Hope for non-toxic treatment for child cancer

OnMedica | November 2018 | Hope for non-toxic treatment for child cancer

One of the most common childhood cancers- neuroblastoma –  has been found by researchers investigating treatments for the condition in animals. Neuroblastoma is the leading single cause of cancer in under 5s. Currently, despite using intensive treatment regimens, children with the most aggressive forms of neuroblastoma have a less than 50% survival rate.  Although researchers in Australia have studied the effects of using this treatment on mice, a combination of two drugs was found to be more effective than other treatments (via OnMedica).

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The research team have recently presented their findings at the 30th EORTC-NI-AACR Symposium, an event that unites academics, scientists and pharmaceutical industry representatives from across the world to discuss the latest advances and the impact of new discoveries in molecular biology. (Full story from OnMedica)

OnMedica Hope for non-toxic treatment for child cancer

Hypnosis may help reduce distress of cancer treatment in children

University of Exeter | June 2018 | Hypnosis may help reduce distress of cancer treatment in children

A team at the University of Exeter have worked alongside Devon Integrated Children’s Service to explore ways of  reducing anxiety in children having treatment for cancer without using drugs. According to the authors of the study almost fifty per cent of children with cancer experience clinically significant emotional distress. This can cause additional anguish for the child and for their families and have a long-lasting impact on mental health. As well as looking at the evidence available on hypnosis, the team also reviewed evidence on listening to music, virtual reality and cognitive behavioural therapy. They found much of the research about whether or not these strategies reduced children’s distress to be  contradictory.

Now, the team report  that hypnosis can reduce the distress associated with injections and other needle procedures, such as extracting bone marrow and giving chemotherapy. Earlier research had found that procedures like these are often more anxiety-inducing for children and young people than the cancer itself.
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Tamsin Ford, Professor of Child and Adolescent Psychiatry at the University of Exeter Medical School, said: “Hypnosis is inexpensive to deliver, and our research found that it was the technique that was most studied, and showed promise in reducing children’s anxiety about the many medical procedures they have to endure. We now need high quality trials to be sure whether hypnosis should be adopted in clinics.”(Source: University of Exeter)

An article based on the research’s findings has been published in the journal Psychooncology

Abstract

OBJECTIVE:

Children and young people (CYP) with cancer undergo painful and distressing procedures. We aimed to systematically review the effectiveness of nonpharmacological interventions to reduce procedural anxiety in CYP.

METHODS:

Extensive literature searches sought randomised controlled trials that quantified the effect of any nonpharmacological intervention for procedural anxiety in CYP with cancer aged 0 to 25. Study selection involved independent title and abstract screening and full text screening by two reviewers. Anxiety, distress, fear, and pain outcomes were extracted from included studies. Where similar intervention, comparator, and outcomes presented, meta-analysis was performed, producing pooled effect sizes (Cohen’s d) and 95% confidence intervals. All other data were narratively described. Quality and risk of bias appraisal was performed, based on the Cochrane risk of bias tool.

RESULTS:

Screening of 11 727 records yielded 56 relevant full texts. There were 15 included studies, eight trialling hypnosis, and seven nonhypnosis interventions. There were large, statistically significant reductions in anxiety and pain for hypnosis, particularly compared with treatment as usual . Evidence from nonhypnosis interventions was equivocal, with some promising individual studies. There was high risk of bias across included studies limiting confidence in some positive effects.

CONCLUSIONS:

Evidence suggests promise for hypnosis interventions to reduce procedural anxiety in CYP undergoing cancer treatment. These results largely emerge from one research group, therefore wider research is required. Promising evidence for individual nonhypnosis interventions must be evaluated through rigorously conducted randomised controlled trials.

Full reference:

Nunns, M., Mayhew, D., Ford, T, Rogers, M., Curle, C., Logan, S., Moore, D.|2018| Effectiveness of nonpharmacological interventions to reduce procedural anxiety in children and adolescents undergoing treatment for cancer: A systematic review and meta-analysis| Psychooncology2018 Apr 30|  doi: 10.1002/pon.4749. [Epub ahead of print]

 

Many young cancer patients do not receive adequate fertility information and support

All cancer patients of reproductive age should be provided with fertility information and referrals for fertility preservation, researchers urge | ScienceDaily

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In the analysis of 23 relevant studies, investigators found that many clinicians are broadly informed about the risk to their patients’ fertility brought about by cancer treatment, but many factors hinder the appropriate discussions and referrals needed to provide adequate fertility support to patients of reproductive age. For example, some oncology clinicians may lack appropriate fertility knowledge and be unsure whose role it is to provide fertility support.

Non-pharmacological interventions for management of fatigue among children with cancer

Systematic review of existing practices and their effectiveness | BMJ Supportive & Palliative Care

Objectives: Fatigue is common among children living with cancer, particularly in advance stages. Little is known about the effectiveness of non-pharmacological approaches to manage this complex and distressing symptom among children. Thus, the present paper aim to critically examine the effectiveness and setting for non-pharmacological interventions to manage fatigue among children with cancer.

Methods: Six electronic databases were screened first in February 2013 and at second instance in March 2015. They include PsycINFO, Medline, EMBASE, CINAHL, Scopus and Cochrane library. All databases were systematically searched for literature on fatigue and cancer, limited to children (as age group) and English language.

Results: 1498 articles were identified, of which six were reviewed. Three types of interventions for managing fatigue were identified including (1) complementary and alternative medicine (healing touch/massage therapy), (2) exercise-based interventions and (3) nursing-based interventions. Most interventions were delivered during active treatment and in hospital settings where parents were involved to optimise participation. Despite fatigue scores being lower among intervention groups, no study findings were observed as being statistically significant.

Conclusion: Fatigue is common among children treated for and living with cancer. The most appropriate setting to deliver non-pharmacological interventions to manage fatigue appears to be in hospital. However, in absence of any strong evidence, professionals need to be cautious about existing non-pharmacological interventions. Future research must adopt more rigorous research designs that are adequately powered using validated measures to identify potential benefits. In addition, researchers may wish to test psychosocial interventions shown to be of benefit in adults.

Full reference: Bhardwaj, T. & Koffman, J. (2017) Non-pharmacological interventions for management of fatigue among children with cancer: systematic review of existing practices and their effectiveness. BMJ Supportive & Palliative Care. Published Online First: 31 July 2017

Young adult cancer survivors struggle to get back to normal

Cancer survivors often talk about wanting to get back to normal, but a new study indicates many young adults who survived the disease struggle with attaining this goal two years after their initial diagnosis |ScienceDaily

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Researchers collected data from 215 cancer patients aged 14 to 39 years who visited five medical facilities nationwide between March 2008 and April 2010. Patients completed a self-report measure of social functioning within the first four months of diagnosis, and again at 12 months and 24 months later. They also answered questions about their social interactions with family and friends, psychological needs and mental health.

Thirty-two percent of the survivors reported consistently low social functioning over time — and some had been off treatment. Zebrack and colleagues say this could stem from the transition from treatment to off-treatment survivorship, a time fraught with new challenges to a cancer survivor, including the negative impact on finances, body image, work plans, relationship with spouse/significant other and plans for having children.

In addition, those reporting low scores on social functioning also had high levels of distress, possibly reflecting an impaired ability to reintegrate into social activities due to the effects of cancer, the study showed.

Movies could replace anaesthetic for child radiotherapy

Children with cancer could be spared dozens of doses of general anaesthesia by projecting a video directly on to the inside of a radiotherapy machine during treatment | OnMedica

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The new research was presented this week at the ESTRO 36 conference (European Society for Radiotherapy & Oncology), taking place in Vienna, Austria.

Catia Aguas, a radiation therapist and dosimetrist at the Cliniques Universitaires Saint Luc, Brussels, Belgium, told the conference that using video instead of general anaesthesia is less traumatic for children and their families, as well as making each treatment quicker and more cost effective.

The study included 12 children aged between one and a half and six years old who were treated with radiotherapy using a Tomotherapy® treatment unit at the university hospital. Six were treated before a video projector was installed in 2014 and six were treated after.

Before the video was available, general anaesthesia was needed for 83% of children’s treatments. Once the projector was installed, anaesthesia was only needed in 33% of treatments.

Read the full commentary here

Cancer as a stressful life event: Perceptions of children with cancer and their peers

Howard Sharp, K.M. Cancer. Published online: 4 May 2017

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Background: The medical traumatic stress model is commonly applied to childhood cancer, assuming that the diagnosis of cancer is a traumatic event. However, to the authors’ knowledge, little is known regarding what specifically children perceive as stressful about cancer or how it compares with other stressful events more often experienced by children.

 

Conclusions: Children do not necessarily view their cancer experience as their most stressful life event. The findings of the current study suggest that the diagnosis of cancer might be better viewed as a manageable stressor rather than a major trauma, and are consistent with the change in the fifth edition of the DSM to eliminate the diagnosis of a life-threatening illness as a qualifying trauma for PTSD.

Read the full abstract here