Prescribing Exercise for Cancer Survivors:Time for Physicians to Become More Proactive.

Survivorship has become an integral component of the cancer care continuum. Advances in diagnosis and treatment have resulted in decreasing cancer mortality and a subsequent increase in the cancer survivorship population. International guidelines recommend counselling these patients with regards to healthy lifestyle changes. Increased physical activity has been shown to have profound impacts on quality of life and has also been shown to reduce recurrence rates in patients with breast, colon and prostate cancer. However physicians remain reluctant to prescribe exercise for these patients. Contributing factors include inadequate understanding of the benefits of these programmes, as well as uncertainty with regards to their patients' ability to tolerate such an intervention. It is thus imperative to raise awareness of the benefits of exercise, to guide physicians' selection of patients for exercise and to outline the available options to promote and increase physical activity as part of a healthy lifestyle.

A Survey of Colorectal Cancer Surveillance Practices In Ireland, And Implementation of A Survivorship Care Plan Pilot Programme

Aims The number of colorectal cancer (CRC) survivors in Ireland is rising. We aimed to survey current surveillance practices and pilot the use of survivorship care plans (SCPs) in the clinic. Methods An online survey was issued to medical oncologists (MOs) in designated cancer centres (DCC) and satellite centres. The SCP was piloted in CRC patients and a follow-up questionnaire assessing their views was issued. Results Responses from 8 DCC and satellite centres were obtained (n=13). Routine surveillance is practiced by 77% (n=10) and 69% (n=9) believe that the MO clinic is inappropriate for follow-up. Most think that the SCP is useful and that ANP-led surveillance clinics should be introduced. Of 16 patients who replied to the survey, most felt that the SCP was bene􀂡cial. Sixty-two percent (n=10) were agreeable to GP follow-up using the SCP. Conclusion Surveillance practices in Ireland are heterogeneous. The SCP may be useful for streamlining follow-up practices nationally.

Oxaliplatin-induced neurotoxicity: acute hyperexcitability and chronic neuropathy.

Oxaliplatin, a platinum-based chemotherapeutic agent, is effective in the treatment of solid tumors, particularly colorectal cancer. During and immediately following oxaliplatin infusion, patients may experience cold-induced paresthesias, throat and jaw tightness, and occasionally focal weakness. We assessed nerve conduction studies and findings on needle electromyography of patients with metastatic colorectal cancer before and during treatment with oxaliplatin. Twenty-two patients had follow-up studies within 48 h following oxaliplatin infusions, and 14 patients had follow-up studies after 3-9 treatment cycles. Repetitive compound muscle action potentials and neuromyotonic discharges were observed in the first 24-48 h following oxaliplatin infusion, but resolved by 3 weeks. After 8-9 treatment cycles, sensory nerve action potential amplitudes declined, without conduction velocity changes or neuromyotonic discharges. The acute neurological symptoms reflect a state of peripheral nerve hyperexcitability that likely represents a transient oxaliplatin-induced channelopathy. Chronic treatment causes an axonal neuropathy similar to other platinum-based chemotherapeutic agents.