ABSTRACT
Climate change is a public health crisis that amplifies exposure to known carcinogens, leading to increased cases of cancer and other diseases. This clear link is a powerful reason for all oncology nurses concerned with cancer prevention and treatment to be involved in climate change solutions. The purpose of this review is to bring awareness to the consequences climate change has on the incidence and mortality of cancer, how it affects people living with cancer, and how oncology nurses can help mitigate these suboptimal outcomes. .
Subject(s)
Climate Change , Oncology Nursing , Delivery of Health Care , Humans , Public HealthABSTRACT
Approximately 50%-70% of patients with cancer will receive radiation therapy. Radiodermatitis is one of the most common side effects of radiation therapy, with as many as 95% of patients experiencing some degree of skin change. Radiodermatitis can cause pain, itching, and burning and potentially has a significant impact on a patient's quality of life. If radiodermatitis becomes severe, it can cause treatment interruption. The prevalence of radiodermatitis coupled with the effect this side effect can have on quality of life prompts the need for evidence-based recommendations for management.
Subject(s)
Neoplasms , Radiodermatitis , Humans , Neoplasms/complications , Neoplasms/radiotherapy , Quality of Life , Radiodermatitis/diagnosis , Radiodermatitis/etiology , SkinABSTRACT
PROBLEM IDENTIFICATION: A systematic review and meta-analysis was conducted to inform the development of guidelines on the management of radiodermatitis among patients with cancer. LITERATURE SEARCH: The authors updated a systematic review to include available literature published through September 30, 2019. DATA EVALUATION: Two investigators assessed risk of bias using the Cochrane Collaboration risk-of-bias tool and certainty of the evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. SYNTHESIS: The use of deodorant/antiperspirant had no effect on development of radiodermatitis. Aloe vera and emu oil were equivalent or less effective than standard care. Oral curcumin had a minimal beneficial effect. Nonsteroidal topical interventions had a minimal beneficial effect on the development of moist desquamation and relief of itching while causing a small increase for grade 2 radiodermatitis. Topical calendula increased risk for the development of radiodermatitis. Topical steroids and dressings each showed benefits to minimize the development of radiodermatitis and moist desquamation while lowering rates of patient-reported symptoms, such as pain and pruritus. IMPLICATIONS FOR RESEARCH: Symptom management strategies for radiodermatitis among patients with cancer that are likely to be effective include topical nonsteroidals, topical steroids, and dressings. SUPPLEMENTAL MATERIAL CAN BE FOUND AT HTTPS: //bit.ly/2FWj3Kp.
Subject(s)
Neoplasms , Radiodermatitis , Bandages , Humans , Neoplasms/complications , Neoplasms/radiotherapy , Radiodermatitis/drug therapy , Radiodermatitis/etiologyABSTRACT
PURPOSE: Radiodermatitis is a side effect of radiation therapy. Evidence-based interventions to minimize severity or delay progression are important for clinical care. This guideline intends to support individuals with cancer, clinicians, and others in decisions regarding radiodermatitis treatment. METHODOLOGIC APPROACH: A panel of healthcare professionals with patient representation was convened to develop a national clinical practice guideline for the management of radiodermatitis. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology and the National Academies of Sciences, Engineering, and Medicine criteria for trustworthy guidelines were followed. The Cochrane Collaboration risk-of-bias tool was used, and certainty of the evidence was assessed using the GRADE approach. A quantitative and narrative synthesis of the evidence was completed. FINDINGS: The panel agreed on eight recommendations and made a conditional recommendation for deodorant/antiperspirant. Aloe vera and oral curcumin had knowledge gaps and were recommended only in the context of a clinical trial. The panel suggested against emu oil, calendula, and nonsteroidal interventions. IMPLICATIONS FOR NURSING: This guideline summarizes evidence-based interventions for the management of radiodermatitis to guide clinical care. SUPPLEMENTARY MATERIAL CAN BE FOUND AT HTTPS: //bit.ly/2GEwJtT.
Subject(s)
Neoplasms , Radiodermatitis , Humans , Radiodermatitis/drug therapy , Radiodermatitis/etiologyABSTRACT
Secondary (acquired) lymphedema is a chronic condition lacking a known cure that most commonly results from cancer treatment, particularly for breast, gynecologic, prostate, and head and neck cancers; lymphoma; and melanoma, and affects an estimated 1 in 1,000 Americans. Lymphedema is characterized by an accumulation of protein-rich lymphatic fluid in the affected part of the body. It can potentially affect functioning, family roles and relationships, occupational roles, and productivity. The majority of strategies to prevent and manage lymphedema are nonpharmacologic, used alone or in combination with one another.
