Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 13 de 13
Filtrar
1.
Cancer ; 130(14): 2538-2551, 2024 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-38520382

RESUMEN

BACKGROUND: Androgen deprivation therapy (ADT) inhibits prostate cancer growth. However, ADT causes loss of bone mineral density (BMD) and an increase in fracture risk; effective interventions for ADT-induced bone loss are limited. METHODS: A phase 2 randomized controlled trial investigated the feasibility, safety, and preliminary efficacy of high-dose weekly vitamin D (HDVD, 50,000 IU/week) versus placebo for 24 weeks in patients with prostate cancer receiving ADT, with all subjects receiving 600 IU/day vitamin D and 1000 mg/day calcium. Participants were ≥60 years (mean years, 67.7), had a serum 25-hydroxyvitamin D level <32 ng/mL, and initiated ADT within the previous 6 months. At baseline and after intervention, dual-energy x-ray absorptiometry was used to assess BMD, and levels of bone cell, bone formation, and resorption were measured. RESULTS: The HDVD group (N = 29) lost 1.5% BMD at the total hip vs. 4.1% for the low-dose group (N = 30; p = .03) and 1.7% BMD at the femoral neck vs. 4.4% in the low-dose group (p = .06). Stratified analyses showed that, for those with baseline 25-hydroxyvitamin D level <27 ng/mL, the HDVD group lost 2.3% BMD at the total hip vs 7.1% for the low-dose group (p < .01). Those in the HDVD arm showed significant changes in parathyroid hormone (p < .01), osteoprotegerin (p < 0.01), N-terminal telopeptide of type 1 collagen (p < 0.01) and C-terminal telopeptide of type 1 collagen (p < 0.01). No difference in adverse events or toxicity was noted between the groups. CONCLUSIONS: HDVD supplementation significantly reduced hip and femoral neck BMD loss, especially for patients with low baseline serum 25-hydroxyvitamin D levels, although demonstrating safety and feasibility in prostate cancer patients on ADT.


Asunto(s)
Antagonistas de Andrógenos , Densidad Ósea , Neoplasias de la Próstata , Vitamina D , Humanos , Masculino , Neoplasias de la Próstata/tratamiento farmacológico , Vitamina D/sangre , Vitamina D/análogos & derivados , Vitamina D/administración & dosificación , Anciano , Antagonistas de Andrógenos/efectos adversos , Antagonistas de Andrógenos/administración & dosificación , Antagonistas de Andrógenos/uso terapéutico , Densidad Ósea/efectos de los fármacos , Persona de Mediana Edad , Osteoporosis/inducido químicamente , Osteoporosis/prevención & control
2.
Integr Cancer Ther ; 18: 1534735419855134, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31165647

RESUMEN

BACKGROUND: Cancer-related fatigue (CRF) often co-occurs with sleep disturbance and is one of the most pervasive toxicities resulting from cancer and its treatment. We and other investigators have previously reported that yoga therapy can improve sleep quality in cancer patients and survivors. No nationwide multicenter phase III randomized controlled trial (RCT) has investigated whether yoga therapy improves CRF or whether improvements in sleep mediate the effect of yoga on CRF. We examined the effect of a standardized, 4-week, yoga therapy program (Yoga for Cancer Survivors [YOCAS]) on CRF and whether YOCAS-induced changes in sleep mediated changes in CRF among survivors. STUDY DESIGN AND METHODS: Four hundred ten cancer survivors were recruited to a nationwide multicenter phase III RCT comparing the effect of YOCAS to standard survivorship care on CRF and examining the mediating effects of changes in sleep, stemming from yoga, on changes in CRF. CRF was assessed by the Multidimensional Fatigue Symptom Inventory. Sleep was assessed via the Pittsburgh Sleep Quality Index. Between- and within-group intervention effects on CRF were assessed by analysis of covariance and 2-tailed t test, respectively. Path analysis was used to evaluate mediation. RESULTS: YOCAS participants demonstrated significantly greater improvements in CRF compared with participants in standard survivorship care at post-intervention ( P < .01). Improvements in overall sleep quality and reductions in daytime dysfunction (eg, excessive napping) resulting from yoga significantly mediated the effect of yoga on CRF (22% and 37%, respectively, both P < .01). CONCLUSIONS: YOCAS is effective for treating CRF among cancer survivors; 22% to 37% of the improvements in CRF from yoga therapy result from improvements in sleep quality and daytime dysfunction. Oncologists should consider prescribing yoga to cancer survivors for treating CRF and sleep disturbance.


Asunto(s)
Supervivientes de Cáncer/psicología , Fatiga/psicología , Meditación/psicología , Neoplasias/psicología , Trastornos del Sueño-Vigilia/psicología , Sueño/fisiología , Yoga/psicología , Fatiga/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Calidad de Vida
3.
JNCI Cancer Spectr ; 3(2): pkz005, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31119206

RESUMEN

BACKGROUND: Cancer-related fatigue (CRF) is a common side effect of adjuvant therapy and becomes a chronic problem for approximately one-third of survivors. Omega-3 polyunsaturated fatty acids (O3-PUFA) demonstrated preliminary antifatigue effects in previous research, but have not been investigated in fatigued cancer survivors. METHODS: Breast cancer survivors 4-36 months posttreatment with a CRF score of 4 or more of 10 using the symptom inventory (SI) were randomly assigned to O3-PUFA (fish oil, 6 g/d), omega-6 PUFA (O6-PUFA; soybean oil, 6 g/d), or a low-dose combination of O3-/O6-PUFA (3 g/d O3-PUFA and O6-PUFA) for 6 weeks. CRF was assessed by the SI (screening question), the Brief Fatigue Inventory, and the Multidimensional Fatigue Symptom Index. Protein and mRNA levels of inflammatory and antioxidant biomarkers, along with fatty acid and lipid levels, were assessed at baseline and week 6. Statistical tests were two-sided. RESULTS: A total of 108 breast cancer survivors consented; 97 subjects were randomly assigned and 81 completed the trial. The SI CRF score decreased by 2.51 points at week 6 with O6-PUFA and by 0.93 points with O3-PUFA, with statistically significant between-group difference (effect size = -0.86, P < .01). Similar changes were observed for the Brief Fatigue Inventory and Multidimensional Fatigue Symptom Index but were not statistically significant. Stratified analyses showed the largest benefit was observed in those with severe baseline CRF (≥7). Compared with O3-PUFA, O6-PUFA supplementation statistically significantly decreased proinflammatory markers in the TNF-α signaling pathway. CONCLUSION: Contrary to our original hypothesis, O6-PUFA statistically significantly reduced CRF compared with O3-PUFA. Further research is needed to confirm these findings and to elucidate mechanisms of action.

4.
Support Care Cancer ; 27(12): 4597-4605, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30929028

RESUMEN

PURPOSE: Research by our group has shown that acupressure bands are efficacious in reducing chemotherapy-induced nausea (CIN) for breast cancer patients who expect nausea, and that their effectiveness in controlling CIN can largely be accounted for by patients' expectations of efficacy, i.e., a placebo effect. The present research examined if the effectiveness of acupressure bands could be enhanced by boosting patients' expectation of the bands' efficacy. METHODS: Two hundred forty-two chemotherapy-naïve patients with breast cancer who expected nausea were randomized. Arms 1 and 2 received acupressure bands, plus a relaxation MP3 and written handout that were either expectancy-enhancing (arm 1) or expectancy-neutral (arm 2). Arm 3 was the control without bands or MP3 and received standard care. All participants received guideline-specified antiemetics. RESULTS: Peak CIN for arms 1, 2, and 3 on a 1-7 scale was 3.52, 3.55, and 3.87, respectively (p = 0.46). Because no differences were observed between arms 1 and 2 (primary analysis), we combined these two arms (intervention) and compared them to controls for the following analyses. A significant interaction was found between intervention/control and receiving doxorubicin-based chemotherapy (yes/no) and pre-treatment anxiety (high/low). Intervention patients receiving doxorubicin had lower peak CIN than controls (3.62 vs. 4.38; p = 0.02). Similarly, intervention patients with high pre-treatment anxiety had a lower peak CIN than controls (3.62 vs. 4.62; p = 0.01). CONCLUSIONS: In breast cancer patients undergoing chemotherapy and having high CIN expectation, acupressure bands combined with a relaxation recording were effective in reducing CIN for patients who received doxorubicin or had high anxiety.


Asunto(s)
Acupresión/métodos , Antineoplásicos/efectos adversos , Musicoterapia/métodos , Náusea/prevención & control , Vómitos/prevención & control , Adulto , Anciano , Antieméticos/uso terapéutico , Antineoplásicos/administración & dosificación , Neoplasias de la Mama/tratamiento farmacológico , Femenino , Humanos , Persona de Mediana Edad , Náusea/inducido químicamente , Relajación , Vómitos/inducido químicamente , Adulto Joven
5.
Support Care Cancer ; 26(5): 1543-1552, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29192329

RESUMEN

PURPOSE: Despite advances in medical technology, radiation dermatitis occurs in 95% of patients receiving radiation therapy (RT) for cancer. Currently, there is no standard and effective treatment for the prevention or control of radiation dermatitis. The goal of the study was to determine the efficacy of oral curcumin, one of the biologically active components in turmeric, at reducing radiation dermatitis severity (RDS) at the end of RT, using the RDS scale, compared to placebo. METHODS: This was a multisite, randomized, double-blinded, placebo-controlled trial of 686 breast cancer patients. Patients took four 500-mg capsules of placebo or curcumin three times daily throughout their prescribed course of RT until 1 week post-RT. RESULTS: A total of 686 patients were included in the final analyses (87.5% white females, mean age = 58). Linear mixed-model analyses demonstrated that curcumin did not reduce radiation dermatitis severity at the end of RT compared to placebo (B (95% CI) = 0.044 (- 0.101, 0.188), p = 0.552). Fewer curcumin patients with RDS > 3.0 suggested a trend toward reduced severity (7.4 vs. 12.9%, p = 0.082). Patient-reported changes in pain, symptoms, and quality of life were not statistically significant between arms. CONCLUSIONS: Oral curcumin did not significantly reduce radiation dermatitis severity compared to placebo. The skin rating variation and broad eligibility criteria could not account for the undetectable therapeutic effect. An objective measure for radiation dermatitis severity and further exploration for an effective treatment for radiation dermatitis is warranted.


Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/radioterapia , Curcumina/uso terapéutico , Calidad de Vida/psicología , Radiodermatitis/tratamiento farmacológico , Administración Oral , Neoplasias de la Mama/patología , Curcumina/farmacología , Método Doble Ciego , Femenino , Humanos , Persona de Mediana Edad , Resultado del Tratamiento
6.
Integr Cancer Ther ; 15(3): 263-71, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-26621521

RESUMEN

UNLABELLED: Background Interventions are needed to alleviate memory difficulty in cancer survivors. We previously showed in a phase III randomized clinical trial that YOCAS©® yoga-a program that consists of breathing exercises, postures, and meditation-significantly improved sleep quality in cancer survivors. This study assessed the effects of YOCAS©® on memory and identified relationships between memory and sleep. STUDY DESIGN AND METHODS: Survivors were randomized to standard care (SC) or SC with YOCAS©® . 328 participants who provided data on the memory difficulty item of the MD Anderson Symptom Inventory are included. Sleep quality was measured using the Pittsburgh Sleep Quality Index. General linear modeling (GLM) determined the group effect of YOCAS©® on memory difficulty compared with SC. GLM also determined moderation of baseline memory difficulty on postintervention sleep and vice versa. Path modeling assessed the mediating effects of changes in memory difficulty on YOCAS©® changes in sleep and vice versa. RESULTS: YOCAS©® significantly reduced memory difficulty at postintervention compared with SC (mean change: yoga=-0.60; SC=-0.16; P<.05). Baseline memory difficulty did not moderate the effects of postintervention sleep quality in YOCAS©® compared with SC. Baseline sleep quality did moderate the effects of postintervention memory difficulty in YOCAS©® compared with SC (P<.05). Changes in sleep quality was a significant mediator of reduced memory difficulty in YOCAS©® compared with SC (P<.05); however, changes in memory difficulty did not significantly mediate improved sleep quality in YOCAS©® compared with SC. CONCLUSIONS: In this large nationwide trial, YOCAS©® yoga significantly reduced patient-reported memory difficulty in cancer survivors.


Asunto(s)
Memoria/fisiología , Neoplasias/fisiopatología , Neoplasias/psicología , Sueño/fisiología , Sobrevivientes/psicología , Yoga/psicología , Adulto , Anciano , Femenino , Humanos , Masculino , Meditación/psicología , Persona de Mediana Edad , Calidad de Vida/psicología , Autoinforme
7.
Explore (NY) ; 10(4): 241-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25037667

RESUMEN

CONTEXT: Hot flashes (HF) are a common distressing symptom in women with breast cancer (BC). Current pharmacologic options are moderately effective and are associated with bothersome side effects. Complementary and alternative medicine is commonly used by cancer patients. However, information on the association of hot flashes severity with such use and self-rated health is lacking. OBJECTIVE: To examine the hot flashes severity in women with breast cancer and its association with complementary and alternative medicine use and self-rated health (SRH). DESIGN: Longitudinal multicenter study to assess information needs of cancer outpatients. PARTICIPANTS: Patients with a diagnosis of breast cancer who were scheduled to undergo chemotherapy and/or radiotherapy. OUTCOME MEASURES: Hot flashes severity (0 = not present and 10 = as bad as you can imagine), use of complementary and alternative medicine (yes/no), and self-rating of health (SRH) status post-treatment and six-months thereafter (1-5, higher score = better SRH). RESULTS: The majority of women with HF (mean age = 54.4 years) were Caucasian and married, with higher education, and 93% had received surgical treatment for BC. At the end of treatment, 79% women reported experiencing HF [mean severity = 5.87, standard deviation (SD) = 2.9]; significantly more severe HF were reported by younger women with poor SRH, poor performance status, and those reporting doing spiritual practices. At follow-up, 73% had HF (mean severity = 4.86, SD = 3.0), and more severe HF were reported by younger women with poor self-rated health who had undergone chemotherapy plus radiotherapy, used vitamins, and did not exercise. CONCLUSIONS: A high percentage of women experienced hot flashes at the end of treatment and at six-month follow-up. A significant association of hot flashes severity with spiritual practice, increased vitamin use, and reduced exercise emphasize the need for future studies to confirm the results. This can facilitate safe use of complementary and alternative medicine and favorable outcomes while managing cancer-related hot flashes.


Asunto(s)
Neoplasias de la Mama , Terapias Complementarias , Salud , Sofocos/terapia , Índice de Severidad de la Enfermedad , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/terapia , Terapias Complementarias/estadística & datos numéricos , Ejercicio Físico , Femenino , Sofocos/epidemiología , Sofocos/etiología , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Prevalencia , Conducta Sedentaria , Terapias Espirituales , Sobrevivientes , Vitaminas
8.
J Cancer Surviv ; 6(2): 146-54, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22160628

RESUMEN

INTRODUCTION: Breast cancer survivors experience diminished health-related quality of life (HRQOL). We report on the influence of tai chi chuan exercise (TCC) on HRQOL and explore associations between changes in HRQOL and biomarkers. METHODS: Breast cancer survivors (N = 21) were randomly assigned to TCC or standard support therapy (SST) for 12 weeks (three times/week; 60 min/session). Interleukin-6, interleukin-8 (IL-8), insulin-like growth factor-1 (IGF-1), insulin-like growth factor-binding protein (IBFBP)-1, IGFBP-3, glucose, insulin, and cortisol were measured pre- and postintervention. Overall HRQOL and subdomains were assessed at preintervention (T1), midintervention (T2) and postintervention (T3) and biomarkers at T1 and T3. RESULTS: The TCC group improved in total HRQOL (T1-T2:CS = 8.54, P = 0.045), physical functioning (T1-T2:CS = 1.89, P = 0.030), physical role limitations (T1-T2 CS = 1.55, P = 0.023), social functioning (T1-T3:CS = 1.50, P = 0.020), and general mental health (T1-T2:CS = 2.67, P = 0.014; T1-T3:CS = 2.44, P = 0.019). The SST improved in social functioning (T1-T2:CS = 0.64, P = 0.043) and vitality (T1-T2:CS = 0.90, P = 0.01). There were relationships between changes in IGF-1 and overall HRQOL (r = -0.56; P < 0.05), physical role limitation (r = -0.68; P < 0.05), and social functioning (r = -0.56; P < 0.05). IGFBP-1 changes were associated with physical role limitations changes (r = 0.60; P < 0.05). IGFBP-3 changes were associated with physical functioning changes (r = 0.46; P ≤ 0.05). Cortisol changes were associated with changes in physical role limitations (r = 0.74; P < 0.05) and health perceptions (r = 0.46; P < 0.05). Glucose changes were associated with emotional role limitation changes (r = -0.70; P < 0.001). IL-8 changes were associated with emotional role limitation changes (r = 0.59; P < 0.05). DISCUSSION/CONCLUSIONS: TCC may improve HRQOL by regulating inflammatory responses and other biomarkers associated with side effects from cancer and its treatments. IMPLICATIONS FOR CANCER SURVIVORS: TCC may be an intervention capable of improving HRQOL in breast cancer survivors.


Asunto(s)
Biomarcadores de Tumor/análisis , Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Ejercicio Físico , Calidad de Vida , Sobrevivientes/psicología , Femenino , Estado de Salud , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Taichi Chuan
9.
Support Care Cancer ; 20(7): 1479-89, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21818642

RESUMEN

PURPOSE: Despite the widespread use of antiemetics, nausea continues to be reported by over 70% of patients receiving chemotherapy. METHODS: In this double blind, multicenter trial, we randomly assigned 744 cancer patients to four arms: 1) placebo, 2) 0.5 g ginger, 3) 1.0 g ginger, or 4) 1.5 g ginger. Nausea occurrence and severity were assessed at a baseline cycle and the two following cycles during which patients were taking their assigned study medication. All patients received a 5-HT(3) receptor antagonist antiemetic on Day 1 of all cycles. Patients took three capsules of ginger (250 mg) or placebo twice daily for 6 days starting 3 days before the first day of chemotherapy. Patients reported the severity of nausea on a 7-point rating scale ("1" = "Not at all Nauseated" and "7" = "Extremely Nauseated") for Days 1-4 of each cycle. The primary outcomes were to determine the dose and efficacy of ginger at reducing the severity of chemotherapy-induced nausea on Day 1 of chemotherapy. RESULTS: A total of 576 patients were included in final analysis (91% female, mean age = 53). Mixed model analyses demonstrated that all doses of ginger significantly reduced acute nausea severity compared to placebo on Day 1 of chemotherapy (p = 0.003). The largest reduction in nausea intensity occurred with 0.5 g and 1.0 g of ginger (p = 0.017 and p = 0.036, respectively). Anticipatory nausea was a key factor in acute chemotherapy-induced nausea (p < 0.0001). CONCLUSIONS: Ginger supplementation at a daily dose of 0.5 g-1.0 g significantly aids in reduction of the severity of acute chemotherapy-induced nausea in adult cancer patients.


Asunto(s)
Antieméticos/uso terapéutico , Náusea/prevención & control , Fitoterapia , Vómitos/prevención & control , Zingiber officinale/química , Antieméticos/administración & dosificación , Antieméticos/aislamiento & purificación , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Náusea/inducido químicamente , Neoplasias/tratamiento farmacológico , Antagonistas del Receptor de Serotonina 5-HT3/uso terapéutico , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Vómitos/inducido químicamente , Vómito Precoz/prevención & control
10.
Clin Breast Cancer ; 11(3): 161-70, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21665136

RESUMEN

BACKGROUND: Tai Chi Chuan (TCC) is an integrative medicine mind-body practice with a physical activity component that has positive effects on aerobic capacity, muscular strength, and quality of life among cancer survivors, similar to the effects elicited by other modes of moderate-intensity exercise. Inflammatory cytokines and insulin and insulin-related signaling molecules may contribute to weight gain and affect cancer recurrence rates and survival; exercise can curb cancer- and treatment-related weight gain, increase survival, and reduce levels of insulin and inflammatory cytokines. Despite knowing the beneficial effects of conventional exercise interventions on these mediators, little is known about the physiologic effects of TCC on these pathways in breast cancer survivors. METHODS: We assessed the effects of a 12-week, moderately intense, TCC intervention (n = 9) compared with a non-physical activity control (n = 10) consisting of psychosocial support therapy (PST), on levels of insulin, insulin-like growth factor (IGF)-1, insulin growth factor-like binding protein (IGFBP)-1, IGFBP-3, and cytokines interleukin (IL)-6, IL-2, and interferon (IFN)-γ in breast cancer survivors. RESULTS: Levels of insulin are significantly different in TCC and PST groups; levels remained stable in the TCC group but increased in the PST control group (P = .099). Bivariate analysis revealed novel and significant correlations (all r > 0.45, all P ≤ .05) of both decreased fat mass and increased fat-free mass with increased IL-6 and decreased IL-2 levels. CONCLUSIONS: This pilot study shows that TCC may be associated with maintenance of insulin levels and changes in cytokine levels that may be important for maintenance of lean body mass in breast cancer survivors.


Asunto(s)
Neoplasias de la Mama/fisiopatología , Citocinas/sangre , Insulina/sangre , Taichi Chuan , Adulto , Anciano , Neoplasias de la Mama/sangre , Neoplasias de la Mama/mortalidad , Femenino , Humanos , Persona de Mediana Edad , Proyectos Piloto , Sobrevivientes
11.
Integr Cancer Ther ; 10(1): 27-37, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21382958

RESUMEN

BACKGROUND: Cancer-related fatigue (CRF) is the most frequently reported side effect of cancer and its treatment. In previous research, Polarity Therapy (PT), an energy therapy, was shown to reduce CRF in patients receiving radiation. This study reports on a small randomized clinical trial designed to collect preliminary data on the efficacy of PT compared with an active control (massage) and passive control (standard care) for CRF among cancer patients receiving radiation therapy. METHODS: Forty-five women undergoing radiation therapy for breast cancer were randomized to 1 of 3 weekly treatment conditions. Patients received standard clinical care, 3 modified massages, or 3 PT treatments. CRF and health-related quality of life (HRQL) were assessed during baseline and the 3 intervention weeks. RESULTS: TResults show CRF ratings were reduced after PT. The effect sizes for PT versus modified massage and versus standard care were small when using the primary measure of CRF (Brief Fatigue Inventory) and large when using the secondary measure of CRF (Daily CRF Diaries).The effect size was medium when assessing the benefit of PT on maintaining HRQL compared with standard care with very little difference between the PT and modified massage conditions. Patients' feedback showed that both the modified massage and PT treatments were deemed useful by radiation patients. CONCLUSION: The present pilot randomized clinical trial supports previous experimental research showing that PT, a noninvasive and gentle energy therapy, may be effective in controlling CRF. Further confirmatory studies as well as investigations of the possible mechanisms of PT are warranted.


Asunto(s)
Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/terapia , Terapias Complementarias/métodos , Fatiga/etiología , Fatiga/terapia , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/radioterapia , Metabolismo Energético , Fatiga/metabolismo , Femenino , Humanos , Masaje , Persona de Mediana Edad , Proyectos Piloto , Calidad de Vida
12.
J Pain Symptom Manage ; 40(3): 379-90, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20579837

RESUMEN

CONTEXT: Previous research has shown that the effectiveness of acupressure bands in reducing chemotherapy-related nausea is related to patients' expectations of efficacy. OBJECTIVE: To test whether an informational manipulation designed to increase expectation of efficacy regarding acupressure bands would enhance their effectiveness. METHODS: We conducted an exploratory, four-arm, randomized clinical trial in breast cancer patients about to begin chemotherapy. All patients received acupressure bands and a relaxation CD. This report focuses on Arm 1(expectancy-neutral informational handout and CD) compared with Arm 4 (expectancy-enhancing handout and CD). Randomization was stratified according to the patient's level of certainty that she would have treatment-induced nausea (two levels: high and low). Experience of nausea and use of antiemetics were assessed with a five-day diary. RESULTS: Our expectancy-enhancing manipulation resulted in improved control of nausea in the 26 patients with high nausea expectancies but lessened control of nausea in 27 patients having low nausea expectancies. This interaction effect (between expected nausea and intervention effectiveness) approached statistical significance for our analysis of average nausea (P=0.084) and reached statistical significance for our analysis of peak nausea (P=0.030). Patients receiving the expectancy-enhancing manipulation took fewer antiemetic pills outside the clinic (mean(enhanced)=12.6; mean(neutral)=18.5, P=0.003). CONCLUSION: This exploratory intervention reduced antiemetic use overall and also reduced nausea in patients who had high levels of expected nausea. Interestingly, it increased nausea in patients who had low expectancies for nausea. Confirmatory research is warranted.


Asunto(s)
Acupresión , Antineoplásicos/efectos adversos , Náusea/psicología , Náusea/terapia , Adulto , Anciano , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/tratamiento farmacológico , Femenino , Humanos , Persona de Mediana Edad , Náusea/inducido químicamente , Educación del Paciente como Asunto , Terapia por Relajación , Sugestión , Vómitos/inducido químicamente , Vómitos/psicología , Vómitos/terapia
13.
J Pain Symptom Manage ; 38(3): 381-9, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19328650

RESUMEN

Previous studies have shown that acupressure bands can reduce chemotherapy-related nausea. Patients' expectations of efficacy account for part of this outcome. We conducted a three-arm randomized clinical trial to investigate the effectiveness of acupressure bands in controlling radiation therapy-induced nausea and to test whether an informational manipulation designed to increase expectation of efficacy would enhance the effectiveness of the acupressure bands. Patients who experienced nausea at prior treatments were randomized to either standard care (Arm 1, n=29) or standard care plus acupressure bands with either neutral (Arm 2, n=30) or positive (Arm 3, n=29) information regarding the efficacy of the bands. Patients reported nausea for two days prior to randomization (baseline) and for five days following using a seven-point semantic rating scale (1=not nauseated to 7=extremely nauseated). Patients in Arms 2 and 3 combined reported greater reduction in average nausea than patients in Arm 1 (P=0.01; mean(bands)=0.70, mean(no bands)=0.10). This equates to a 23.8% decrease in nausea in the band groups compared to a 4.8% decrease in the control group, a 19% difference. The informational manipulation failed to alter efficacy expectations and there was no statistically significant difference in nausea between patients in Arms 2 and 3. Acupressure bands are an effective, low-cost, nonintrusive, well-accepted, and safe adjunct to standard antiemetic medication. An attempt to boost the efficacy of the acupressure bands by providing positive information was not successful.


Asunto(s)
Acupresión/métodos , Náusea/etiología , Náusea/terapia , Radioterapia/efectos adversos , Acupresión/instrumentación , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Neoplasias/radioterapia , Vómitos/etiología , Vómitos/terapia , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA