Purpose: This study was to investigate symptom occurrence related to the disease characteristics of patients with cancer. Method: A total of 301 patients with cancer participated in this study. The participants were recruited from University Hospitals located in Seoul, Wonju, Kwangju, Daegu, and Pusan. Data collection was performed by using a questionnaire on symptom occurrence. The obtained data was analyzed using SPSS computer program that included descriptive statistics, Pearson correlation, one-way ANOVA, and t-test. Result: The mean score of fatigue was the highest (3.24), followed by loss of appetite, lack of concentration, change in appearance, pain, insomnia, change in bowel pattern, nausea/vomiting, coughing, and dyspnea. Most symptoms were significantly correlated with each other. The level of symptom occurrence in patients with lung cancer or cervix cancer was significantly higher than the level in patients with stomach cancer. Patients receiving radiation therapy or a combined therapy of radiation therapy and chemotherapy experienced significantly higher level of symptom occurrence than those receiving chemotherapy only. Also, female patients experienced higher level of symptom occurrence than male patients did. Conclusion: The sites of cancer, types of treatment, and gender influence the level of symptom occurrence of patients with cancer. Thus, these variables should be considered when assessing and planing for symptom occurrence of patients with cancer.
Purpose: The purpose of this study was to analyze nursing research trends on the complementary and alternative therapies (CAT) for the cancer patients in Korea. Method: Thirty eight articles published in 17 nursing-related journal from 1987 to 2008 were analyzed. Results: Nursing Researches on CAT for the cancer patients have increased since 2000. Among the 38 studies, 34 studies used Quasi-experimental design and 13 studies (33%) were conducted for the breast cancer patients. Mind-body therapy (53%), manual healing therapy (42%), and pharmacologic and biological therapy (5%) were the often used CAT types. Nausea, vomiting, vital signs, immune cell, pain, and fatigue were measured as physiologic outcome variables; anxiety, depression, and hope as psychological outcome variables; and quality of life as social outcome variables. Conclusion: More CAM studies are needed targeting the patients with various cancer types and home-based cancer patients.
Purpose: The purpose of this study was to identify correlates influencing cognitive impairment in breast cancer patients receiving chemotherapy. Methods: Study subjects consisted of 102 breast cancer patients who received chemotherapy. Subjects were the members of a breast cancer self-help group. Data were collected using structured self-reporting questionnaires including scales of cognitive impairment, physical status, fatigue, quality of life, emotional status, sleeping, family support, and menopausal symptoms. Statistical Package for Social Sciences was used for statistical analyses. Results: Breast cancer patients receiving chemotherapy appeared to show a high level of cognitive impairment. Among demographic characteristics, the effects of economic status and family type on cognitive impairment were found to be statistically significant. Among disease related characteristics, the effect of duration of chemotherapy on cognitive impairment was statistically significant. Menopausal symptoms were positively associated with cognitive impairment. The model including postmenopausal symptoms and caregiver type explained about 66% of variability in cognitive impairment. Conclusion: These findings highlight the importance of contextual factors in understanding cognitive impairment in breast cancer patients receiving chemotherapy and can be used to develop appropriate, effective nursing interventions.
Purpose: To assess chemoradiation related acute morbidity in women with carcinoma cervix and to find and correlation between hematologic toxicity and organ system specific damage. Materials and Methods: A prospective study was carried out between August 2012 and July 2013 enrolling 79 women with cancer cervix receiving chemo-radiotherapy. Weekly assessment of acute morbidity was done using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4 and the toxicities were graded. Results: Anemia [77 (97.5%)], vomiting [75 (94.8%)] and diarrhea [72 (91.1%)], leukopenia [11 (13.9%)], cystitis [28 (35.4%], dermatitis [19 (24.1%)] and fatigue [29 (36.71%)] were the acute toxicities noted. The toxicities were most severe in $3^{rd}$ and $5^{th}$ week. All women could complete radiotherapy except two due to causes unrelated to radiation morbidity; seven (8.86%) had to discontinue chemotherapy due to leukopenia and intractable diarrhea. Though there was no correlation between anemia and other toxicities, it was found that all with leukopenia had diarrhea. Conclusions: Chemoradiation for cancer cervix is on the whole well tolerated. Leukopenia and severe diarrhea were the acute toxicities that compelled discontinuation of chemotherapy in two women. Though anemia had no correlation with gastrointestinal toxicity, all of those with leukopenia had diarrhea.
Cordyceps militaris has been reported to the diverse pharmaceutical effects including cancer, inflammatory diseases, and bacteria or virus infection. However, the effect of C. militaris on exercise performance has not yet been elucidated. In this study, we investigated the beneficial effect of C. militaris on exercise performance. To evaluate exercise performance, we prepared C. militaris ethyl acetate extract (CMEE) and conducted grip strength tests every week after administration. Additionally, blood samples were collected at the end of the experiment for biochemical analysis. The administration of CMEE slightly increased grip strength, and this result was similar to the red ginseng treated group. According to the result of biochemical analysis, CMEE had an effect on the biomarkers related to ATP generation pathway but had little influence on the muscle fatigue related biomarkers. Therefore, C. militaris has the possibility of improving exercise performance, which could be associated with the increase in ATP production rather than the decrease in muscle fatigue during exercise.
Backgrounds: The demand of complementary and alternative medicine (CAM) including Korean Medicine (KM) is increasing worldwide. But cancer patients (CP) still have a difficulty in gathering CAM information or communicating with their doctors, and clinical status in cancer care is unclear in the field of KM in Korea especially. The aim of this study is to examine clinical status of KM for cancer symptom care by KM doctors in medical service institutions. Methods: Total forty nine KM doctors completed the site survey questionnaire. The questionnaire items were to list chief symptom complaints of CP treated with KM and effective KM therapies. Results: The majority of the respondents were general physicians without KM specialist board (67.4%) who have 10-20 years clinical experience with CP (55.1%). Primary cancer lesion, diagnostic status, and treatment period were not different in KM clinical service institutions. In chief symptom complaints of CP treated with KM, gastrointestinal (32.9%), musculoskeletal (19.9%), circulatory & respiratory (16.2%), psychiatric (14.1%), urinary (5.8%) symptoms were in turn. In effective KM therapies assessed by KM doctors, xerostomia (45.7%) and cancer-related fatigue (44.8%) were more effective with herbal treatments. Peripheral neuropathy (43.4%), depression, insomnia (38.2%), and cancer pain (31.9%) were preferred to treat using acupuncture. Conclusion: The CP treated with KM used evenly KM medical service institutions regardless of hospital size, and there will be further survey for CP treated KM in the future.
Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.
Purpose: The purpose of this study was to identify symptom cluster experienced by patients with advanced non-small cell lung cancer (NSCLC) on gefitinib treatment. In addition, this study assessed the patterns in severity of the symptom cluster and differences in quality of life (QOL) and function among subgroups by the severity of symptom cluster. Methods: This study was conducted as a secondary analysis of symptoms of 72 patients from a mother study. Factor analysis was used to identify symptom clusters measured with EORTC QLQ-C30 and LC13 symptom related items. Results: Three symptom clusters were identified: cluster 1 was comprised of fatigue, anorexia and dysphagia; cluster 2 of dyspnea, cough and insomnia; and cluster 3 of pain, constipation and nausea/vomiting. These three symptom clusters were improved one week after gefitinib administration. The group with more severe symptom clusters showed significantly lower QOL and function than the group with less severe symptom clusters. Conclusion: Since symptom clusters experienced by the patients with advanced NSCLC influenced on the QOL and function, it is important for nurses to understand and observe their symptom clusters. In addition, there is an necessity to develop nursing interventions to effectively care patients with the symptom clusters.
This case study describes the effect of Bojungikki-tang on chemotherapy-induced alopecia. Alopecia is a well-documented cause of distress to patients undergoing cancer treatment, but no approved pharmacological treatment exists for chemotherapy-induced hair loss. A 70-year-old female diagnosed with a cholangiocarcinoma and liver metastasis received chemotherapy, including gemcitabine and cisplatin, every three weeks. As a result of the continuous chemotherapy, she suffered various toxicity-related side effects, including bone marrow suppression, general weakness, nausea, peripheral numbness, and hair loss. Bojungikki-tang was initially administered to improve the patient's general weakness and fatigue. After three months of treatment, the patient's hair loss and general condition improved, and the color of the new hair was dark, despite the chemotherapy. The treatment did not improve other symptoms, such as bone marrow suppression and peripheral numbness. This case suggests that Bojungikki-tang could have a beneficial effect on chemotherapy-induced alopecia.
Objective : The purpose of this report was to provide the information activity and safety of Palmul-tang by analyzing domestic/international papers and theses about Palmul-tang, Methods: Domestic/international papers and theses related to Palmul-tang were reviewed and analyzed, These papers were then classified by year, experimental method and subject, Results: The following results were obtained in this study. 1. The study of Palmul-tang started from 1985 and was continuously increased. The study was mainly forcused on experimental model rather than clinical study. 2. As these studies were classified by subject, papers related to immune intensification were most abundant by 20 papers, Besides there were several papers related to cardiovascular activity, reproductive activity, anti-apoptotic activity and cerebral hemodynamics. 3. Among the papers related to immune intensification. the studies on recovery of fatigue were mostabundant by 10 papers and the studies of on immune cell and cytokine express were six. In addition to. several studies were associated with anti-cancer activity and anti-allergic activity. Recovery of fatigue was determined by measurement of fatigue markers in a living body such as lactate. CPK, pyruvate and triglyceride and assessment of exercise capability of animals such as swimming test. slopped plate test. Rota-rod test, and activity cage test after Palmul-tang treatment. 4. According to experimental data. it is supported that Palmul-tang has been used as Qi and Blood intensifier with immune intensification and recovery of fatigue. 5. The paper related to safety of Palmul-tang was only one paper which is studied on acute toxicity of Palmul-tang with experiment with ICR mouse. There was no study on evaluating safety by observing liver and kidney functions after Palmul-tang treatment Conclusion: Palmul-tang is being used in various ways associating with immune intensification. cardiovascular activity and reproductive activity. However. studies on efficacy and mechanism of Palmul-tang should be conducted at the molecular biology level and studies on safety of Palmul-tang need to be completed at the clinical level.
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