Managing adverse events associated with sorafenib in renal cell carcinoma.

Sorafenib, a multi-targeted kinase inhibitor, is approved in Europe for the treatment of patients with advanced renal cell carcinoma whose treatment with an interferon or interleukin-2-based therapy has previously failed, or who are unsuitable for such therapy. Unlike some first-generation anti-cancer therapies, sorafenib is generally associated with moderate and manageable adverse events. Some of the most common adverse events include a hand-foot skin reaction, diarrhoea and rash. As nurses provide an interface between the patient and the clinical team, it is important that they understand how sorafenib-related adverse events impact on patients. It is equally vital that nurses are able to recognize and manage these adverse events. Our experience has shown that with patient education, early reporting, monitoring and treatment, the adverse events of sorafenib therapy can be easily and effectively managed. Optimal adverse event management helps ensure treatment compliance and ensures that patients receive maximum benefit from therapy.

Capecitabine-based combination therapy for breast cancer: implications for nurses.

PURPOSE/OBJECTIVES: To review available data and implications for nurses of combination regimens containing capecitabine for metastatic breast cancer. DATA SOURCES: Peer-reviewed publications or abstracts from major oncology conferences and reviews of capecitabine focusing on nursing implications. DATA SYNTHESIS: Capecitabine has proven efficacy in combination with docetaxel and is under evaluation in the neoadjuvant, adjuvant, and metastatic settings in combination with several oral and IV chemotherapeutic and biologic agents. CONCLUSIONS: Capecitabine-containing regimens demonstrate high activity in a range of settings but typically have more complex safety profiles, dose-modification schemes, and scheduling requirements than monotherapy. IMPLICATIONS FOR NURSING: Patients need to be aware of a wider range of likely side effects and should understand that they have been prescribed combination therapy rather than more simple, single-agent treatments because of its potential to improve outcome.

Hair and cancer chemotherapy: consequences and nursing care--a literature study.

Hair is a body appendage that throughout history has been a symbol of the social, cultural and political climate, in addition to connoting religious affiliation. Hair loss on the other hand has been associated with a loss of attractiveness, individuality, a state of disgrace and illness, in addition to the ageing process, death and a loss of sexuality. One of the most common side-effects of chemotherapy is hair loss (alopecia). Alopecia can range from sporadic thinning of the hair to complete baldness. Several factors may contribute to the severity of hair loss including drug, dose and schedule as well as hair care practices. Prevention of alopecia has been a focus in the medical and nursing literature since the late 1960s. Mechanical, physical and biological measures have been used with varying success. The goal of prevention is primarily the reduction of patient distress caused by chemotherapy-induced alopecia. Patient reactions to alopecia vary and may be dependent on the individual importance of hair, prognosis, degree of expected hair loss, the amount of information and preparation given, and physical and psychological coping mechanisms. Nurses play an important role in assisting the patient to cope with alopecia by giving the needed information and teaching self-care strategies to minimize alopecia, cope with alopecia, and protect the skin and eyes following alopecia. These interventions are aimed at helping the patient move through a potentially devastating experience to a renewed sense of well-being.

Locks of love.

Locks of Love is a nonprofit organization that provides custom hairpieces to financially disadvantaged children under age 18 across the United States who are suffering from long-term medical hair loss. This article will provide information to those readers who wish to cut their long hair and donate it to a needy child or to those who may simply be interested in learning more about this organization.

Hair-raising. The latest news on male-pattern baldness.

The initiating event in balding seems to be an abnormal sensitivity to the male sex hormones. In addition, a multifactorial model is emerging in which hormones affect the hair follicle in a way that causes it to be perceived as a foreign body by the immune system, which then mounts an attack. Several new classes of agents have the potential to treat hair loss. More than 40 U.S. and several hundred foreign patents have been issued for hair-loss treatment agents. As is common in dermatology, no single agent works universally against hair loss, so the treatment process is often one of trial and error.

The symptom experience of alopecia.

OBJECTIVES: To examine the physiology and pathophysiology of loss of hair, the impact of alopecia on the patient, nursing and self-care interventions, and available resources. DATA SOURCES: Published articles pertaining to alopecia and personal experiences of coping with alopecia. CONCLUSIONS: Hair loss often is the most traumatic side effect for cancer patients. It causes depression, loss of self-confidence, and humiliation in men and women of all ages. Too few studies exist to make a definitive recommendation for scalp hypothermia and the use of scalp tourniquets. The major controversy and issue to consider with these hair-preservation techniques is scalp metastases. Further studies are needed to identify the impact of alopecia on patient self-image and quality of life. IMPLICATIONS FOR NURSING PRACTICE: Nursing interventions should be directed toward helping the patient and family adapt to and cope with alopecia. Patient education, identification of available resources, and supportive listening are therapeutic interventions.

The development of an oncology alopecia wig program.

Many of the physically uncomfortable side effects of chemotherapy are well controlled today, but little has been addressed about the emotionally devastating effects of alopecia. In 1991, The Moses H. Cone Memorial Hospital developed an Oncology Alopecia Wig Program that provides emotional support and teaches selection of and care of wigs.

When your patients lose their hair.

1. Hair loss, even when it occurs gradually, is usually accompanied by psychologic discomfort. For some chemotherapy patients, the prospect of hair loss is viewed with more dread than any of the other physical discomforts that accompany chemotherapy. 2. The pattern and extent of hair loss cannot be accurately predicted for a given patient. Chemotherapy causes alopecia by damaging hair stem cells and hair follicles making the hair brittle and causing scalp hair to break off or fall out. 3. Education and support of the patient is highly significant in helping the patient adjust to hair loss. Nurses can inform the patient in advance of anticipated hair loss, suggest techniques for coping with hair loss, and encourage alternate methods of expressing sexuality.