Narrative medicine: feasibility of a digital narrative diary application in oncology.

OBJECTIVES: We implemented narrative medicine in clinical practice using the Digital Narrative Medicine (DNM) platform. METHODS: We conducted a preliminary, open, uncontrolled, real-life study in the oncology and radiotherapy departments of Istituto di Ricovero e Cura a Carattere Scientifico National Cancer Institute Regina Elena, Rome, Italy. We recruited adult Italian-speaking patients who then completed the DNM diary from the start of treatment. The primary endpoint was DNM feasibility; secondary endpoints were health care professionals' opinions about communication, therapeutic alliance, and information collection and patients' opinions about therapeutic alliance, awareness, and coping ability. We used open- and closed-ended questions (scores 1 to 5) and a structured interview. RESULTS: Thirty-one patients (67%) used the diary (84% women). Health care professionals' mean scores for feasibility and utility were ≥4.0. Patients' utility scores were related to health care professionals' feedback regarding the narratives. The main advantages for health care professionals were the opportunity to obtain relevant patient data and to strengthen communication and patient relationships (mean scores 4.4-5.0). Both groups strongly encouraged introduction of the diary in clinical practice. CONCLUSION: Use of the DNM in oncology patients assisted clinicians with understanding their patients experience.

Double-blind randomized phase III study comparing a mixture of natural agents versus placebo in the prevention of acute mucositis during chemoradiotherapy for head and neck cancer.

BACKGROUND: There is no widely accepted intervention in the prevention of acute mucositis during chemoradiotherapy for head and neck carcinoma. In the present double-blind study, we tested 4 natural agents, propolis, aloe vera, calendula, and chamomile versus placebo. METHODS: Patients undergoing concomitant chemo-intensity-modulated radiotherapy (IMRT) were given natural agent or matched placebo; grade 3 mucositis on physical examination according to Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 was the primary endpoint. Various covariates were tested at logistic regression, including the individual amount of mucosa receiving at least 9.5 Gy per week (V9.5w). RESULTS: One hundred seven patients were randomized from January 2011 to July 2014, and 104 were assessable (51%-49% were assigned to the placebo group and 53%-51% were assigned to the natural agent). Overall, 61 patients developed peak grade 3 mucositis with no difference between arms (P = .65). Conversely, V9.5w (P = .007) and primary site (P = .037) were independent predictors. CONCLUSION: The selected natural agents do not prevent mucositis, whereas the role of V9.5w is confirmed.

[The impact of Reiki on side effects in patients with head-neck neoplasia undergoing radiotherapy: a pilot study]. / L'impatto del Reiki sugli effetti collaterali nei pazienti con neoplasia testa-collo in trattamento radioterapico: uno studio pilota.

BACKGROUND: Cancer patients often report symptoms related to therapeutic treatment, whose management is based on traditional medicine. In recent years, however, there has been growing interest towards adopting some form of complementary medicine, among these, Reiki. The aim of this study is to evaluate how this type of discipline can contribute to managing radiotherapy-related symptoms in patients with head and neck cancer. METHOD: The study was performed in the Radiotherapy Department at the Regina Elena National Cancer Institute in Rome. To assess QoL, the FACT-H N questionnaire was used, while the CTCAE Scale was adopted to evaluate mucositis, cutaneous toxicity and salivation. RESULTS: 10.5% of patients were reported to experience strong pain in the fifth week, compared to 21.1% of patients in the previous week; a degree of mucositis equal to G3 was also found in 15.5% of cases according to the clinical evaluation, as well as in 10.5% of patients according to the functional one. Only one case (5.3%) of grade 3 cutaneous toxicity was registered. CONCLUSION: The study shows how the Reiki treatment benefits patients in most cases, with both psychological support to help deal with the therapeutic process together with integrated support towards pain therapy.