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Phung TH, Pitt E, Alexander K, Bradford N. Non-pharmacological interventions for chemotherapy-induced diarrhoea and constipation management: A scoping review. Eur J Oncol Nurs 2024; 68:102485. [PMID: 38104513 DOI: 10.1016/j.ejon.2023.102485] [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: 10/18/2023] [Revised: 11/16/2023] [Accepted: 11/26/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE Chemotherapy-induced diarrhoea (CID) and constipation (CIC) are among the most common and severe gastrointestinal symptoms related to chemotherapy. This review aimed to identify and describe the evidence for non-pharmacological interventions for the management of CID and CIC. METHODS The scoping review was based on the Joanna Briggs Institute methodology and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Evidence from five databases were included: CINAHL, MEDLINE, Embase, PubMed, and APA PsycInfo. Data were systematically identified, screened, extracted and synthesised narratively to describe the evidence for non-pharmacological interventions and their effects on CID and CIC. RESULTS We included 33 studies, of which 18 investigated non-pharmacological interventions for CID management, six for CIC management, and nine for both CID and CIC management. Interventions were categorized into five groups, including (1) digital health interventions, (2) physical therapies, (3) diet and nutrition therapies, (4) education, and (5) multimodal. Diet and nutrition therapies were the most common to report potential effectiveness for CID and CIC outcomes. Most of the interventions were implemented in hospitals under the supervision of healthcare professionals and were investigated in randomised control trials. CONCLUSIONS The characteristics of non-pharmacological interventions were diverse, and the outcomes were inconsistent among the same type of interventions. Diet and nutritional interventions show promise but further research is needed to better understand their role and to contribute to the evidence base. Nurses are well placed to assess and monitor for CIC and CID, and also deliver effective non-pharmacological interventions.
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Affiliation(s)
- Thi Hanh Phung
- School of Nursing, Faculty of Health, N block, Queensland University of Technology, Kelvin Grove, 4059, Australia; Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Viet Nam.
| | - Erin Pitt
- School of Nursing, Faculty of Health, N block, Queensland University of Technology, Kelvin Grove, 4059, Australia; Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, Queensland University of Technology, X block, 66 Musk Avenue, Kelvin Grove, 4059, Australia; Cancer Nurses Society of Australia, 165 Sovereign Hill Drive, Gabbadah, Western Australia, 6041, Australia
| | - Kimberly Alexander
- School of Nursing, Faculty of Health, N block, Queensland University of Technology, Kelvin Grove, 4059, Australia; Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, Queensland University of Technology, X block, 66 Musk Avenue, Kelvin Grove, 4059, Australia; Cancer Nurses Society of Australia, 165 Sovereign Hill Drive, Gabbadah, Western Australia, 6041, Australia; Centre for Children's Health Research, Children's Health Queensland Hospital and Health Services, South Brisbane, 4101, Australia
| | - Natalie Bradford
- School of Nursing, Faculty of Health, N block, Queensland University of Technology, Kelvin Grove, 4059, Australia; Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, Queensland University of Technology, X block, 66 Musk Avenue, Kelvin Grove, 4059, Australia; Cancer Nurses Society of Australia, 165 Sovereign Hill Drive, Gabbadah, Western Australia, 6041, Australia; Centre for Children's Health Research, Children's Health Queensland Hospital and Health Services, South Brisbane, 4101, Australia
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An ex vivo organ culture screening model revealed that low temperature conditions prevent side effects of anticancer drugs. Sci Rep 2022; 12:3093. [PMID: 35197531 PMCID: PMC8866511 DOI: 10.1038/s41598-022-06945-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/09/2022] [Indexed: 11/08/2022] Open
Abstract
Development of chemotherapy has led to a high survival rate of cancer patients; however, the severe side effects of anticancer drugs, including organ hypoplasia, persist. To assume the side effect of anticancer drugs, we established a new ex vivo screening model and described a method for suppressing side effects. Cyclophosphamide (CPA) is a commonly used anticancer drug and causes severe side effects in developing organs with intensive proliferation, including the teeth and hair. Using the organ culture model, we found that treatment with CPA disturbed the growth of tooth germs by inducing DNA damage, apoptosis and suppressing cellular proliferation and differentiation. Furthermore, low temperature suppressed CPA-mediated inhibition of organ development. Our ex vivo and in vitro analysis revealed that low temperature impeded Rb phosphorylation and caused cell cycle arrest at the G1 phase during CPA treatment. This can prevent the CPA-mediated cell damage of DNA replication caused by the cross-linking reaction of CPA. Our findings suggest that the side effects of anticancer drugs on organ development can be avoided by maintaining the internal environment under low temperature.
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