An overview of the safety and side effects of nonpharmacologic interventions for cancer care is also covered. In addition, the integration of non-pharmacological therapies with Western medicine in the treatment of cancer is also included.
An Overview of Non-pharmacological Therapies for Palliative Cancer Care
Cancer Incidence, Treatment, and Survival
Nonpharmacologic therapies have an evolving role in the management of cancer and cancer-related symptoms, and those that have established efficacy and safety provide new therapeutic strategies for healthcare professionals, patients, survivors, and their family caregivers. In addition to the direct effects of the non-pharmacological therapies, involving patients and survivors in promoting their own well-being by participating in the management of their disease-related symptoms will increase their sense of self-efficacy and quality of life (Deng et al.). 2009.
Palliative Care
However, the combination of therapies, especially if chemotherapy is included, increases the risk of side effects and associated symptoms (Kirkova et al. 2010. Cancer and cancer treatments are often associated with side effects that produce symptoms that negatively affect patients' quality of life. (QoL) and well-being (Yennurajalingam et al. 2012.
Non-pharmacological Therapies
Patients may continue to use nonpharmacologic therapies because of emotional reactions to their diagnosis, health care providers, and/or the health care system. Evidence-based non-pharmacological therapies, as discussed below, have a role in this form of integrative practice.
- Energy-based Therapies
- Reiki
- Healing Touch
- Qigong
- Expressive Arts Therapies
- Music Therapy
- Art Therapy
- Mind-Body Therapies
- Psychotherapy
- Hypnosis
- Relaxation Training with Controlled Breathing
- Guided Imagery
- Meditation
- Movement Therapies
- Exercise
- Yoga
- Taichi
- Touch Therapies
- Massage Therapy
- Re fl exology
Mindfulness meditation is the form of meditation most commonly studied in the cancer patient population (Deng et al. 2009. Statistically significant improvement in fatigue and sleep quality was found in the treatment arm (Lengacher et al. 2012.
Uses of Non-pharmacological Therapies for Cancer Symptom Management in Palliative Care
- Pain
- Nausea and Vomiting
- Dyspnea
- Fatigue
- Insomnia
- Cancer-related Anxiety and Distress
- Cancer-related Depression
Non-pharmacological therapies have been shown to be very effective in the management of ANV (Table 1.4) (Mundy et al. 2003. There is also preliminary evidence that yoga and exercise may be useful in the management of insomnia (Table 1.7).(Deng et al. 2009.
Conclusion
Krohn M, Listing M, Tjahjono G et al (2011) Depression, mood, stress and Th1/Th2 immune balance in primary breast cancer patients undergoing classical massage therapy. Rao MR, Raghuram N, Nagendra HR, Gopinath KS, Srinath BS, Diwakar RB et al (2009) Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: a randomized controlled trial.
Effect of Massage Therapy on Anxiety and Depression in Cancer Patients
Introduction
However, psychological approaches to treating cancer patients have not yet been successfully developed and a number of cancer patients suffer from psychological problems such as anxiety, depression and hopelessness. Of course, cancer itself causes various physical and mental discomfort, such as pain, anxiety, depression, fatigue, and symptoms specific to the type and location of the cancer.
- Effect of Aromatherapy Massage on Anxiety and Depression
- Effects of Aromatherapy, Except for Anxiety and Depression
In this chapter, the author reviewed studies on the effect of massage therapies, including aromatherapy massage, in the treatment of cancer. However, there have been no studies on the effects of aromatherapy massage on circadian rhythm disorder, which is often seen in the elderly.
- Use of Aromatherapy in Cancer
There are some studies on the effect of massage therapy on mood improvement and anxiety reduction. Keir ST (2011) Effect of massage therapy on stress levels and quality of life in brain tumor patients – observations from a pilot study.
Effects of Massage Therapy on the Relief of Cancer Pain
Introduction
Many of the dangerous effects of unrelieved pain mimic the effects of opioid analgesics (Table 3.1. Pulmonary System). Unrelieved pain causes reflex muscle spasms and leads to splinting, which reduces lung vital capacity, functional residual capacity, and alveolar ventilation.
It is becoming clear that there is an emerging interest, not only in the general public, but also among health care providers in the use of MT for the management of cancer pain. With an emerging emphasis on evidence-based practice in health care, it is important to convincingly show the relative benefits of massage with more rigorous approach and/or systematic reviews, so that clinicians can translate the research evidence into best practices and ultimately to improve pain management in the cancer population. .
- Types of Massage
- Safety and Adverse Effects of MT
- Quali fi cation of the Massage Therapists
Acupressure a It is based on the Chinese meridian system to strengthen the yin, yang and Qi of the body. Practitioners should be aware of the above side effects and complications of MT in cancer patients and develop and follow safety protocols before and during MT.
- Sampling
- Inclusion and Exclusion Criteria
- Extracted Information
- Calculation of Effect Sizes
- Results
- Characteristics of Subjects and Research Design
- Characteristics of Study Massage Interventions
- Characteristics of Outcome Measures
- Conclusions
NA massage or combined massage (MT + aromatherapy ↓pain intensity, ↑ ↑anxiety/depression (within subjects) Pain descriptor, symptom distress (NS) No cumulative effect on pain and mood Stephenson et al. References Sample ( n) protocol Measurement Effect size (d) Significance of massage effects Wilkie et al.
- Pain Neural Mechanisms
- Transduction
- Transmission
- Pain Perception
- Modulation
When the nociceptive signal reaches the CNS, it is processed in the dorsal horn of the spinal cord. Axons of dorsal horn projection cells (second-order neurons) enter the brain via several pathways, including: (1) the spinothalamic tract (STT); (2) spinoreticular tract (SRT); (3) spinomesencephalic tract; (4) spinocervical tract; (5) second-order dorsal column tract; and (6) the spinohypothalamic tract.
The Effect of Acupressure
- Introduction
- Methods
- Results
- Randomized Controlled Trials (RCTs)
- Quasi-experimental Study
- Systematic Reviews
- Safety and Adverse Effects
- The Mechanism of Acupressure on Chemotherapy-induced Nausea
- Autonomic Nervous System
- Serotonin
- Cholecystokinin (CCK) and the Dorsal Vagal Complex
- Opioids
- g -Aminobutyric Acid (GABA)
- Catecholamine
- Functional Magnetic Resonance Imaging
- Summary of Mechanism
- Discussion
- Sham Acupuncture
- Mechanism of Acupressure on Chemotherapy-induced Nausea
- International Clinical Guidelines for Acupressure
- Conclusion
Gabapentin, which increases GABA in the brain, improved nausea in patients with chemotherapy-induced nausea (Guttuso et al. 2003. Acupuncture at PC6 activated the right nodule and right uvula of the cerebellum (Ren et al. 2010.
Suh EE (2012) The effects of P6 acupressure and nurse-issued counseling on chemotherapy-induced nausea and vomiting in patients with breast cancer. Oncol Nurs Forum 39(1):E1–E9 Taspinar A, Sirin A (2010) Effect of acupressure on chemotherapy-induced nausea and vomiting i.
Effects of Qigong Therapy on Alleviating Symptoms in Cancer Patients: An Overview
- Introduction
- Methods .1 Data Sources
- Study Selection and Data Extraction
- Assessment of the Quality of the SRs
- Results
- General Characteristics of Included SRs
- Quality of Included SRs
- Descriptions of Included SRs
- Discussion
- Appraisals of Included SRs
- Adverse Events of Qigong
- Possible Mechanisms of Qigong
- Possible Interpretation
- Recent RCTs
- Limitations of This Overview
- Perspectives
- Conclusion
The quality of the SRs was mixed, but two SRs had only minor defects. Chan CL, Wang CW, Ho RT, Ng SM, Chan JS, Ziea ET et al (2012) A systematic review of the effectiveness of Qigong exercise in cancer supportive care.
Effects of Yoga on the Quality of Life in Cancer Patients
Introduction
- Cancer Epidemiology
- Impacts of Cancer and Treatment
- De fi nition of the QoL
- Scope and Assessment of QoL
These psychological and physical symptoms may even persist over 16 months after treatment (Brant et al. 2011). Disease-specific instruments are designed to focus more narrowly on a specific type of cancer or treatment and are more responsive to change (Velikova et al. 1999; Ferrans 2010.
- Yoga and MBSR Usage Among Cancer Patients
Key poses include cobra (bhujangasana), sunbird (chakravakasana), lunge steps, warrior variations, forward bends, triangle, twists and torso (savasana). Iyengar Yoga Bower et al. A combination of precise postures (asanas), breathing exercises (pranayama) and meditation focusing on precise muscle-skeletal alignment and using props (belts, blankets, blocks and chairs) Galantino et al.
Effects of Yoga/MBSR on QoL in Cancer Patients
- Clinical Studies
- Clinical Guidelines of Using Yoga
Yoga/MBSR Group, Frequency and Duration Control Group Outcome Measures of QoL Findings Lengacher et al. Yoga/MBSR Group, Frequency and Duration Control Group Outcome Measures of QoL Findings Culos-Reed et al.
Safety and Adverse Effects of Yoga/MBSR
Furthermore, the American College of Chest Physicians (ACCP) published an evidence-based clinical practice guideline to distinguish between alternative therapies and complementary therapies and to describe the evidence base for the use of complementary therapies in lung cancer. Although the goals of this guideline are to evaluate the evidence for complementary therapies in the care of lung cancer patients, the authors found that only a few complementary modalities have been studied in patients with a single cancer diagnosis.
Mechanisms of Yoga/MBSR
Kulkarni and Bera (2009) also reported that the relaxation potential of yoga can induce psycho-neuroimmunological effects by integrating the pituitary-neuroendocrine network with the cortical information processing aspect of yoga instruction through human information processing and subsequently modulating the immune system. system via hypothalamic-limbic-pituitary-adrenal functions (Fig. 6.1. Endorphin secretion from the nervous system, triggered by the limbic system, initiates the pituitary-adrenal axis to stimulate the immune system and generates a feedback response from the peripheral nervous system to the immune action to the central nervous system system.
Conclusions and Recommendations
Anxiolytic effects of a yoga program in patients with early breast cancer undergoing conventional treatment: a randomized controlled trial. Vadiraja HS, Rao MR, Nagarathna R, Nagendra HR, Rekha M, Vanitha N et al (2009b) Effects of yoga program on quality of life and affect in patients with early breast cancer undergoing adjuvant radiotherapy: a randomized controlled trial.
Introduction
Mind-body therapies, including mindfulness/meditation, biofeedback, hypnosis, relaxation therapy, art therapy, Qigong, Taichi, and yoga have demonstrated efficacy in their potential to alleviate stress and improve patients' quality of life. with cancer and survivors. Although additional research is needed, the body of evidence presented in this chapter suggests that clinicians should give mind-body therapies serious consideration when counseling cancer patients and survivors about adjuvant treatment options.
Ef fi cacy of Mind-body Therapy on Stress Reduction in Cancer Care
Mindfulness/Meditation
Patients in the treatment group reported significantly less stress, depression and anxiety than the controls. Treatment group participants reported significantly less stress, depression, and anxiety than control participants.
Biofeedback
Taken together, these studies suggest that various forms of mindfulness or mediation can effectively help cancer patients with limited mobility manage stress. However, the lack of a control group in several of these studies and the omission of physiological measurement of stress are limitations.
Hypnosis
Patients were also instructed to distance themselves from hot flashes and imagine themselves symptom-free in the future. After the intervention, women in the treatment group reported significant improvements in the number of hot flashes experienced, as well as in the severity of these hot flashes (p < 0.001), as measured by the Hot Flash Related Daily Interference Scale (HFRDIS). ) (Timmerman 2001.
Relaxation
The authors show that the results of the study were strong support that art therapy was effective in improving the quality of life of breast cancer patients. Health-related quality of life was assessed (pre- and post-intervention) with the Short Form Health Survey (SF-36) (Ware, 2000.
Qigong
The results of this study showed significant differences in overall scores and in each subscale of the SCL-90-R, with effect sizes ranging from 0.13 to 0.33, with the total score reporting an effect size of 0.16 (CI 0.08–0 ,24). Although the results of this study are impressive, it is not possible with these data to determine the relative contribution of art therapy to the effectiveness of the overall treatment protocol.
Taichi
Results showed a significant difference between the Taichi group and psychosocial support participants in changes in self-esteem at 12 weeks (F p = 0.10), with the Taichi group showing significant improvements in self-esteem self-esteem and a decrease in the amount of psychosocial support in the group. . Although the changes in self-esteem after six weeks were not significantly different (F p = 0.40), the Taichi group reported improvements in self-esteem, while the psychosocial support group showed a decrease in self-esteem.
Yoga
In addition, post-intervention cortisol levels were significantly lower for the intervention group compared to the control group (p = 0.03). Finally, perceived stress scores decreased significantly in participants in the yoga intervention group (p <0.001), but not in participants in the control group (p = 0.17).
Conclusion
Chae YR, Seo K (2010) Health-related quality of life in women with breast cancer in Korea: do sociodemographic characteristics and time since diagnosis make a difference. Nidich S, Fields J, Rainforth M, Pomerantz R, Cella D, Kristeller J et al (2009) A randomized controlled trial of the effects of transcendental meditation on quality of life in elderly breast cancer patients.
Introduction
The development of mindfulness has been integrated into various structured training programs and therapies, such as mindfulness-based stress reduction, mindfulness-based cognitive therapy, as well as programs that integrate mindfulness training specifically developed for cancer patients. Mindfulness-based stress reduction programs in particular have shown great potential for changing people's experiences with stress-related complaints and increasing well-being.
Effect of Mindfulness-based Interventions in Cancer Care
- Mindfulness-based Programs for Cancer Patients .1 MBSR Program
- MBCT
- Variations of Mindfulness-based Interventions
- Effects of Mindfulness Interventions in Cancer Patients – A Meta-analysis
- Effects on Positive Affect Outcomes
- Effects on Negative Affect Outcomes
- Effects on Physical Health Outcomes
- Effects on Measures of Mindfulness
- Components of Mindfulness Meditation Interventions
- Mechanisms of Mindfulness Interventions – A Theoretical Framework
- Attention Regulation
- Body Awareness
- Emotion Regulation
- Change in Perspective on the Self
- Clinical Signi fi cance
- Integration of Mindfulness Meditation in Cancer Care, and Future Directions
- Introduction
A few controlled studies have reported effects of mindfulness-based interventions on various measures of mindfulness (Anderson et al. Shapiro SL, Schwartz GE, Bonner G (1998) Effects of mindfulness-based stress reduction on medicine and premedical students.
Aromatherapy, Physical and Movement-based Therapies on Symptom Management
Aromatherapy
