Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Dyspnea, or breathlessness, is a very distressing and prevalent symptom for patients with terminal cancer. Assessment for this symptom is generally poorly conducted, and it is therefore frequently underdiagnosed and inadequately treated. This paper outlines several tools found in the literature that may be beneficial to us in assessing this symptom. ⋯ We also found that patients experiencing dyspnea were 39% more likely to complain of other symptoms than patients with no shortness of breath and were 55% more likely to report other symptoms as being severe. A short section will also outline the medical and nursing management of dyspnea and will include a discussion of possibly correcting the cause of breathlessness, environmental issues, and pharmacological management of dyspnea. It is advocated that during the terminal stages of a patient's illness, when assessment tools are no longer feasible or possible, that a "breathing comfortably" approach be adopted for patient and family comfort.
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Support Care Cancer · Mar 1997
Randomized Controlled Trial Clinical TrialTreatment of cancer chemotherapy-induced toxicity with the pineal hormone melatonin.
Experimental data have suggested that the pineal hormone melatonin (MLT) may counteract chemotherapy-induced myelosuppression and immunosuppression. In addition, MLT has been shown to inhibit the production of free radicals, which play a part in mediating the toxicity of chemotherapy. A study was therefore performed in an attempt to evaluate the influence of MLT on chemotherapy toxicity. ⋯ Alopecia and vomiting were not influenced by MLT. This pilot study seems to suggest that the concomitant administration of the pineal hormone MLT during chemotherapy may prevent some chemotherapy-induced side-effects, particularly myelosuppression and neuropathy. Evaluation of the impact of MLT on chemotherapy efficacy will be the aim of future clinical investigations.
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Support Care Cancer · Mar 1997
Scalp cooling in the prevention of alopecia in patients receiving depilating chemotherapy.
To assess any difference in the incidence of alopecia during treatment and of skull metastases during follow-up among breast cancer patients undergoing scalp cooling during chemotherapy and those treated at ambient temperatures. A series of 35 breast cancer patients receiving adjuvant chemotherapy were consecutively assigned either to a scalp cooling regimen (19 patients) or to an ambient temperature regimen (16 patients). Hypothermia was administered with electrically cooled caps (SCS II: Amit Technology, Jerusalem) for 1 h after treatment. ⋯ Patient comfort levels were high. Follow-up (median time 14 months) has disclosed no scalp metastases. The implementation of routine scalp hypothermia as part of adjuvant chemotherapy treatment, especially in cancers without tendencies to bone metastases, should be seriously considered.
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Support Care Cancer · Mar 1997
Editorial CommentDyspnea and cancer: support in agonizing conditions.