative Care Wards Versus Those in General Wards.

CONTEXT: While the survival of cancer patients is prolonged due to the development of new treatment strategies and advancing technologies, the prevalence of symptoms such as neuropathic pain affecting the quality of life is also increasing. AIMS: The aim of this study is to determine the relationship between neuropathic pain (NP) and quality of life in hospitalized cancer patients and to compare patients in general wards and those in palliative care wards in terms of NP and quality of life. SUBJECTS AND METHODS: A total of 156 patients, 53 cancer patients hospitalized in the palliative care unit and 103 cancer patients hospitalized in general wards, were included in the study. The Douleur Neuropathic 4 test was used for NP assessment, and the Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HAD), Brief Fatigue Inventory (BFI), and Short Form of Brief Pain Inventory (SF-BPI) were used for assessing pain characteristics and their effects on quality of life. RESULTS: NP was present in 39.7% of cases and nociceptive pain (NP) was present in 32.7% of cases. There were no complaints of pain 27.6% of cases. The patients with no pain complaint were excluded, 54.9% of the patients had NP and 45.1% had NS. The scores of BFI, HAD-depression, ESAS overall, and ESAS tiredness were significantly lower in patients with NP treated general wards compared to patients with NP in the palliative care wards (P < 0.05). Cancer patients with NP in general wards had significantly higher scores of SF-BPI effect, SF-BPI severity, ESAS overall, ESAS pain, ESAS tiredness, ESAS nausea, ESAS appetite, and ESAS well-being as compared to those of general cancer patients with NS (P < 0.05). CONCLUSIONS: Since there was a homogeneous distribution among the groups in terms of both cancer treatment and pain management, we directly related the deterioration of the patients' quality of life to NP.

Factors influencing response to lymphedema treatment in patients with breast cancer-related lymphedema.

PURPOSE: In clinical practice, noticeable differences are seen in patient response to the treatment of breast cancer-related lymphedema. Although some factors influencing response to treatment are mentioned in the literature, there is no sufficient evidence and results are confusing. For this reason, our objective in this study is to identify predictive and response-related factors for response to treatment of breast cancer-related lymphedema. METHODS: We analyzed data retrospectively from the files of patients with breast cancer-related lymphedema between 2006 and 2012. Patient demographics, clinical variables, and patient variables were recorded. Circumference measurements of lymphedema and healthy arms were recorded. We used a computer program (Limb Volumes Professional version 5.0) to transform these values to limb volumes in milliliters. RESULTS: The average age of 331 patients was 54.4 ± 10.9. The average length of lymphedema treatment was 2.92 ± 1.3 weeks. A statistically significant positive correlation was found between postoperative weight gain and postoperative duration, number of chemotherapy (CT) cycles, duration of tamoxifen use, and duration of hormonal therapy (p < 0.05). There was a statistically significant negative correlation between posttreatment arm volume and activity level, postoperative duration, and postoperative weight gain (p < 0.05). CONCLUSION: The treatment methods used for treating breast cancer had no effect on the response to treatment of lymphedema. Weight gain during the treatment of breast cancer is important for both the development of lymphedema and the response to treatment. When treating breast cancer-related lymphedema, the relationship between activity level and postoperative weight gain may provide us guidance in clinical practice.

Can yoga have any effect on shoulder and arm pain and quality of life in patients with breast cancer? A randomized, controlled, single-blind trial.

OBJECTIVE: To examine the effects of yoga on shoulder and arm pain, quality of life (QOL), depression, and physical performance in patients with breast cancer. METHODS: This prospective, randomized study included 42 patients. The patients in Group 1 underwent a 10-week Hatha yoga exercise program. The patients in Group 2 were included in a 10-week follow-up program. Our primary endpoint was arm and shoulder pain intensity. RESULTS: The group receiving yoga showed a significant improvement in their pain severity from baseline to post-treatment, and these benefits were maintained at 2.5 months post-treatment. When compared to the control group, there were no statistically significant differences between the 2 groups with respect to the parameters assessed at the end of week 10. CONCLUSION: Yoga was an effective and safe exercise for alleviating shoulder and arm pain, which is a complication with a high prevalence in patients with breast cancer.

Effects of complex decongestive therapy on quality of life, depression, neuropathic pain, and fatigue in women with breast cancer-related lymphedema.

OBJECTIVES: To investigate the effects of complex decongestive therapy (CDT) on the quality of life, depression, neuropathic pain, and fatigue in patients with breast cancer-related lymphedema (BCRL). PATIENTS AND METHODS: Between March 2015 and June 2015, a total number of 60 patients (mean age 55.7±10.3 years; range 18 to 85 years) with BCRL were included in the study. Demographic data and previous medical records were recruited from medical files. The European Organization for Research and Treatment of Cancer Quality of Life- C30 (EORTC QLQ-C30) for the quality of life, the Brief Fatigue Inventory (BFI) for fatigue, Douleur Neuropathique 4 Questions (DN4) for neuropathic pain, and the Beck Depression Inventory (BDI) for the emotional status were used before and after the treatment. All patients received 20 sessions (one hour) of CDT for four weeks (five days per week). RESULTS: There was a statistically significant reduction in the volume of the involved limbs after the treatment (p<0.001). There was also a significant reduction in the general health and functional scores of the EORTC QLQ-C30 (p<0.001, p=0.004, respectively). The DN4, BFI, and BDI scores were significantly improved after the treatment (p<0.001, p=0.043, p=0.019, respectively). CONCLUSION: Our study results suggest that CDT is an effective and safe method to achieve not only a significant volume reduction in the limbs involved by lymphedema, but also good outcomes in the management of other symptoms related to BCRL.