CHAPTER 6 CONCLUSION 6.1 Conclusions In summary, this study found that CHM group had better

From personal experience, I have witnessed several family members undergo chemotherapy. Often their side effects of the treatment were worse than the disease itself. Effects, varying form person-to-person, ranged from nausea and

Positive Aspects: Research and understanding of medicine, pharmacodynamics, pharmacokinetics, metabolism, and genetic markers can significantly advance.

Leukemia broadly describes conditions that affect erythropoiesis in the bone marrow, lymphatic system, and spleen. As with all other cancers, leukemia begins from the mutation of DNA in certain cells. Classifications of leukemias are based on the age of onset and the leukocyte involved (Lewis et al. 2014, 665). The most common leukemia is chronic lymphocytic leukemia (CLL), accounting for approximately 30% of cases in the United States (Copstead and Banasik 2013, 222). The normal function of the bone marrow, spleen, and liver becomes interrupted by the invasion of malignant lymphocytes (B cells); since the B cells are functionally inactive, a patient becomes more susceptible to infections. The sluggish progression of CLL unfortunately leads to late diagnoses and poor prognosis (Lewis et al. 2014, 665). Patients that become symptomatic in later stages will experience fatigue, weight loss, anorexia, and an increased susceptibility to infection, due to abnormal antibody production. Patient specific factors such as age, disease progression, and medication side effects will determine the course of treatment (Copstead and Banasik 2013, 223). The fragile state of patients with CLL requires continuous examination of drug therapy and interventions to prevent further complications.

Pharmacogenomics, a component of precision medicine, is the study of how genes affect a person’s response to particular drugs. It involves a combination of pharmacology and genomics, to manufacture medication and doses that are customized to fulfill the variations found in people’s genes. (Reference 2016)

Some studies investigated the treatment-related cancers role and developing of CVM either due to a direct effect or for unknown reasons 21, 22.

Cancer survivors are predisposed to experiencing issues in the areas of physical, psychological, social and spiritual due to the cancer disease process and cancer treatments (Mullen & Mistry, 2018, p.337). Common physical issues include fatigue, dysphagia and pain (Sugerman, 2013, p.218). Fatigue is an issue experienced by majority of cancer survivors (Mullen & Mistry, 2018, p.339). Mullen and Mistry (2018, p.339) state that it is important to perform a thorough assessment in order determine the cause of fatigue as fatigue can also be caused by other comorbidities including heart fatigue, hypothyroidism, hormone imbalances and/ or sleep disturbances. Nonpharmacologic treatment for fatigue includes participating in regular exercise, yoga, meditation and massage therapy (Kantor & Suzan, 2016, p.305). Pharmacologic interventions include steroids, epoetin alfa and methylphenidate (Kantor & Suzan, 2016, p.305). Additionally, in order to alleviate the impact of dysphagia, it would be beneficial for John to have a review with a dietitian as a dietitian will accurately assess the nutritional needs of John and

The prior study based the design protocol and the variable of diagnoses on limited data. Each of the represented modules of treatment integrated for the study were layered to improve the statistical collection of program performance.

Limitation of the study: Based on Magalhaes et al. (2012), accuracy in detecting the illness was not identified, the perpetual utilization of the heterogeneous therapeutic regimen. An active control study was included in the meta- analysis study, and there is no inactive treatment performed.

Hyperthermia is a healthier treatment because it is safer. While there are other cancer treatments, this one has less severe effects. Chemotherapy can cause heart problems, reduced lung capacity, kidney and urinary issues, numbness, bone and joint problems,

GB is a very pleasant individual who was admitted for chemotherapy. GB is a 41 y/o Hispanic male with an oncology diagnosis of MCL. The expected duration of this admission is 14 days for his high-dose chemotherapy for MCL, cycle #3A of R-CODOX –M regimen, of Chemotherapy. GB has been placed on a regular diet; current weight: 66kg; height: 169 cm; BMI: 23 (normal weight range); Braden score: 22 (not a fall risk, continue to reassess/monitor); placed on chemotherapy precautions and has a central line-triple lumen. GB’s wife has been staying with him at night and keeps him company when she

The clinical signficance of some outcome measures in clinical trials, in particular mean changes in rating scale scores, can be difficult to translate to the clinic. Recent CPMP guidelines suggest that response rates provide a more meaningful approach. A measure calculated from response rates that has direct clinical utility is the Number Needed to Treat (NNT). The NNT indicates the number of patients that need to be treated before a pre-defined treatment response is achieved. Thus, low NNT values are better than high ones. NNTs are useful in making policy decisions and decisions regarding indivdual patients and have been advocated by the UK National Health Service Research and Development Directorate evidence based publication ‘Bandolier’.

Chemotherapy can increase a patient’s life span and improve the outcome of cancer treatment. However, the side effects of nausea and vomiting can be debilitating to the patient’s quality of life. According to Navari, (2013), specific patients’ characteristics and the type of chemotherapy administered can increase the risk of chemotherapy induced nausea and vomiting. For example history of motion sickness and pregnancy induced nausea and vomiting increases a patient’s risk, women are more at risk than men and in younger patients whilst patients with high alcohol consumption experiences less risk (NCCN, 2011).

[23] and Doyle et al. [53]. We applied the results of the former study to the model, because it was more relevant in terms of health states. The study derived utilities in health states of NSCLC IIIb and IV and disutilities in grade III-IV toxicities under the situation where metastatic NSCLC patients received second-line chemotherapy. Only, we recited disutility in anemia from Westwood et al. [14]. We assumed that adverse events occurred during the first cycle, and adverse event rates relied on the type of treatment regimen regardless of the first-line or the second-line treatment. Finally, in case of an oral medication, 0.02 obtained from Tabberer et al. [24] was added to the utilities investigated by Nafees et al., because the study was carried out under the situation on intravenous treatments such as pemetrexed or

This was clearly defined in the study. Internal validity was demonstrated though patient assignment and exclusion criteria made by an investigator not participating in data collection. Additional use of PASS software was used to randomize and provide allocation preventing imbalances in the treatment assignments. External validity was demonstrated with clear objective of the study defined, a pilot study was conducted and an intention-to-treat strategy was developed adjust for patients not completing the study. The Sharpiro-Wilk test, Mann-Whitney U test, X2, and Fisher exact test along with consolidated standards of reporting trials (CONSORT) were employed to further generate validity within the study. The data was displayed using graphs and tables with explanations relevant to the research finding and outcomes. This enhanced the written analysis of the findings. Valid resources and references were used for the study and evidenced by the use these citations within the

Evolution of cancer therapy has made cancer a more manageable disease today than ever before. However, chemotherapy-induced cardiac complications are an important cause of morbidity and mortality in patients. Patients are likely to suffer from a cardiac disease rather than recurrent cancer. It is therefore necessary to manage both, the neoplasm and associated toxicities of antineoplastic drugs, especially cardiotoxicity. [1, 2]