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Valsecchi AA, Fusco V, Di Maio M, Santini D, Tucci M, De Giorgi U, Dionisio R, Vignani F, Cinieri S. Management of cancer treatment-induced bone loss in patients with breast and hormone sensitive prostate cancer: AIOM survey. TUMORI JOURNAL 2024; 110:174-185. [PMID: 38462772 DOI: 10.1177/03008916241236279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
PURPOSE Cancer treatment-induced bone loss is a side effect of hormonal therapy that can severely affect patients' quality of life. The aim of this survey was to obtain an updated picture of management of bone health in patients with breast cancer undergoing adjuvant hormonal therapy and in patients with hormone sensitive prostate cancer according to Italian oncologists. METHODS Our survey was made up of 21 multiple-choice questions: the first part dealt with the respondents' characteristics, while the second with management of bone health in the described setting. An invitation to complete the survey was sent by e-mail to 2336 oncologists, members of Italian Association of Medical Oncology, in October 2022. RESULTS Overall, 121 (5.2%) Italian oncologists completed the survey. In most cases (57%) the oncologist personally took charge of the management of bone health in patients at risk for cancer treatment-induced bone loss. At the beginning of hormonal therapy, most respondents reported to require bone health diagnostic exams, such as dual-energy X-ray absorptiometry (89%), repeated with different timing. Main reported reasons (not mutually exclusive) for prescribing antiresorptive drugs were modifying fracture risk (87%), densitometry values (75%) or prognosis (34%). Answers about the management of antiresorptive therapy were heterogeneous. CONCLUSION A heterogeneous approach on the management of cancer treatment-induced bone loss in Italy arises from this survey. This scenario highlights the need for a major consensus of the Italian scientific community on the diagnostic and therapeutic approach of cancer treatment-induced bone loss and for a greater awareness of this topic among Italian oncologists.
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Affiliation(s)
- Anna Amela Valsecchi
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - Vittorio Fusco
- Oncology Unit, Department of Medicine Translational Medicine Unit, Department of Integration, Research and Innovation, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - Daniele Santini
- UOC Oncologia A, Policlinico Umberto 1, La Sapienza Università, Roma, Italy
| | - Marcello Tucci
- Department of Medical Oncology, Cardinal Massaia Hospital, Asti, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori, Dino Amadori, Meldola, Italy
| | - Rossana Dionisio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - Francesca Vignani
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - Saverio Cinieri
- Medical Oncology Unit, Ospedale di Summa A. Perrino, Brindisi, Italy
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Shan J, Lv S, Chen L, Li T, Li J, Wang S, Zhang C. A cross-sectional study on Chinese oncology nurses' knowledge of bone health among cancer patients. Support Care Cancer 2023; 31:501. [PMID: 37526757 PMCID: PMC10393862 DOI: 10.1007/s00520-023-07966-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 07/23/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE To understand the knowledge status, obstacle factors, and management confidence of oncology nurses on the bone health of cancer patients, and in addition to provide reference for establishing bone health knowledge training system for oncology nurses and guiding them to manage bone health of cancer patients. METHODS A total of 602 nurses engaged in oncology nursing in 6 hospitals in Hebei Province were selected by cluster sampling, and an online anonymous survey was conducted by sending questionnaires to oncology nurses from the Hebei Cancer Prevention and Control Association. The questionnaire was developed by the study team. There are 4 parts, namely general information, nurses' role and job responsibilities, knowledge of skeletal-related events (SREs) and cancer treatment-induced bone loss (CTIBL), and understanding and confidence in bone health management, for a total of 33 questions. RESULTS Thirty-seven percent of oncology nurses received training on bone health and other related contents; 40.48% of oncology nurses used domestic and foreign guidelines when managing patients with bone metastases or CTIBL. Only approximately one-third of oncology nurses had confidence in managing the side effects of bone metastases and bone modification drugs and identifying patients at risk of CTIBL and fracture; only 33.04% of oncology nurses believed that weight-bearing exercise can prevent bone loss; less than 50% of oncology nurses believed that aromatase inhibitor therapy, ovarian suppression therapy, androgen deprivation therapy, and low body weight were risk factors for pathological fractures. The reasons that hindered oncology nurses from optimizing the management of patients with bone metastases and understanding the preventive measures and risk factors for bone loss mainly included lack of relevant knowledge training, lack of understanding of effective intervention measures, and lack of training and professionalism of specialized nurses, including insufficient development time and guidelines for clinical nursing practice. CONCLUSION Managers must continuously improve the training system of oncology nurses, enrich the content of training pertaining to bone health for cancer patients, formulate clinical nursing practice guidelines, and give oncology nurses more time for professional development.
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Affiliation(s)
- Jing Shan
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, No. 12, Jiankang Road, Chang'an District, Shijiazhuang, Hebei, China.
| | - Sumei Lv
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, No. 12, Jiankang Road, Chang'an District, Shijiazhuang, Hebei, China
| | - Lu Chen
- Nursing Department, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, Shijiazhuang, Hebei, China
| | - Tianhua Li
- Department of Gynecological, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, Shijiazhuang, Hebei, China
| | - Jingwen Li
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, No. 12, Jiankang Road, Chang'an District, Shijiazhuang, Hebei, China
| | - Shuangyan Wang
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, No. 12, Jiankang Road, Chang'an District, Shijiazhuang, Hebei, China
| | - Congcong Zhang
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, No. 12, Jiankang Road, Chang'an District, Shijiazhuang, Hebei, China
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Li X, Zhang K, Xu D, Xu Y. The effect of Orem's nursing theory on the pain levels, self-care abilities, psychological statuses, and quality of life of bone cancer patients. Am J Transl Res 2023; 15:1438-1445. [PMID: 36915789 PMCID: PMC10006768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/07/2021] [Indexed: 03/16/2023]
Abstract
OBJECTIVE This study aims to explore the impact of Orem-based nursing intervention on the pain levels, self-care abilities, psychological statuses, and quality of life in bone cancer patients. METHODS A total of 91 patients with primary bone cancer admitted to our hospital from January 2019 to January 2020 were randomly placed into one of two groups. The patients in the control group (n=43) underwent routine nursing care, and the patients in the experimental group (n=48) underwent Orem-based nursing care during the perioperative period. The two groups were compared in terms of their postoperative recovery times and treatment effects, and their adverse emotion scores, pain levels, self-care abilities, and quality of life before and after intervention. RESULTS The treatment efficacy in the two groups was similar, but the postoperative recovery times in the experimental group were shorter than they were in the control group (P < 0.05). Compared with before the intervention, the SDS, SAS, and VAS scores were significantly decreased in both groups (P < 0.05), and their self-care abilities and quality of life were significantly higher (P < 0.05) after intervention. CONCLUSION Orem-based nursing combined with perioperative care can mobilize patients' initiative, significantly improve patients' adverse emotions and pain levels, shorten their postoperative recovery times, and help improve their self-care abilities and quality of life.
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Affiliation(s)
- Xia Li
- Department of Critical Care Medicine, Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine Wenzhou 325000, Zhejiang, China
| | - Kaiya Zhang
- Department of Critical Care Medicine, Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine Wenzhou 325000, Zhejiang, China
| | - Duoduo Xu
- Department of Urology Surgery/ENT/Anorectal, Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine Wenzhou 325000, Zhejiang, China
| | - Yaoyao Xu
- Department of Critical Care Medicine, Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine Wenzhou 325000, Zhejiang, China
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Gao Q, Yao Y, Xu Q. Guideline and Implementation of Osteosarcoma Nursing Care for Children and Adolescents. Appl Bionics Biomech 2022; 2022:2021162. [PMID: 36267672 PMCID: PMC9578899 DOI: 10.1155/2022/2021162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 11/29/2022] Open
Abstract
Clinical trials on pediatric oncology use therapeutic techniques with the overwhelming majority of children's cancer patients obtaining therapy via clinical investigation procedures. Medical treatment is scheduled according to a specific protocol for enrolled patients. These protocols often do not refer to nursing care. Nursing care, on the other hand, must complement the medical care specified in the medical research protocol. Safe treatment administration, assessment of treatment responses, patients' and families' education, and communication with the whole medical team are just a few of the critical nursing tasks that should be properly managed. Nursing care standards have been developed in this study to strike a good balance between the procedure for clinical research and the nursing care connected with it. These recommendations outline the nursing activities and considerations that must be made while caring for pediatric cancer patients who are engaged in a specific clinical investigation procedure. The objective of this study is to outline the procedure through which nursing care guidelines could be developed and evaluated. The goal of this study was to find out the involvement of nurses in the process of health education for osteosarcoma and family patients.
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Affiliation(s)
- Qian Gao
- Nursing Department, Department of Bone Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, 310009, China
| | - Yuhong Yao
- Nursing Department, Department of Bone Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, 310009, China
| | - Qi Xu
- Nursing Department, Department of Thoracic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, 310009, China
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Rayner-Myers SD, Hunter K, Pituskin E. Direct and Indirect Mechanisms of Chemotherapy-Induced Bone Loss in Adjuvant Breast Cancer: An Integrative Review. Semin Oncol Nurs 2022; 38:151280. [PMID: 35477650 DOI: 10.1016/j.soncn.2022.151280] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Breast cancer survivors are at increased risk of bone complications, indicating the need to better understand the effects of necessary treatments on bone health. The role of chemotherapy in bone loss is unclear, and its influence over time is not understood. This integrative review examined the existing literature on chemotherapy-induced bone loss in patients with early-stage, curative breast cancer focusing on long-term outcomes. Evaluating the mechanisms of chemotherapy-induced bone loss in humans along with preclinical (animal) models may elucidate pathways and improve care by providing targets for bone health-related interventions. DATA SOURCES A review of retrieved articles dated January 2010 to December 2020 from MEDLINE and EMBASE databases were searched. A total of six clinical (human) and three preclinical (animal) studies were included. CONCLUSION The findings identified two main themes (1) indirect and direct cellular mechanisms of chemotherapy-induced bone loss and (2) long-term bone complications and symptoms in breast cancer survivors. Implications for pre- and postmenopausal women are presented. IMPLICATIONS FOR NURSING PRACTICE Enhanced bone surveillance performed by the specialized oncology nurse can improve long-term bone health outcomes. Prospective analyses evaluating short- and long-term chemotherapy-induced bone loss are recommended for future clinical trials to inform practice and evidence-informed interventions and treatments.
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Affiliation(s)
| | - Kathleen Hunter
- Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), Edmonton, AB, Canada
| | - Edith Pituskin
- Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), Edmonton, AB, Canada.
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Vitamin D Deficiency in Women with Breast Cancer: A Correlation with Osteoporosis? A Machine Learning Approach with Multiple Factor Analysis. Nutrients 2022; 14:nu14081586. [PMID: 35458148 PMCID: PMC9031622 DOI: 10.3390/nu14081586] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 12/16/2022] Open
Abstract
Breast cancer (BC) is the most frequent malignant tumor in women in Europe and North America, and the use of aromatase inhibitors (AIs) is recommended in women affected by estrogen receptor-positive BCs. AIs, by inhibiting the enzyme that converts androgens into estrogen, cause a decrement in bone mineral density (BMD), with a consequent increased risk of fragility fractures. This study aimed to evaluate the role of vitamin D3 deficiency in women with breast cancer and its correlation with osteoporosis and BMD modifications. This observational cross-sectional study collected the following data regarding bone health: osteoporosis and osteopenia diagnosis, lumbar spine (LS) and femoral neck bone mineral density (BMD), serum levels of 25-hydroxyvitamin D3 (25(OH)D3), calcium and parathyroid hormone. The study included 54 women with BC, mean age 67.3 ± 8.16 years. Given a significantly low correlation with the LS BMD value (r2 = 0.30, p = 0.025), we assessed the role of vitamin D3 via multiple factor analysis and found that BMD and vitamin D3 contributed to the arrangement of clusters, reported as vectors, providing similar trajectories of influence to the construction of the machine learning model. Thus, in a cohort of women with BC undergoing Ais, we identified a very low prevalence (5.6%) of patients with adequate bone health and a normal vitamin D3 status. According to our cluster model, we may conclude that the assessment and management of bone health and vitamin D3 status are crucial in BC survivors.
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Li L, Liu Y, Ren X, Qu K, Liu X. Effectiveness of advanced nursing care (ANC) on bone cancer pain, psychological disorders and quality of life in patients with primary bone cancers: A protocol for a PRISMA-compliant meta-analysis. Medicine (Baltimore) 2020; 99:e22711. [PMID: 33120765 PMCID: PMC7581169 DOI: 10.1097/md.0000000000022711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Advanced nursing care (ANC) has been reported to effectively relieve bone cancer pain, prevent psychological disorders and improve the quality of life (QoL) in patients with primary bone cancers (PBC) during the treatment. However, the exact effect of ANC remains controversial. This systematic review will aimed to assess the effectiveness of ANC on bone cancer pain, psychological disorders and QoL in patients with PBC. METHODS Eligible randomized controlled trials (RCTs) and high-quality prospective cohort studies were searched from Excerpt Medica Database (Embase), PubMed, Google Scholar, Medline, Cochrane Library, Web of Science (WOS), China National Knowledge Infrastructure (CNKI), Chinese Bio Medical Database (CBM), China Scientific Journal Database (CSJD), and Wanfang Database. Papers in English or Chinese published from January 2000 to July 2020 will be included without any restrictions. The clinical outcomes including bone cancer pain, psychological disorders, QoL, and adverse events of ANC in patients with PBC were systematically evaluated.Two reviewers will separately carry out study selection and data extraction. Stata 14.0 and Review Manager 5.3 were used for data analysis. Methodological quality for each eligible clinical trial will be assessed by using Cochrane risk of bias tool. Subgroup and meta-regression analysis will be carried out depending on the availability of sufficient data. RESULTS This study will comprehensively summarize all potential evidence to systematically investigate the effects and safety of ANC on bone cancer pain, psychological disorders and QoL in patients with PBC. CONCLUSION The findings of this study will help to determine whether ANC is effective or not on bone cancer pain, psychological disorders and QoL in patients with PBC. INPLASY REGISTRATION NUMBER INPLASY202090037.
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Affiliation(s)
| | | | - Xiaofeng Ren
- Department of Nursing, Liaocheng People's Hospital, Liaocheng, Shandong Province
| | - Kai Qu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province, China
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