Molecular and physical technologies for monitoring fluid and electrolyte imbalance: A focus on cancer population.

Several clinical examinations have shown the essential impact of monitoring (de)hydration (fluid and electrolyte imbalance) in cancer patients. There are multiple risk factors associated with (de)hydration, including aging, excessive or lack of fluid consumption in sports, alcohol consumption, hot weather, diabetes insipidus, vomiting, diarrhea, cancer, radiation, chemotherapy, and use of diuretics. Fluid and electrolyte imbalance mainly involves alterations in the levels of sodium, potassium, calcium, and magnesium in extracellular fluids. Hyponatremia is a common condition among individuals with cancer (62% of cases), along with hypokalemia (40%), hypophosphatemia (32%), hypomagnesemia (17%), hypocalcemia (12%), and hypernatremia (1-5%). Lack of hydration and monitoring of hydration status can lead to severe complications, such as nausea/vomiting, diarrhea, fatigue, seizures, cell swelling or shrinking, kidney failure, shock, coma, and even death. This article aims to review the current (de)hydration (fluid and electrolyte imbalance) monitoring technologies focusing on cancer. First, we discuss the physiological and pathophysiological implications of fluid and electrolyte imbalance in cancer patients. Second, we explore the different molecular and physical monitoring methods used to measure fluid and electrolyte imbalance and the measurement challenges in diverse populations. Hydration status is assessed in various indices; plasma, sweat, tear, saliva, urine, body mass, interstitial fluid, and skin-integration techniques have been extensively investigated. No unified (de)hydration (fluid and electrolyte imbalance) monitoring technology exists for different populations (including sports, elderly, children, and cancer). Establishing novel methods and technologies to facilitate and unify measurements of hydration status represents an excellent opportunity to develop impactful new approaches for patient care.

Incorporating clinical trial data into daily cancer care.

The objective of clinical trials is to determine the effectiveness and safety of specific interventions. Regulatory agencies, clinicians, and patients depend on clinical trials because they provide the most reliable information about treatment outcomes. The ability to predict how a patient may respond to a given treatment and what potential types, degree, and frequency of adverse events could occur is invaluable. Although data from clinical trials can determine effective treatment options for patients, it is the explanation of what to expect from treatment and how it may affect quality of life that will determine which option a patient chooses. Translating clinical trial data into "real life" can be challenging for the oncology advanced practitioner (AP) because primary and secondary endpoints may differ among clinical trials. This variability can produce confusion when comparing, contrasting, and translating clinical evidence into clinical practice. This article reviews clinical trial endpoints and surrogate markers and describes how findings can influence decision-making and patient care. With social media increasing patients' awareness and encouraging active participation in their own care, it is imperative that APs be able to articulate clinical trial outcomes along with their strengths, limitations, and life impact.

Understanding cancer-understanding the stories of life and living.

BACKGROUND: Storytelling is an effective and efficient educational methodology for American Indians/Alaska Natives (AIs/ANs). It has been used for hundreds of years, is well respected, and has significant implications in the oncology setting. Storytelling not only values the individual sharing the story but also offers educational information and emotional support to those who hear it. METHODS: Content analysis of transcripts from an educational session in which AIs/ANs were encouraged to share stories of living with/surviving cancer identified 12 themes that revealed the essence of their cancer experiences. RESULTS: The themes identified were: cancer journey, responsibility to self and community, getting beyond the diagnosis, cancer lessons-cancer gifts, the strength of our stories, being connected, prospering through cancer, pain is more than a word, survival is an attitude, spirituality and cancer, specific cancer issues and understanding our ways. CONCLUSIONS: These themes are a reminder for health care professionals to spend time looking at, listening to and trying to understand how cancer and its treatments affect the everyday lives of people and families we treat and how this should guide our overall management plan. They teach us the importance of taking time to listen to the stories, responding to the cultural needs of every patient and family member and honoring teach the cancer journeys of all people.