1
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Choi JI, Jung S, Oh GH, Son KL, Lee KM, Jung D, Kim TY, Im SA, Lee KH, Shin MS, Hahm BJ, Yeom CW. The Effect of Temperament on the Association Between Pre-treatment Anxiety and Chemotherapy-Related Symptoms in Patients With Breast Cancer. Psychiatry Investig 2022; 19:949-957. [PMID: 36444158 PMCID: PMC9708865 DOI: 10.30773/pi.2022.0078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/04/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Pre-treatment anxiety (PA) before chemotherapy increases complaints of chemotherapy-related symptoms (CRS). The results on the association have been inconsistent, and the effect of temperament remains unclear. We aimed to determine whether PA is a risk factor for CRS and the effect of differing temperaments on CRS. METHODS This prospective study comprised 176 breast cancer patients awaiting adjuvant chemotherapy post-surgery. We assessed CRS, PA, and temperament using the MD Anderson Symptom Inventory (MDASI), the Hospital Anxiety and Depression Scale, and the short form of the Temperament and Character Inventory-Revised, respectively. The MDASI was re-administered three weeks after the first chemo-cycle. RESULTS PA showed weak positive correlation with several CRS after the first cycle; no CRS was significantly associated with PA when pre-treatment depressive symptoms and baseline CRS were adjusted in multiple regression analysis. Moderation model analysis indicated that the PA effect on several CRS, including pain, insomnia, anorexia, dry mouth, and vomiting, was moderated by harm avoidance (HA) but not by other temperament dimensions. In particular, PA was positively associated with CRS in patients with low HA. CONCLUSION The results in patients with low HA indicate that more attention to PA in patients with confident and optimistic temperaments is necessary.
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Affiliation(s)
- Jung-In Choi
- Department of Clinical Medical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sanghyup Jung
- Department of Psychiatry, National Rehabilitation Center, Seoul, Republic of Korea.,Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Gyu Han Oh
- Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Lak Son
- Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | | | - Dooyoung Jung
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Min-Sup Shin
- Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chan-Woo Yeom
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
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Patel P, Robinson PD, Devine KA, Positano K, Cohen M, Gibson P, Holdsworth M, Phillips R, Spinelli D, Thackray J, van de Wetering M, Woods D, Cabral S, Sung L, Dupuis LL. Prevention and treatment of anticipatory chemotherapy-induced nausea and vomiting in pediatric cancer patients and hematopoietic stem cell recipients: Clinical practice guideline update. Pediatr Blood Cancer 2021; 68:e28947. [PMID: 33686754 DOI: 10.1002/pbc.28947] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 12/20/2022]
Abstract
This 2021 clinical practice guideline update provides recommendations for preventing anticipatory chemotherapy-induced nausea and vomiting (CINV) in pediatric patients. Recommendations are based on systematic reviews that identified (1) if a history of acute or delayed CINV is a risk factor for anticipatory CINV, and (2) interventions for anticipatory CINV prevention and treatment. A strong recommendation to optimize acute and delayed CINV control in order to prevent anticipatory CINV is made. Conditional recommendations are made for hypnosis, systematic desensitization, relaxation techniques, and lorazepam for the secondary prevention of anticipatory CINV. No recommendation for the treatment of anticipatory CINV can be made.
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Affiliation(s)
- Priya Patel
- Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada
| | | | - Katie A Devine
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Karyn Positano
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Paul Gibson
- Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada.,Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Mark Holdsworth
- College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
| | - Robert Phillips
- Department of Haematology and Oncology, Leeds Teaching Hospital, NHS Trust, Leeds, UK
| | - Daniela Spinelli
- Patient Representative.,Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jennifer Thackray
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Deborah Woods
- University of California, Davis Health, Pediatric Hematology/Oncology, Davis, California, USA
| | - Sandra Cabral
- Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada
| | - Lillian Sung
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.,Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - L Lee Dupuis
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
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3
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Dev V, Consedine NS, Reynolds LM. The “Ick” Factor: An Unrecognized Affective Predictor of Physical Symptoms During Chemotherapy. Ann Behav Med 2020; 55:345-355. [DOI: 10.1093/abm/kaaa055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients undergoing chemotherapy experience a range of aversive symptoms. These symptoms vary across individuals and at least some of this variation can be predicted by psychological factors, such as distress. However, while psychological distress predicts some of the symptoms, it is limited in important ways.
Purpose
To (a) assess the viability of disgust—a discrete emotion that specifically evolved for health-related reasons—as a predictor of chemotherapy-related symptoms (particularly, taste- and smell-related changes) and (b) compare the predictive utility of disgust sensitivity and propensity against the most commonly used affective predictor, that is, psychological distress.
Methods
Patients with cancer (N = 63) about to initiate chemotherapy were recruited in a prospective observational study. Psychosocial predictor variables were assessed at baseline, and outcomes (i.e., physical symptoms, body mass index [BMI], and food-based sensory-processing changes) were assessed at both baseline and 6 week follow-up.
Results
Psychological distress did not predict any of the outcomes. Both disgust sensitivity (β = .53, p = .003) and propensity (β = −.56, p = .002) predicted greater food-based sensory-processing changes, while disgust sensitivity marginally predicted greater chemotherapy-related physical symptoms (β = .34, p = .060); neither of these two forms of disgust predicted BMI.
Conclusions
The study provides first evidence showing (a) associations between trait disgust and food sensory-processing changes that arise during chemotherapy and (b) disgust as being a more useful predictor of food- and digestion-related symptoms than psychological distress. In doing so, it opens new doors for better care to be provided to patients undergoing chemotherapy.
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Affiliation(s)
- Vinayak Dev
- Department of Psychological Medicine, University of Auckland, Grafton, Auckland, New Zealand
| | - Nathan S Consedine
- Department of Psychological Medicine, University of Auckland, Grafton, Auckland, New Zealand
| | - Lisa M Reynolds
- Department of Psychological Medicine, University of Auckland, Grafton, Auckland, New Zealand
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4
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Akechi T. Psycho-oncology: History, Current Status, and Future Directions in Japan. JMA J 2018; 1:22-29. [PMID: 33748519 PMCID: PMC7969909 DOI: 10.31662/jmaj.2018-0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 05/11/2018] [Indexed: 11/11/2022] Open
Abstract
One of the most relevant risk factors for cancer is aging; thus, the number of patients who develop cancer and die is increasing in Japan. Cancer has been a leading cause of death since 1981, and more than one-fourth of Japanese people die of cancer. More than 1,000,000 and 37,000 Japanese people develop cancer and die every year, respectively, making it a major health problem in Japan. Psycho-oncology is a relatively new medical field that was established in the 1970s in Western countries and introduced in Japan in the 1980s. Psycho-oncology was developed for investigating two issues neglected in previous medical research: the impact of behavioral and psychosocial factors on cancer morbidity and mortality and the psychological influence of cancer on patients, their families, and medical staff. Because of progress made in cancer treatment, cancer diagnosis is not necessarily equivalent to a death sentence. However, approximately half of patients with cancer die, and many patients with cancer and their families need appropriate care for psychological distress. The most common psychiatric problems patients with cancer experience are adjustment disorders, major depression, and/or delirium. In addition, the suicide rate in Japan for individuals within 1 year of a cancer diagnosis is more than 20 times higher than that for individuals without cancer. Physical symptoms, such as pain and nausea/vomiting, can be closely associated with psychological function. Mental health professionals, particularly psycho-oncologists, are expected to work with other cancer professionals to manage patients' distress. The present review focuses on patients with cancer' psychological distress and physical symptoms that are closely associated with psychological function and provides an overview of the current status of psycho-oncology in Japan. The future perspective of psycho-oncology is also discussed.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Department of Psycho-oncology and Palliative Medicine, Nagoya City University Hospital, Nagoya, Japan
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5
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Fletcher C, Wilson C, Hutchinson AD, Grunfeld EA. The relationship between anticipated response and subsequent experience of cancer treatment-related side effects: A meta-analysis comparing effects before and after treatment exposure. Cancer Treat Rev 2018; 68:86-93. [DOI: 10.1016/j.ctrv.2018.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
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6
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Devlin EJ, Denson LA, Whitford HS. Cancer Treatment Side Effects: A Meta-analysis of the Relationship Between Response Expectancies and Experience. J Pain Symptom Manage 2017; 54:245-258.e2. [PMID: 28533160 DOI: 10.1016/j.jpainsymman.2017.03.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 02/22/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Abstract
CONTEXT Although previous research has, overall, suggested a moderate relationship between response expectancies (REs) and cancer treatment-related side effects, empirical results have been mixed. OBJECTIVES We aimed to further explore these relationships, hypothesizing that REs would predict subsequent toxicities with the inclusion of more recent studies, across a broader range of side effects, while incorporating the impact of potential moderators including patients' experience with treatment and measurement methods. We further investigated the impact of REs across individual toxicities. METHODS A systematic search and analysis were conducted across four databases (PsychInfo, PubMed, CINAHL, and Embase) and reference lists, from 1985 to February 2016. This provided 27 eligible studies with 4474 participants, through which the main analysis, moderator analyses, and individual side-effect analyses were explored. RESULTS REs were moderately related to side effects overall (r = 0.26), and effect sizes were significantly influenced by sample diagnostic homogeneity, whereas differences between type and timing of measurement showed trends. Of the 16 toxicities examined, 15 demonstrated significant relationships between REs and side-effect experience, with hair loss (r = 0.48) the strongest. No clear difference emerged between objective and subjective side effects; however, significant differences across individual toxicities were revealed. CONCLUSION Findings support a relationship between REs and a wide range of subsequent side effects, yet differences between individual RE-toxicity associations emerged. These findings provide direction for the measurement of side effects and REs and support REs as potential targets for intervention during the informed consent process.
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Affiliation(s)
- Elise J Devlin
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Linley A Denson
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Hayley S Whitford
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia; Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
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7
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Datta A, Aditya C, Mukhopadhyay A. RETRACTED ARTICLE: The Impact of Breast Cancer on Women's Everyday Life in Eastern India. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:816. [PMID: 27237721 DOI: 10.1007/s13187-016-1045-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Arunima Datta
- Department of Psychology, Netaji Subhas Bose National Cancer Research Institute, 16A Park Lane, 700016, Kolkata, India.
| | - Chandana Aditya
- Department of Psychology, Bijoykrishna Girls' College, Howrah, India
| | - Ashis Mukhopadhyay
- Department of Oncology, Netaji Subhas Bose National Cancer Research Institute, Kolkata, India
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8
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Dupuis LL, Roscoe JA, Olver I, Aapro M, Molassiotis A. 2016 updated MASCC/ESMO consensus recommendations: Anticipatory nausea and vomiting in children and adults receiving chemotherapy. Support Care Cancer 2016; 25:317-321. [PMID: 27510314 DOI: 10.1007/s00520-016-3330-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 07/06/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE We aimed to update the 2011 recommendations for the prevention and treatment of anticipatory nausea and vomiting in children and adults receiving chemotherapy. METHODS The original systematic literature search was updated. Randomized studies were included in the evidence to support this guideline if they as follows: were primary studies published in a journal in full text (i.e., abstracts, letters, book chapters, and dissertations were excluded); published in English; evaluated an intervention for the prevention or treatment of anticipatory nausea and vomiting; reported the proportion of patients experiencing complete control of anticipatory nausea and vomiting consistently and; included at least ten participants per study arm for comparative studies and at least ten participants overall for noncomparative studies. RESULTS Eighty-eight new citations were identified. Of these, nine were brought to full-text screening; none met inclusion criteria. The guideline panel continues to recommend that anticipatory nausea and vomiting are best prevented through optimization of acute and delayed phase chemotherapy-induced nausea and vomiting control. Benzodiazepines and behavioral therapies, in particular progressive muscle relaxation training, systematic desensitization and hypnosis, continue to be recommended for the treatment of anticipatory nausea and vomiting. CONCLUSIONS No new information regarding interventions aimed at treating or preventing ANV that met criteria for inclusion in this systematic review was identified. The 2015 MASCC recommendations affirm the content of the 2009 MASCC recommendations for the prevention and treatment of anticipatory nausea and vomiting.
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Affiliation(s)
- L Lee Dupuis
- Department of Pharmacy and Research Institute, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. .,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
| | - Joseph A Roscoe
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Ian Olver
- Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Matti Aapro
- IMO Clinique de Genolier, Genolier, Switzerland
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9
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Dupuis LL, Robinson PD, Boodhan S, Holdsworth M, Portwine C, Gibson P, Phillips R, Maan C, Stefin N, Sung L. Guideline for the prevention and treatment of anticipatory nausea and vomiting due to chemotherapy in pediatric cancer patients. Pediatr Blood Cancer 2014; 61:1506-12. [PMID: 24753095 DOI: 10.1002/pbc.25063] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 03/18/2014] [Indexed: 11/06/2022]
Abstract
This guideline provides an approach to the prevention and treatment of anticipatory chemotherapy-induced nausea and vomiting (CINV) in children. It was developed by an international, inter-professional panel using AGREE II methods and is based on systematic literature reviews. Evidence-based recommendations for pharmacological and non-pharmacological interventions to prevent and treat anticipatory CINV in children receiving antineoplastic agents are provided. Gaps in the evidence used to support the recommendations are identified. The contribution of this guideline to anticipatory CINV control in children requires prospective evaluation.
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Affiliation(s)
- L. Lee Dupuis
- Department of Pharmacy; The Hospital for Sick Children; Toronto Ontario
- Leslie Dan Faculty of Pharmacy; University of Toronto; Toronto Ontario
- Program in Child Health Evaluative Sciences; Research Institute, The Hospital for Sick Children; Toronto Ontario
| | | | - Sabrina Boodhan
- Department of Pharmacy; The Hospital for Sick Children; Toronto Ontario
- Leslie Dan Faculty of Pharmacy; University of Toronto; Toronto Ontario
| | - Mark Holdsworth
- College of Pharmacy; University of New Mexico; Albuquerque New Mexico
| | - Carol Portwine
- Division of Hematology/Oncology, Department of Pediatrics; McMaster University; Hamilton Ontario
| | - Paul Gibson
- Pediatric Hematology/Oncology, Children's Hospital; London Health Sciences Centre; London Ontario
| | - Robert Phillips
- Regional Department of Haematology and Oncology; Leeds Children's Hospital; Leeds United Kingdom
- Centre for Reviews and Dissemination; University of York; York United Kingdom
| | - Cathy Maan
- Pediatric Hematology/Oncology, Children's Hospital; London Health Sciences Centre; London Ontario
| | - Nancy Stefin
- Division of Hematology/Oncology, Department of Pediatrics; McMaster University; Hamilton Ontario
| | - Lillian Sung
- Division of Haematology/Oncology; The Hospital for Sick Children; Toronto Ontario
- Program in Child Health Evaluative Sciences; Research Institute, The Hospital for Sick Children; Toronto Ontario
- Department of Paediatrics; University of Toronto; Toronto Ontario
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10
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Rock EM, Limebeer CL, Parker LA. Anticipatory nausea in animal models: a review of potential novel therapeutic treatments. Exp Brain Res 2014; 232:2511-34. [DOI: 10.1007/s00221-014-3942-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 03/31/2014] [Indexed: 11/24/2022]
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11
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Rodríguez M. Individual differences in chemotherapy-induced anticipatory nausea. Front Psychol 2013; 4:502. [PMID: 23950751 PMCID: PMC3738859 DOI: 10.3389/fpsyg.2013.00502] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 07/17/2013] [Indexed: 12/05/2022] Open
Abstract
Anticipatory Nausea (AN) is a severe side effect of chemotherapy that can lead cancer patients to discontinue their treatment. This kind of nausea is usually elicited by the re-exposure of the patients to the clinical context they need to attend to be treated. There has been considerable agreement that AN represents a paradigmatic example of Pavlovian conditioning, and within this framework, several behavioral interventions have been proposed in order to prevent this phenomenon. However, some studies have questioned the validity of the Pavlovian approach, suggesting that CS-US associations are neither necessary nor sufficient for AN to occur. The data and the alternative theories behind such criticisms are discussed. Additionally, it is suggested that animal models of AN could be enriched by taking into account rats' individual differences.
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Affiliation(s)
- Marcial Rodríguez
- Laboratory of Comparative Psychology, Department of Experimental Psychology, Faculty of Education and Humanities, University of Granada Ceuta, Spain
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12
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Younger J, Gandhi V, Hubbard E, Mackey S. Development of the Stanford Expectations of Treatment Scale (SETS): A tool for measuring patient outcome expectancy in clinical trials. Clin Trials 2012; 9:767-76. [DOI: 10.1177/1740774512465064] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background A patient’s response to treatment may be influenced by the expectations that the patient has before initiating treatment. In the context of clinical trials, the influence of participant expectancy may blur the distinction between real and sham treatments, reducing statistical power to detect specific treatment effects. There is therefore a need for a tool that prospectively predicts expectancy effects on treatment outcomes across a wide range of treatment modalities. Purpose To help assess expectancy effects, we created the Stanford Expectations of Treatment Scale (SETS): an instrument for measuring positive and negative treatment expectancies. Internal reliability of the instrument was tested in Study 1. Criterion validity of the instrument (convergent, discriminant, and predictive) was assessed in Studies 2 and 3. Methods The instrument was developed using 200 participants in Study 1. Reliability and validity assessments were made with an additional 423 participants in Studies 2 and 3. Results The final six-item SETS contains two subscales: positive expectancy (α = 0.81–0.88) and negative expectancy (α = 0.81–0.86). The subscales predict a significant amount of outcome variance (between 12% and 18%) in patients receiving surgical and pain interventions. The SETS is simple to administer, score, and interpret. Conclusion The SETS may be used in clinical trials to improve statistical sensitivity for detecting treatment differences or in clinical settings to identify patients with poor treatment expectancies.
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Affiliation(s)
- Jarred Younger
- Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Vanisha Gandhi
- Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Emily Hubbard
- Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - Sean Mackey
- Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
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13
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Kohila V, Jaiswal A, Ghosh SS. Rationally designed Escherichia coli cytosine deaminase mutants with improved specificity towards the prodrug 5-fluorocytosine for potential gene therapy applications. MEDCHEMCOMM 2012. [DOI: 10.1039/c2md20209c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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14
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Higgins SC, Montgomery GH, Raptis G, Bovbjerg DH. Effect of pretreatment distress on daily fatigue after chemotherapy for breast cancer. J Oncol Pract 2011; 4:59-63. [PMID: 20856780 DOI: 10.1200/jop.0822002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Fatigue is one of the most frequently reported and adverse effects of cancer chemotherapy. The present study tested the hypothesis that women's levels of emotional distress at the time of their initial outpatient chemotherapy treatment would predict the severity of their postinfusion fatigue. METHODS Sixty stage I (32.6%) and II (67.4%) patients with breast cancer (mean age, 44.5 years) who were receiving standard outpatient chemotherapy participated. The independent variable, emotional distress, was assessed for "last night," "this morning," and "right now" with a visual analog scale (0 to 100). The dependent variable, post-treatment fatigue (PTF), was assessed (0 to 100) over each of the subsequent 6 days using end-of-day diaries, which also included assessments of distress and nausea (0 to 100). For the statistical analyses, post-treatment fatigue was divided into three phases with means calculated for days 1 through 2 (phase 1), 3 to 4 (phase 2), and 5 to 6 (phase 3). RESULTS Consistent with the study hypothesis, patients' pretreatment distress level in the clinic was a significant (P < .001) predictor of PTF. There was also a significant (P < .025) interaction with phase, with distress becoming a predictor of PTF after phase 1. Multivariate analysis indicated that prior levels of distress were not independent predictors of PTF. CONCLUSIONS This study is the first to demonstrate time-specific effects of pretreatment distress on PTF. Possible mechanisms of these effects now warrant investigation, as do possible benefits of brief interventions to reduce patient distress immediately before treatment.
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Affiliation(s)
- Sara C Higgins
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences; Biobehavioral Medicine Program, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY
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15
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Colagiuri B, Zachariae R. Patient expectancy and post-chemotherapy nausea: a meta-analysis. Ann Behav Med 2011; 40:3-14. [PMID: 20387022 DOI: 10.1007/s12160-010-9186-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Post-chemotherapy nausea remains a significant burden to cancer patients. While some studies indicate that expecting nausea is predictive of experiencing nausea, there are a number of conflicting findings. PURPOSE The purpose of this study was to conduct a meta-analytic review to determine the strength of the relationship between expectancy and post-chemotherapy nausea. METHODS The findings from 17 relevant studies (n = 2,400) identified through systematic searches of Medline, PsycInfo, and Cinhal were analyzed using a combination of meta-analytic techniques. RESULTS Overall, there was a robust positive association between expectancy and post-chemotherapy nausea (ESr = 0.18, equivalent to Cohen's d = 0.35), suggesting that patients with stronger expectancies experience more chemotherapy-induced nausea. Although weaker associations were found in studies employing multivariate analysis, specifically controlling for a history of nausea, and involving breast cancer patients, none of the moderators assessed were statistically significant. CONCLUSIONS These findings suggest that patient expectancies may contribute to post-chemotherapy nausea and that expectancy-based manipulations may provide a useful intervention strategy.
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Affiliation(s)
- Ben Colagiuri
- School of Psychology, A18, University of Sydney, Sydney, NSW, 2006, Australia.
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16
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Akechi T, Okuyama T, Endo C, Sagawa R, Uchida M, Nakaguchi T, Sakamoto M, Komatsu H, Ueda R, Wada M, Furukawa TA. Anticipatory nausea among ambulatory cancer patients undergoing chemotherapy: prevalence, associated factors, and impact on quality of life. Cancer Sci 2010; 101:2596-600. [PMID: 20946120 PMCID: PMC11159932 DOI: 10.1111/j.1349-7006.2010.01718.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The purposes of this study were to investigate the prevalence of anticipatory nausea (AN), its associated factors, and its impact on quality of life (QOL) among ambulatory cancer patients receiving chemotherapy. Patients were randomly selected to participate in this study, and were asked to complete the Morrow Assessment of Nausea and Emesis scale, the Hospital Anxiety and Depression Scale, the Short-form Supportive Care Needs Survey questionnaire, and the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire. Complete data were available for 214 patients. A total of 10.3% of the patients experienced very mild to severe AN. The presence of AN was significantly associated with most domains of the investigated patients' outcome, including psychological distress and perceived needs, with the exception of the health system and information domain of patients' needs, and the physical functioning domain of QOL. Anticipatory nausea was also associated with QOL even after adjustments for age, sex, performance status, and psychological distress. The prevalence of AN in ambulatory cancer patients who receive chemotherapy may not be as high as previously reported. However, given its potentially significant impact on relevant outcome, including QOL, AN should not be neglected in current clinical oncology practice. (Cancer Sci 2010; 101: 2596-2660).
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Hospital, Mizuho-ku, Nagoya, Japan.
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17
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Assessment of symptom control in patients with cancer in Northwestern Turkey. Eur J Oncol Nurs 2010; 15:137-44. [PMID: 20832359 DOI: 10.1016/j.ejon.2010.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 06/10/2010] [Accepted: 07/09/2010] [Indexed: 11/21/2022]
Abstract
AIM The main purpose of this cross-sectional study was to compare symptoms occurring before and after chemotherapy treatment and to investigate the factors affecting those symptoms. The secondary purpose was to determine the most commonly occurring symptoms experienced by the patients with cancer after chemotherapy. METHODS Fifty inpatients and outpatients receiving chemotherapy for the first time with various cancer diagnoses and hospitalized in the oncology unit of Trakya University Medical Faculty Hospital between July 2006 and April 2007 were attended to the study. Data were collected using the Edmonton Symptom Assessment Scale (ESAS). RESULTS It was discovered that symptoms of fatigue, nausea, loss of appetite, impaired sense of well-being, changes in skin and nails, stomatitis and numbness in hands among chemotherapy patients increased by a statistically significant margin after treatment (p<0.05). Post-chemotherapy symptoms increased markedly (p<0.05) among patients within groups determined by age, gender, marital status, stage of cancer and date of diagnosis. Cross-group comparisons of post-chemotherapy participants analyzed in terms of marital status, clinical stage of disease, and date of diagnosis revealed that fewer symptoms (drowsiness and shortness of breath) increased compared to other symptoms measured along with treatment (p<0.05). CONCLUSION We conclude that by considering personal characteristic (i.e. age, gender, etc.) as well as disease-related characteristics (i.e. clinical stage of the disease, etc.), individual nursing care might significantly contribute to the alleviation and management of symptoms.
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Risk factors at pretreatment predicting treatment-induced nausea and vomiting in Australian cancer patients: a prospective, longitudinal, observational study. Support Care Cancer 2010; 19:1549-63. [PMID: 20811914 DOI: 10.1007/s00520-010-0982-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Accepted: 08/16/2010] [Indexed: 11/12/2022]
Abstract
PURPOSE Despite significant advances in antiemetic management, almost 50% of cancer patients still experience nausea and vomiting during treatment. The goal of antiemetic therapy is complete prevention of treatment-induced nausea and/or vomiting (TINV); however, realisation of this goal remains elusive, thus supplementary strategies identifying patients at high risk must be employed in the interim. Consequently, we examined TINV incidence and its risk factors, including patient, clinical and pretreatment quality of life (QOL)/psychological factors. METHODS Two hundred newly diagnosed cancer patients beginning combined treatment participated in this prospective, longitudinal, observational study. QOL (including TINV), psychological adjustment, and patient/clinical characteristics were examined at pretreatment, on-treatment (8 weeks ± 1 week) and post-treatment. RESULTS Overall, 62% of patients experienced TINV, with TIN incidence (60%) doubling that of TIV (27%). Eight independent risk factors predicted 73% of TIN incidence: high premorbid/anticipatory NV, moderately/highly emetogenic chemotherapy (M/HEC), longer treatment (>3 months), female gender, surgery prior to adjuvant chemotherapy ± radiotherapy, private health insurance and low emotional functioning (pretreatment). Six independent risk factors predicted 77% of TIV incidence: premorbid/anticipatory vomiting, M/HEC, female gender, cancer resection and low role functioning (pretreatment). CONCLUSIONS TINV still represents a very major concern for patients. Several pretreatment risk factors for the development of TIN and TIV, respectively, were identified. Patients about to undergo cancer treatment, particularly combined treatment involving emetogenic chemotherapy and surgery, should be screened for these factors with a view to modifying standard pretreatment/maintenance antiemetic therapy. Furthermore, and consistent with recent research, it is recommended that more comprehensive interventions combining antiemetics with other effective pharmacological (e.g. anxiolytics) and non-pharmacological approaches (e.g. acupuncture, relaxation techniques) be considered by clinicians in attempts to improve control of TIN and TIV (and overall QOL) for their patients. In this way, optimal holistic care will be ensured for cancer patients by clinicians providing conventional oncology treatment.
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19
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Denial and physical outcomes in lung cancer patients, a longitudinal study. Lung Cancer 2010; 67:237-43. [DOI: 10.1016/j.lungcan.2009.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Revised: 04/07/2009] [Accepted: 04/11/2009] [Indexed: 11/22/2022]
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20
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Sohl SJ, Schnur JB, Montgomery GH. A meta-analysis of the relationship between response expectancies and cancer treatment-related side effects. J Pain Symptom Manage 2009; 38:775-84. [PMID: 19775863 PMCID: PMC2783563 DOI: 10.1016/j.jpainsymman.2009.01.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Revised: 01/13/2009] [Accepted: 02/19/2009] [Indexed: 01/30/2023]
Abstract
Response expectancies, defined as expectations for nonvolitional responses, have been proposed to contribute to the experience of side effects of cancer and its treatment. To statistically evaluate this association, a systematic search of the published literature was conducted, resulting in 14 studies appropriate for meta-analysis. Results revealed a significant (Z=6.58, P<0.001) medium-sized (r=0.36) association between patients' response expectancies for cancer treatment-related side effects and the experience of these side effects. Assessment of response expectancies with reference to the time the treatment-related side effect would occur resulted in larger effect sizes than when such temporal specificity in assessment was not included, Q(1)=10.27, P<0.01. Effect sizes were also moderated by patients' prior experience with cancer treatment, Q(1)=18.91, P=0.001, such that prior experience led to stronger associations between response expectancies and side effects than no prior experience. Relationships between response expectancies and pain, fatigue, nausea, and vomiting were explored. Effect sizes did not differ between side effects, with the exception that the relationship was significantly stronger for pain than for vomiting (P<0.05). Overall, these results support the contribution of response expectancies to cancer treatment-related side effects. Additionally, the results support the conduct of research on interventions to alter response expectancies, with the goal of reducing side effects and improving patient quality of life.
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Affiliation(s)
- Stephanie J Sohl
- Department of Oncological Sciences, Mount Sinai School of Medicine, New York, New York 10029-6574, USA.
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21
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Shin HW, Noh DY, Lee ES, Nam SJ, Park BW, Ahn SH, Yun YH. Correlates of existential well-being and their association with health-related quality of life in breast cancer survivors compared with the general population. Breast Cancer Res Treat 2009; 118:139-50. [DOI: 10.1007/s10549-009-0326-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Accepted: 01/20/2009] [Indexed: 11/30/2022]
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Lee J, Dodd M, Dibble S, Abrams D. Review of acupressure studies for chemotherapy-induced nausea and vomiting control. J Pain Symptom Manage 2008; 36:529-44. [PMID: 18440769 DOI: 10.1016/j.jpainsymman.2007.10.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Revised: 10/03/2007] [Accepted: 11/01/2007] [Indexed: 01/22/2023]
Abstract
The purpose of this review was to evaluate the effects of a noninvasive intervention, acupressure, when combined with antiemetics for the control of chemotherapy-induced nausea and vomiting (CINV). Ten controlled acupressure studies were included in this review. The review evaluated one quasi-experimental and nine randomized clinical trials, which included two specific acupressure modalities, that is, acupressure band and finger acupressure. The effects of the acupressure modalities were compared study by study. Four of seven acupressure band trials supported the positive effects of acupressure, whereas three acupressure band trials yielded negative results regarding the possible effects of acupressure; however, all the studies with negative results had methodological issues. In contrast, one quasi-experimental and two randomized finger acupressure trials all supported the positive effects of acupressure on CINV control. The reported effects of the two acupressure modalities in each phase of CINV produced variable results. Acupressure bands were effective in controlling acute nausea, whereas finger acupressure controlled delayed nausea and vomiting. The overall effect of acupressure was strongly suggestive but not conclusive. Differences in the acupressure modality, the emetic potential of chemotherapeutic agents, antiemetic use, and sample characteristics of each study made study-to-study comparisons difficult. Suggestive effects of acupressure, cost-effectiveness, and the noninvasiveness of the interventions encourage researchers to further investigate the efficacy of this modality. Acupressure should be strongly recommended as an effective, nonpharmacologic adjuvant intervention for CINV control if its positive effects are reproduced in future acupressure clinical trials.
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Affiliation(s)
- Jiyeon Lee
- School of Nursing, University of California, San Francisco, California 94143, USA.
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23
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Mustian KM, Darling TV, Janelsins MC, Jean-Pierre P, Roscoe JA, Morrow GR. Chemotherapy-Induced Nausea and Vomiting. ACTA ACUST UNITED AC 2008; 4:19-23. [PMID: 24761161 DOI: 10.17925/ohr.2008.04.1.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Despite treatment advances, nausea and vomiting, especially anticipatory nausea and vomiting, delayed nausea and vomiting and nausea alone, are still the most common, expected and feared side effects among patients receiving chemotherapy. Of the 70 to 80% of cancer patients who experience chemotherapy-induced nausea and vomiting many will delay or refuse future chemotherapy treatments and contemplate stopping all treatments because of fear of further nausea and vomiting. The purpose of this chapter is to provide an overview of the patho-psychophysiology of CINV, the recommended guidelines for standard treatment, and highlight newer targeted treatment approaches.
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Affiliation(s)
- Karen M Mustian
- University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Center, Box 704, 601 Elmwood Avenue, Rochester, NY 14642
| | - Tom V Darling
- University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Center, Box 704, 601 Elmwood Avenue, Rochester, NY 14642
| | - Michelle C Janelsins
- University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Center, Box 704, 601 Elmwood Avenue, Rochester, NY 14642
| | - Pascal Jean-Pierre
- University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Center, Box 704, 601 Elmwood Avenue, Rochester, NY 14642
| | - Joseph A Roscoe
- University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Center, Box 704, 601 Elmwood Avenue, Rochester, NY 14642
| | - Gary R Morrow
- University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Center, Box 704, 601 Elmwood Avenue, Rochester, NY 14642
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Zachariae R, Paulsen K, Mehlsen M, Jensen AB, Johansson A, von der Maase H. Anticipatory Nausea: The Role of Individual Differences Related to Sensory Perception and Autonomic Reactivity. Ann Behav Med 2007; 33:69-79. [PMID: 17291172 DOI: 10.1207/s15324796abm3301_8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Anticipatory nausea (AN) during chemotherapy has been difficult to control with conventional antiemetics. AN can lead cancer patients to delay or discontinue chemotherapy, possibly compromising the treatment. PURPOSE The aim is to investigate the possible influence on the development of AN of individual differences in absorption, somato-sensory amplification, and autonomic perception-measures theorized to be related to sensory perception and autonomic reactivity. METHODS Prior to treatment, 125 women (M age = 48.5 years) undergoing adjuvant chemotherapy for breast cancer rated their expected severity of side effects and completed the Tellegen Absorption Scale, the Somato-Sensory Amplification Scale, and the Autonomic Perception Questionnaire. AN, as well as anticipatory vomiting (AV), distress, and worry/anxiety, were measured prior to the fourth, sixth, and last cycle of chemotherapy. Posttreatment nausea (PN), vomiting, and fatigue were measured after the first, fourth, sixth, and last cycle. RESULTS 34% of the women reported AN before 1 or more cycles. When controlling for treatment characteristics and other known predictors, AN was significantly associated with high absorption in addition to severity of PN, pretreatment worry/anxiety, and not receiving radiotherapy between chemotherapy sessions. AV was not associated with any of the variables investigated. Our data suggest that the association is strongest in the early phases of treatment. CONCLUSIONS Our results partly confirm the results of a previous study showing absorption and autonomic perception as predictors of anticipatory side effects in cancer patients receiving chemotherapy. Individuals high in absorption may be more autonomically reactive to aversive stimuli and, subsequently, more conditionable. Additional radiotherapy could be a competing stimulus, reducing the conditioning of chemotherapy-related nausea. Further studies investigating possible psycho-physiological mechanisms in the development of AN are needed.
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Affiliation(s)
- R Zachariae
- Psychooncology Research Unit, Department of Oncology, Aarhus University Hospital, and Institute of Psychology, University of Aarhus, Denmark.
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Roscoe JA, Jean-Pierre P, Shelke AR, Kaufman ME, Bole C, Morrow GR. The role of patients' response expectancies in side effect development and control. Curr Probl Cancer 2006; 30:40-98. [PMID: 16516693 DOI: 10.1016/j.currproblcancer.2005.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Joseph A Roscoe
- Department of Radiation Oncology, University of Rochester, James P. Wilmot Cancer Center, Rochester, New York, USA
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26
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Higgins SC, Montgomery GH, Bovbjerg DH. Distress before chemotherapy predicts delayed but not acute nausea. Support Care Cancer 2006; 15:171-7. [PMID: 16896879 DOI: 10.1007/s00520-006-0113-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Accepted: 06/14/2006] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Posttreatment nausea (PTN) is a common side effect of cytotoxic cancer chemotherapy. Previous retrospective research has suggested that the severity of PTN may be, in part, related to pretreatment psychological factors (e.g., emotional distress and expectations for nausea). MATERIALS AND METHODS The purpose of the present study was to examine these relationships prospectively, with distress and nausea expectations assessed by validated self-report measures completed in the clinic before the participants' first outpatient treatment infusion and with PTN (0-100) assessed by end-of-day diaries completed at home on each of the first 5 days after treatment. The participants were chemotherapy-naive women (N=56) scheduled for standard adjuvant treatment for stage I-II breast cancer (mean age=45.6 years). PTN was evaluated for acute (days 0-1) and delayed (days 2-5) responses. RESULTS The results revealed a significant relationship between pretreatment distress and the severity of the patients' subsequent delayed nausea (p<0.007) but not a relationship with acute PTN (p<0.19). No significant relationships were seen between expectations and PTN. However, there was evidence of an additive effect of nausea expectations and distress, with the highest levels of delayed PTN seen in patients with both expectations and higher distress before treatment. The results suggest a selective effect of pre-infusion psychological variables on the delayed phase of nausea after chemotherapy, consistent with an emerging view that the different phases of nausea are mediated by different neural pathways. CONCLUSION Future research should examine the possibility that delayed nausea, which the literature suggests is more resistant to antiemetic drugs than acute nausea, might be responsive to psychological interventions before initial treatments.
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Affiliation(s)
- Sara C Higgins
- Biobehavioral Medicine Program, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.
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Pugliese P, Perrone M, Nisi E, Garufi C, Giannarelli D, Bottomley A, Terzoli E. An integrated psychological strategy for advanced colorectal cancer patients. Health Qual Life Outcomes 2006; 4:9. [PMID: 16460566 PMCID: PMC1409769 DOI: 10.1186/1477-7525-4-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2003] [Accepted: 02/06/2006] [Indexed: 11/12/2022] Open
Abstract
Background There is evidence regarding the usefulness of psychosocial intervention to improve health related quality of life (HRQOL) in adult cancer patients. The aim of this report is to describe an integrated approach and to evaluate its feasibility in routine clinical practice in 98 advanced colorectal cancer (ACC) patients during chronomodulated chemotherapy. Methods A prospective non-randomised design was developed and applied in a cancer out-patient setting. The intervention consisted of an integrated approach, whereby the psycho-oncologist had an active role in the health care team with the physician and routinely included psychological understanding in the medical treatment program. The psychological evaluation assessed: a) adaptation, awareness, psychopathological disorders through a psychodynamic interview; b) anxiety and depression using the HAD scale; c) subjective perception of care quality through a structured interview and d) HRQOL evaluation assessment with the EORTC QLQ C30. Outcomes data were collected before and after 18 weeks of chemotherapy. Results After 18 weeks of chemotherapy a significant improvement of adaptation and awareness was observed. The HADs results showed a significant decrease in anxiety when compared to pre-treatment. The structured interview showed a significant increase of patients who positively experienced the impact of medical treatment on HRQOL, anxiety, depression, interpersonal relationships, free-time and who positively experienced the care quality. Indeed, a majority of patients positively experienced the team relationship modality during the whole treatment. All scales on the EORTC questionnaire remained unchanged during the entire treatment. Conclusion Our results suggest that it is feasible to carry out an integrated approach during chemotherapy. These results seem to support the integrated approach as a tool in aiding advanced colorectal cancer patients' ability to cope with their diagnosis and treatment although an appropriately designed study is required to confirm this.
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Affiliation(s)
- Patrizia Pugliese
- Service of Psychology, Regina Elena Cancer Institute, Via Elio Chianesi, 53, 00144 Rome, Italy
| | - Maria Perrone
- Service of Psychology, Regina Elena Cancer Institute, Via Elio Chianesi, 53, 00144 Rome, Italy
| | - Enrica Nisi
- Service of Psychology, Regina Elena Cancer Institute, Via Elio Chianesi, 53, 00144 Rome, Italy
| | - Carlo Garufi
- S.C. Medical Oncology "C", Regina Elena Cancer Institute, Rome, Italy
| | | | - Andrew Bottomley
- European Organisation for Research and Treatment of Cancer, EORTC Data Center, Brussels, Belgium
| | - Edmondo Terzoli
- S.C. Medical Oncology "C", Regina Elena Cancer Institute, Rome, Italy
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Yoo HJ, Ahn SH, Kim SB, Kim WK, Han OS. Efficacy of progressive muscle relaxation training and guided imagery in reducing chemotherapy side effects in patients with breast cancer and in improving their quality of life. Support Care Cancer 2005; 13:826-33. [PMID: 15856335 DOI: 10.1007/s00520-005-0806-7] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2004] [Accepted: 03/01/2005] [Indexed: 11/27/2022]
Abstract
GOALS This study was designed to assess the effectiveness of progressive muscle relaxation training (PMRT) and guided imagery (GI) in reducing the anticipatory nausea and vomiting (ANV) and postchemotherapy nausea and vomiting (PNV) of patients with breast cancer and to measure their effects on the patients' quality of life (QoL). PATIENTS AND METHODS Thirty chemotherapy-naive patients with breast cancer were randomized to the PMRT and GI group and 30 to the control group. Before each of six cycles of adjuvant chemotherapy, each patient was administered a self-report Multiple Affect Adjective Checklist (MAACL), and incidents of ANV and PNV for the first three postchemotherapy days were recorded. All patients were administered the Functional Assessment of Cancer Therapy-Breast (FACT-B) at baseline and after 3 and 6 months. RESULTS We found that the PMRT and GI group was significantly less anxious, depressive, and hostile than the control group. We also found that the PMRT and GI group experienced significantly less ANV and PNV and that 6 months after CT, the QoL of the PMRT and GI group was higher than that of the control group. CONCLUSION These results indicate that PMRT and GI were associated with both the improvements in ANV and PNV and in the QoL of patients with breast cancer.
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Affiliation(s)
- Hee J Yoo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Pungnap-dong Songpa-gu, 138-736 Seoul, South Korea.
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Farrell C, Heaven C, Beaver K, Maguire P. Identifying the concerns of women undergoing chemotherapy. PATIENT EDUCATION AND COUNSELING 2005; 56:72-77. [PMID: 15590225 DOI: 10.1016/j.pec.2003.12.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2003] [Revised: 11/12/2003] [Accepted: 12/22/2003] [Indexed: 05/24/2023]
Abstract
This cross-sectional study aimed to identify key concerns of cancer patients receiving in-patient chemotherapy, determine the prevalence of anxiety and depression, and assess whether ward nurses could identify patients' concerns. Thirty-three women on a chemotherapy ward in the northwest of England who had breast, ovarian, cervical or uterine cancer were interviewed using a Concerns Checklist and the Hospital Anxiety and Depression Scale. Patients expressed an average of 10.3 concerns (range: 2-27). Eighty percent of these were not identified by the nurses, who showed a clear bias towards physical symptoms and treatment-related concerns. The nurses were unable to identify the three main concerns in 70% of patients. Twenty-four percent of patients were found to be probable cases of anxiety and/or depression; there was a moderate correlation between the number of concerns and levels of anxiety and depression. Given the body of evidence that lack of identification of concerns leads to unmet needs, increased psychological distress, dissatisfaction with care and possible complaints, this study has provided clear evidence for the need to address this key area of care, and has highlighted the potential of the Concerns Checklist in busy clinical environments.
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Affiliation(s)
- Carole Farrell
- Christie Hospital NHS Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK
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30
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Aapro MS, Molassiotis A, Olver I. Anticipatory nausea and vomiting. Support Care Cancer 2004; 13:117-21. [PMID: 15599779 DOI: 10.1007/s00520-004-0745-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2004] [Accepted: 11/02/2004] [Indexed: 02/06/2023]
Abstract
Anticipatory nausea and vomiting (ANV) is not only a learned response but can occur without prior exposure to chemotherapy depending on patient emotional distress and expectations. The best method to avoid development or reinforcement of ANV is to avoid both vomiting and nausea from the first exposure to chemotherapy. If ANV develops, benzodiazepines have been documented to help in adult patients, and several psychological techniques are also of help, including systematic desensitization. The evidence on which these conclusions are based is reviewed in this article.
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Affiliation(s)
- Matti S Aapro
- IMO Clinique de Genolier, CH-1272 Genolier, Switzerland.
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31
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Silva LM, Takahashi CS, Carrara HHA. Study of chromosome damage in patients with breast cancer treated by two antineoplastic treatments. TERATOGENESIS, CARCINOGENESIS, AND MUTAGENESIS 2002; 22:257-69. [PMID: 12111710 DOI: 10.1002/tcm.10019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The frequencies of chromosomal aberrations (CAs) and sister chromatid exchanges (SCEs) were determined in peripheral blood lymphocyte cultures from women with breast cancer treated by chemotherapy (CT) with FEC (5-fluorouracil, epirubicin, and cyclophosphamide) or CMF (cyclophosphamide, methotrexate, and 5-fluorouracil) cocktail in six CT cycles. The number of patients in each CT cycle were from 1 to 3 for SCE and 2 to 5 for CA. Samples were collected before and 48 h after CT. Although the size of the sample was limited and interindividual variability was wide, it appears that a 21-day interval between CT sessions is sufficient for cell recovery. This fact was demonstrated by the reduction in CA and SCE frequencies between cycles in parallel with the unchanged mitotic index and proliferative index values.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/drug therapy
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/genetics
- Carcinoma, Lobular/pathology
- Cell Division/drug effects
- Chromosome Aberrations/drug effects
- Chromosomes, Human/drug effects
- Chromosomes, Human/ultrastructure
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/pharmacology
- DNA Damage
- Drug Administration Schedule
- Epirubicin/administration & dosage
- Epirubicin/pharmacology
- Female
- Fluorouracil/administration & dosage
- Fluorouracil/pharmacology
- Humans
- Methotrexate/administration & dosage
- Methotrexate/pharmacology
- Middle Aged
- Mitotic Index
- Sister Chromatid Exchange/drug effects
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Affiliation(s)
- L M Silva
- Faculty of Medicine of Ribeirão Preto, Department of Genetics, São Paulo University, São Paulo, Brazil.
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Cooper R, Gent P. An overview of chemotherapy-induced emesis highlighting the role of lorazepam as adjuvant therapy. Int J Palliat Nurs 2002; 8:331-5. [PMID: 12165717 DOI: 10.12968/ijpn.2002.8.7.10673] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
By preventing and optimizing emesis control in patients receiving chemotherapy, clinicians may significantly improve patients' functional status and quality of life. Improved tolerability may lead to greater patient acceptance of chemotherapy and prevent premature withdrawal or cessation of treatment. Controlling chemotherapy-induced emesis also helps to decrease the direct and indirect costs of managing cancer. This article reviews improvements made in antiemetic therapy and considers how the addition of lorazepam may further optimize the prevention and management of emesis at various stages of manifestation.
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Affiliation(s)
- Ruth Cooper
- Department of Palliative Medicine, Roxburghe House, Aberdeen, UK
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Hickok JT, Roscoe JA, Morrow GR. The role of patients' expectations in the development of anticipatory nausea related to chemotherapy for cancer. J Pain Symptom Manage 2001; 22:843-50. [PMID: 11576801 DOI: 10.1016/s0885-3924(01)00317-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although anticipatory nausea (AN), which is reported by one-third of patients receiving chemotherapy for cancer, is thought to develop primarily by classical conditioning, response expectancies may also be important. The role of patients' expectations of nausea in the development of AN was examined in 63 female cancer patients receiving their first course of chemotherapy. Twenty women (32%) expected to experience nausea and twelve (19%) reported AN before the third cycle. Pretreatment expectations predicted AN at cycle three (Spearman's r = 0.41, P = 0.001). AN developed in 40% of patients who expected nausea, 13% of those who were uncertain whether they would develop it, and no patients who did not expect nausea. Logistic regression indicated that expecting nausea was the strongest predictor (chi(2) =13.15; P < 0.001). Results support a role for cognitive factors in the development of chemotherapy side effects and suggest testing psychologic interventions to modify patients' expectations.
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Affiliation(s)
- J T Hickok
- University of Rochester Cancer Center, Rochester, NY 14642, USA
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Montgomery GH, Bovbjerg DH. Specific response expectancies predict anticipatory nausea during chemotherapy for breast cancer. J Consult Clin Psychol 2001; 69:831-5. [PMID: 11680560 DOI: 10.1037/0022-006x.69.5.831] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Clinical research has demonstrated that large numbers of chemotherapy patients continue to experience nausea in the clinic prior to infusions. A better understanding of the mechanisms responsible for such anticipatory nausea (AN) is likely to provide critical information for identifying intervention targets. In the present study the authors investigated the contribution of expectancy, history of nausea, and distress to AN in 60 women with Stage I or II breast cancer receiving standard adjuvant chemotherapy. The predictors were each independently associated with AN (p < .05). However, only expectations significantly predicted AN in simultaneous regression analyses. Results suggest that interventions to reduce AN during chemotherapy should target patients' expectations.
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Affiliation(s)
- G H Montgomery
- Ruttenberg Cancer Center, Mount Sinai School of Medicin, New York, New York 10029, USA.
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Affiliation(s)
- E M Quigley
- Sections of Gastroenterology and Hepatology University of Nebraska Medical Center Omaha, Nebraska, USA
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