Management of Emotionally Challenging Responses of Hospitalized Patients with Cancer

Acute effect of orange chromatic environment on perceived health status, pain, and vital signs during chemotherapy treatment

PURPOSE

The study is aimed at assessing the acute effect of orange color and natural light exposure on cancer patients during chemotherapy sessions. Warmer environments and rooms receiving more sunlight hours were expected to impact vital signs, quality of life, and pain symptoms.

METHODS

We used a single-group repeated-measures clinical trial design. For the purpose of the study, chemotherapy rooms were modified based on two experimental factors: color (white vs. orange) and sunlight orientation (south vs. north). On four consecutive sessions, cancer patients were randomly assigned to one of the following conditions: orange-north, orange-south, white-north, and white-south. They received chemotherapy per standard of care. The following outcomes were assessed: blood pressure, body temperature, heart rate, and European Quality of Life Five-Dimension Five-Level Scale Questionnaire (EUROQOL-5D-5L) including the visual analogue scale (EQ-VAS).

RESULTS

Statistically significant beneficial effect of orange color room in self-rated health was found (p = 0.036, d = 0.28). Small differences in other parameters (body temperature, d = 0.34; diastolic blood pressure, d = 0.37; systolic blood pressure, d = 0.28) did not reach statistical significance. No differences were found based on room orientation.

CONCLUSIONS

Compared with a cool-color design, a warm-color living environment could have a positive effect on patients' well-being during chemotherapy sessions. Although the clinical effect size on perceived health status and vital signs could be considered small, the cost-effectiveness analysis would support the use of the proposed configurations. More research is still needed.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03873519.

FOXK transcription factors: Regulation and critical role in cancer

Growing evidence suggests that alterations of gene expression including expression and activities of transcription factors are closely associated with carcinogenesis. Forkhead Box Class K (FOXK) proteins, FOXK1 and FOXK2, are a family of evolutionarily conserved transcriptional factors, which have recently been recognized as key transcriptional regulators involved in many types of cancer. Members of the FOXK family mediate a wide spectrum of biological processes, including cell proliferation, differentiation, apoptosis, autophagy, cell cycle progression, DNA damage and tumorigenesis. Therefore, the deregulation of FOXKs can affect the cell fate and they promote tumorigenesis as well as cancer progression. The mechanisms of FOXKs regulation including post-translational modifications (PTMs), microRNAs (miRNAs) and protein-protein interactions are well demonstrated. However, the detailed mechanisms of FOXKs activation and deregulation in cancer progression are still inconclusive. In this review, we summarize the regulatory mechanisms of FOXKs expression and activity, and their role in the development and progression of cancer. We have discussed whether FOXKs act as tumor suppressors/oncoproteins in tumor cells and their therapeutic applications in malignant diseases are also discussed. This review may assist in designing experimental studies involving FOXKs and it would strength the therapeutic potential of FOXKs as targets for cancers.