- Email: [email protected]
Scalp cooler is effective in reducing chemotherapy-induced alopecia among breast cancer patients: A single institution experience
abstracts
Annals of Oncology
CN96
Level of physical activity and nutritional status in cancer patients with fatigue: An exploratory cross-sectional study
P. Jahn1, F. Jahn2, C. Leithold2, V. Mathies3 Nursing Science, University Medicine Tu¨bingen, Tu¨bingen, Germany, 2Department of Internal Medicine IV, Haematology and Oncology, Martin Luther Universit€ at HalleWittenberg, Halle, Germany, 3Institute for Nutritional Science, Martin-Luther-University Halle-Wittenberg, Halle, Germany
Methods: Two cases were retrospectively reviewed through medical history records to determine possible nursing implications to prevent or detect earlier cases in the future. Results: Patient A: 53 year old woman being treated for Acute Myeloid Leukaemia (AML) with grade 4 neutropenia. She referred pain in her catheter site and presented fever and hypotension. After some days NF was diagnosed requiring 3 surgical interventions. Pseudomonas Aeruginosa was isolated in blood cultures. Patient B: 71 year old woman under treatment for AML with grade 3 neutropenia. NF in her Peripheral Insertion Central Catheter site was diagnosed. She presented no symthoms the days before but fever in the diagnosis. She required 2 surgical interventions. Klebsiella oxytoca and Enterobacter cloacae were isolated in blood cultures. Intensive care admission and longer hospitalization was required in both cases. NF was controlled but they had long term consequences (loss of mobility, paresthesia or pain). Conclusions: FN is a rare potentially lethal infection in neutropenic patients. Oncology Nurses must be aware of this complication and patient implications in order to detect it earlier. Prompt diagnosis is crucial to prevent major surgical trauma, mortality and long-term morbidity. Legal entity responsible for the study: Hosptial Clınic de Barcelona. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CN98
1
Everyday life with long-term chemotherapy induced peripheral neuropathy among patient in adjuvant treatment for colorectal cancer: A multi methods study
M. Jensen1, M. Yilmaz2, B. Pedersen3 Oncology Unit, Aalborg Universitetshospital - Region Nordjylland, Aalborg, Denmark, 2 Department of Oncology, Aalborg University Hospital, Aalborg, Denmark, 3 Department of Oncology, Aalborg Universitetshospital - Region Nordjylland, Aalborg, Denmark
1
Background: Cancer-related fatigue (CRF) is one of the most common side effects and leads to a significant impairment of quality of life (QoL). At the same time many cancer patients suffer from malnutrition. Studies show that both physical activity and a good nutritional status reduce CRF. Until now this has only been considered in isolation. This study aims a comprehensive view to evaluate the relation of fatigue with malnutrition and level of activity. Methods: 18 patients of the oncological sports and exercise therapy at the University Hospital Halle (Saale) were examined in a cross-sectional design. Outcome measures were the relevant values of body composition, such as body mass [% of fat-free mass] (BCM [% of FFM]), extracellular mass to body cell mass (ECM / BCM) and phase angle u, which were determined by bioelectrical impedance analysis (BIA). Moreover CRF with EORTC QLQ FA12, Nutritional related QoL with FAACT, History and Current Level of Activity (Questionnaire from Woll) and Malnutrition with Subjective Global Assessment (SGA). The statistical analysis was made with description and Pearson’s correlations. Following, a linear regression analysis was supplemented with an ANOVA. Results: The correlation between physical fatigue and habitual physical activity had a correlation coefficient of -0.641 (p ¼ 0.004). Between the physical fatigue and FAACT Total Score a negative linear correlation (correlation coefficient ¼ -0.739, p < 0.01) could be found. The correlation of the physical fatigue and the values from the BIA did not show any significant results. The linear regression analysis showed that 47.8 % of the total fatigue could be explained by the Functional Assessment of Anorexia/ Cachexia Therapy (corr. R2 ¼ 0.478, p ¼ 0.001) and that ECM/BCM and BCM [% of FFM] do not provide additional explanatory power. Conclusions: It could be confirmed that the QoL of cancer patients is strongly limited by the CRF. The negative correlation between habitual activity and physical fatigue supports the hypothesis of the so-called "prehabilitation". It has been shown that it is a legitimate strategy to present nutritional status and level of physical activity in cancer patients with CRF at the same time. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: P. Jahn: Research grant / Funding (institution): Chugai. C. Leithold: Honoraria (self): Fresenius. All other authors have declared no conflicts of interest.
CN97
Catheter related necrotizing fascitiis in haematological patients: Case report and implications for nursing
A. Rosich Soteras, A. Serrahima Mackay, N. Borras - Maixenchs, J. Arcarons Martı Haematology and Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain Background: Necrotizing fasciitis (NF) is a live-treating acute skin infection of soft tissues and muscles, extended from a trivial skin lesion, with rapid progression to necrosis. It is relatively uncommon and has a high mortality rate (32.2%) approaching 100% without treatment. Most cases present an anaerobic bacterium that produce gas, accumulated in the soft tissue spaces giving the characteristic image of gas gangrene on X rays (1). Site inspection reveals inflammation, oedema, and discoloration or gangrene and anaesthesia. A distinguishing clinical feature is the induration of the subcutaneous tissues (2). Early diagnosis is mandatory. Delay is associated with more extensive surgery and higher rates of amputation and mortality (1). Therapy includes radical surgical debridement with empirical broad-spectrum antibiotic coverage (2,3). Immunosuppressed patients or suffering from haematological malignancies are particularly at risk presenting an atypical etiopathology (3).
Volume 30 | Supplement 5 | October 2019
Background: Studies describe that up to 90 % of all patients develop chemotherapy induced peripheral neuropathy (CIPN) during and after treatment for colorectal cancer with the chemotherapeutic drug oxaliplatin. Patients may struggle with CIPN many years after treatment completion, and in worst case live with it permanently with deep impact on their everyday life. Until date, there is no treatment to prevent or treat CIPN. Thus, it is urgent to understand the influence of CIPN and detect early signs of this side effect. Still, no golden standard method of assessment and evaluation of CIPN exists. The study aims to answer: 1. What questionnaire is deemed suitable by patients and nurses regarding reporting and sharing the experience of side effects during and after oxaliplatin treatment? 2. How does chemotherapy CIPN progresses and impact everyday life among patients receiving oxaliplatin from initiation of adjuvant chemotherapy until 3 years follow up? 3. How do patients experience and cope with CIPN and how does it influence on their perception of body and self in everyday life during and after adjuvant chemotherapy for colorectal cancer? Methods: The study applies a multi-methods design. To ensure the practicability and meaningfulness of the questionnaire, the questionnaire are chosen in collaboration with patients and nurses in the clinical setting. Two questionnaires are tested; functional assessment of cancer treatment gynecological oncology group neurotoxicity (FACT/GOG-Ntx) and Oxaliplatin associated neurotoxicity questionnaire (OANQ). To explore a more precise and a common understanding and perception of the grade of CIPN, a three-year follow up with the chosen questionnaires will be conducted. The patients’ experiences of side effects are explored within a phenomenological frame of reference and individual in-depth interviews. Results: The study contributes to identification of early and late signs of CIPN and provides insight into the challenges patients experience. It may assist healthcare providers to address the specific needs of these patients. Conclusions: The study is ongoing. Legal entity responsible for the study: Marlene Ægidiussen Jensen. Funding: The Novo Nordisk Foundation - Nursing research. Disclosure: All authors have declared no conflicts of interest.
CN99
Scalp cooler is effective in reducing chemotherapy-induced alopecia among breast cancer patients: A single institution experience
E. Gianotti, A. Righi Ausl Modena, Ospedale Ramazzini, Carpi, Italy Background: Chemotherapy-induced temporary hair loss is one of the most common and distressing side-effects of cancer therapy. Scalp cooling is a long known method to reduce chemotherapy-induced alopecia in cancer patients, especially when antracycline or taxanes are used. However scalp cooling to reduce hair loss is still a controversial issue. Methods: We included 210 breast cancer patients receiving chemotherapy both in (neo) adjuvant and palliative setting. Evaluation was focused on the quantification of chemotherapy-induced alopecia (CIA), satisfaction and side effects of the scalp cooling system. the severity of hair loss was assessed according to CTCAE version 4.0 by the nurses team together with the patient. Nurses completed questionnaires on patients
doi:10.1093/annonc/mdz276 | v843
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz276.030/5576614 by guest on 24 October 2019
from the mean values of symptoms (physical symptoms: 14.85610.25, emotional symptoms: 6.8465.24, well-being 3.7362.61). There is a statistically significant difference between type of cancer and shortness of breath (p ¼ 0.015) between gender and nausea (p ¼ 0.013) gender and shortness of breath (p ¼ 0.013). In addition, there is statistically difference between drowsiness and how is chemotherapy given (p ¼ 0.0017). The rest of the comparisons revealed that there is a statistical significant difference between pain and type of chemotherapy regimen (p ¼ 0.014), nausea and type of chemotherapy regimen (p ¼ 0.012), well-being and type of chemotherapy regimen (p ¼ 0.003) as well as between total symptoms and type of chemotherapy regimen (p ¼ 0.025). Conclusions: Edmonton Symptom Assessment Scale was an important clinical instrument for assessing symptoms in clinical practice. There is a need for further research in order to use this tool in a daily clinical practice in one day chemotherapy clinic. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
abstracts
CN100
Results: The mean age of the nursing students was 20.05 6 2.04; most of the students were female (82.6%). The knowledge level of warning signs of cancer of the students who were female was significantly higher than male students; as following; the symptoms of change in bowel or bladder habits (p ¼ 0.001); unusual bleeding or discharge (p ¼ 0.01); thickening or lump in the breast or elsewhere (p ¼ 0.004); indigestion or difficulty in swallowing (p ¼ 0.002); obvious change in a wart or mole (p ¼ 0.003); nagging cough or hoarseness (p ¼ 0.04). The knowledge level of warning signs of cancer of the students who took ’Internal Medicine Nursing’ lesson was significantly higher than others; as following; the symptoms of change in bowel or bladder habits (p ¼ 0.000); a sore that doesn’t heal (p ¼ 0.002); unusual bleeding or discharge (p ¼ 0.03); indigestion or difficulty in swallowing (p ¼ 0.000); obvious change in a wart or mole (p ¼ 0.000); nagging cough or hoarseness (p ¼ 0.001). Conclusions: It is thought that the majority of nursing students know warning signs of the cancer and are associated with the education given in ’Internal Medicine Nursing’. It is recommended that nursing students take part in early diagnosis and screening programs in cancer. Female nursing students more aware than male students. Because; cancer prevention campaigns have focused breast and cervical cancer which involves only females. Cancer prevention campaigns should be organized for lung, prostate and colorectal cancer which are more common in men. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Nursing management of fatigue in cancer patients: Mixed methods study
A. Tolotti1, L. Bonetti2, A. Bordoni3, N. Prieto-Casais4, L. Moser1, D. Sari5, D. Valcarenghi2 Nursing Development and Research Unit, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland, 2Nursing Development and Research Unit, EOC Ospedale Regionale Bellinzona e Valli - Istituto Oncologico della Svizzera Italiana (IOSI), Bellinzona, Switzerland, 3Radiotherapy and Palliative Care Unit, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland, 4Haematology Unit, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland, 5Nursing Department, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
CN102
1
Background: Fatigue represents a complex and frequent symptom in cancer patients and influences their quality of life. Although nurses consider the initial evaluation of the patient to be fundamental, this problem is underestimated in clinical practice and often leads to under-treatment. In addition, the patients and their families still often do not report the symptom because they fear that it will lead to a reduction or suspension of treatment or they think that the symptom is inevitable. Methods: Mixed methods study. Data were collected using Brief Fatigue Inventory, patients’ interviews, focus groups with nurses and analysis of patients’ records. The setting is represented by two impatient departments of Oncology Institute of Southern Switzerland. Quantitative data were analysed with SPSS 22.0. For the interviews and focus groups, the analysis processes were conducted according to conventional content analysis using Nvivo 10 software. Results: 71 questionnaires were analysed, 39 males and 32 females. The mean age was 65,7614 years. Fatigue was reported 5 times (7%) in nursing documents and 17 times problems fatigue was reported by nurses 5 times (7%) in patients’ records, while in 17 cases (23.9%) related problems were reported. 12 patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses’ gesture, to be informed. Three themes were identified from nurses focus group: objectivity and subjectivity in the assessment of asthenia, nursing contribution in the multidisciplinary management of asthenia and difficulty in evaluating outcomes. Conclusions: A not systematic approach to the management of fatigue emerges. Patients are satisfied with the care received but would like more information and specific interventions. Quantitative and qualitative results seem converge. Fatigue is still an underestimated problem in clinical practice. Specific training interventions for health professionals are needed. Legal entity responsible for the study: The authors. Funding: Scientific Research Advisory Board (ABREOC). Disclosure: All authors have declared no conflicts of interest.
CN101
S. Michalopoulou1, K. Kazakos1, E. Vlachou2, D-A. Owens2, I. Chatzi3, I. Boutziona4, M. Lavdaniti1 1 Nursing Department, Postgraduate Program "Diabetes Melllitus Care", Alexander Technological Educational Institute, Thessaloniki, Greece, 2Nursing, University of West Attica, Athens, Greece, 32nd Pathology Department, Konstantopouleio General Hospital, Athens, Greece, 4Oncology Department, Papageorgiou Hospital, Thessaloniki, Greece Background: Cancer and diabetes are prevalent diseases worldwide. The purpose of this study was to assess quality of life and the factors influence it in the individuals with coexistence diabetes type 2 and cancer. Methods: A cross-sectional study was conducted in a large hospital in a major Greek city. Convenience sample of 101 patients with cancer and diabetes type 2 undergoing chemotherapy constituted the study group. Quality of life was measured by the Audit of Diabetes Depedent-QoL-Questionnaire (ADDQoL-19). Information on social-demographic, treatment of tumors and diabetes, and other clinical characteristics were collected by other questionnaire. Descriptive statistics were used for demographic characteristics. For data that were not normally distributed, nonparametric tests (Mann-Whitney U test, Kruskal-Wallis test) were applied. Results: The majority of patients had cancer stage II (n ¼ 52, 51,5%) and diabetes 2 for almost seven years. Individuals with coexistence of diabetes 2 and cancer reported that disease affected the overall quality of life (1.8461.18). Also, there is a negative score in other subscale as freedom to eat (-1.43 60.80) and financial situation (-1.2560,84). It was found that cancer’s stage influences the general quality of life domain (p ¼ 0.023). Also, there were statistical significant differences between type of regimen for diabetes and several domains of quality of life. More particular, working life (p ¼ 0.004), family life (p ¼ 0.003), friendship and social life (p ¼ 0.005), physical health (p ¼ 0.003), leisure activities (p ¼ 0.004) and financial situation (p ¼ 0.004) are some of these domains that they are further influenced. Additionally the family status influences self-confidence (p ¼ 0.001) and motivation (p ¼ 0.007). Conclusions: Taking all the above under consideration, we conclude that social-demographic and clinical characteristics were associated with quality of life in patients with cancer and diabetes 2. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Awareness of nursing students about the warning signs of cancer
H.K. Yakar, S. Oguz, N. Kısır, S. Yuruk Nursing, Marmara Unıversity Faculty of Health Sciences, Istanbul, Turkey
Assessment of quality of life in patients with cancer and diabetes 2 in Northern Greece
CN103
Radiation dose variables related to the causes of skin toxicities in women with breast cancer: A study proposal
E. Pujol1, C.L. Puigmarti2, S. Pelaez3, S. Garcia1 Clinical Trial Department, Institut Catal a D’Oncologia (ICO Girona), Girona, Spain, 2 Haematology, Catalan Institute of Oncology (ICO)-Hospital Universitari Josep Trueta, 3 a D’oncologia (ICO Girona), Girona, Spain Girona, Spain, Radiotherapy, Institut Catal
1
Background: Early diagnosis of cancer is an important factor in increasing success in treatment. Nursing and nursing students who take care of the patient in clinical area practices can have a major impact on the disease by providing early diagnosis of the cancer. Limited study was explored awareness of nursing student about the warning signs of cancer. Methods: A cross-sectional descriptive study was conducted from January-March 2019. The sample size was measured Raosoft online calculator programme. A total of 460 nursing students participated in this study. Data was was obtained from nursing student via self-report using the data collection form developed by researchers based on literature. The Chi-square test was performed to evaluate differences among groups.
v844 | Cancer Nursing: Symptom Management
Background: Dermatologic toxicities related to radiotherapy treatments affect substantially the patient’s quality of life. It is well stated that the causes are closely related to the radiotherapy treatment technique and to the individual genetic variation factors. More specifically, the received by each skin point is suggested as one of the most important among those causes. But there are still no studies proving this correlation as the skin radiation dose is only assessed within a 15% uncertainty using the current feasible procedures in a common department. On the contrary, we would expect a good
Volume 30 | Supplement 5 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz276.030/5576614 by guest on 24 October 2019
baseline characteristics and type of chemotherapy received during each session of scalp-cooling The following chemotherapeutic treatments were included: doxorubicin alone or in combination with cyclophosphamide (AC); AC followed by paclitaxel,paclitaxel alone; FEC ; FEC followed by docetaxel. Results: The mean overall success rate of scalp cooling (<50% hair loss) was at 62%. In the final results, major hair loss was avoided in 85% patients given taxane treatment, in 79% of patients given FEC treatment and in 32% of patients given AC treatment. None of these patients needed to use a wig and all of them were satisfied about the results at the final evaluation. 87% of the patients considered the avoidance of hair loss to be important before starting the chemotherapy. 12 patients discontinued scalp cooling for side-effects or low compliance. Conclusions: Nurse team were properly trained and provided with higher experience; a standardized approach was used by the nurse staff for each patient with dedicated time. Our experience showed that scalp cooler provides a good chance for breast cancer patients to keep their hair during anthracyclines and/or taxane containing (neo-)adjuvant chemotherapy and could be integrated into daily practice of chemotherapy unit. Legal entity responsible for the study: Fabrizio Artioli. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Annals of Oncology
Annals of Oncology
CN96
Level of physical activity and nutritional status in cancer patients with fatigue: An exploratory cross-sectional study
P. Jahn1, F. Jahn2, C. Leithold2, V. Mathies3 Nursing Science, University Medicine Tu¨bingen, Tu¨bingen, Germany, 2Department of Internal Medicine IV, Haematology and Oncology, Martin Luther Universit€ at HalleWittenberg, Halle, Germany, 3Institute for Nutritional Science, Martin-Luther-University Halle-Wittenberg, Halle, Germany
Methods: Two cases were retrospectively reviewed through medical history records to determine possible nursing implications to prevent or detect earlier cases in the future. Results: Patient A: 53 year old woman being treated for Acute Myeloid Leukaemia (AML) with grade 4 neutropenia. She referred pain in her catheter site and presented fever and hypotension. After some days NF was diagnosed requiring 3 surgical interventions. Pseudomonas Aeruginosa was isolated in blood cultures. Patient B: 71 year old woman under treatment for AML with grade 3 neutropenia. NF in her Peripheral Insertion Central Catheter site was diagnosed. She presented no symthoms the days before but fever in the diagnosis. She required 2 surgical interventions. Klebsiella oxytoca and Enterobacter cloacae were isolated in blood cultures. Intensive care admission and longer hospitalization was required in both cases. NF was controlled but they had long term consequences (loss of mobility, paresthesia or pain). Conclusions: FN is a rare potentially lethal infection in neutropenic patients. Oncology Nurses must be aware of this complication and patient implications in order to detect it earlier. Prompt diagnosis is crucial to prevent major surgical trauma, mortality and long-term morbidity. Legal entity responsible for the study: Hosptial Clınic de Barcelona. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CN98
1
Everyday life with long-term chemotherapy induced peripheral neuropathy among patient in adjuvant treatment for colorectal cancer: A multi methods study
M. Jensen1, M. Yilmaz2, B. Pedersen3 Oncology Unit, Aalborg Universitetshospital - Region Nordjylland, Aalborg, Denmark, 2 Department of Oncology, Aalborg University Hospital, Aalborg, Denmark, 3 Department of Oncology, Aalborg Universitetshospital - Region Nordjylland, Aalborg, Denmark
1
Background: Cancer-related fatigue (CRF) is one of the most common side effects and leads to a significant impairment of quality of life (QoL). At the same time many cancer patients suffer from malnutrition. Studies show that both physical activity and a good nutritional status reduce CRF. Until now this has only been considered in isolation. This study aims a comprehensive view to evaluate the relation of fatigue with malnutrition and level of activity. Methods: 18 patients of the oncological sports and exercise therapy at the University Hospital Halle (Saale) were examined in a cross-sectional design. Outcome measures were the relevant values of body composition, such as body mass [% of fat-free mass] (BCM [% of FFM]), extracellular mass to body cell mass (ECM / BCM) and phase angle u, which were determined by bioelectrical impedance analysis (BIA). Moreover CRF with EORTC QLQ FA12, Nutritional related QoL with FAACT, History and Current Level of Activity (Questionnaire from Woll) and Malnutrition with Subjective Global Assessment (SGA). The statistical analysis was made with description and Pearson’s correlations. Following, a linear regression analysis was supplemented with an ANOVA. Results: The correlation between physical fatigue and habitual physical activity had a correlation coefficient of -0.641 (p ¼ 0.004). Between the physical fatigue and FAACT Total Score a negative linear correlation (correlation coefficient ¼ -0.739, p < 0.01) could be found. The correlation of the physical fatigue and the values from the BIA did not show any significant results. The linear regression analysis showed that 47.8 % of the total fatigue could be explained by the Functional Assessment of Anorexia/ Cachexia Therapy (corr. R2 ¼ 0.478, p ¼ 0.001) and that ECM/BCM and BCM [% of FFM] do not provide additional explanatory power. Conclusions: It could be confirmed that the QoL of cancer patients is strongly limited by the CRF. The negative correlation between habitual activity and physical fatigue supports the hypothesis of the so-called "prehabilitation". It has been shown that it is a legitimate strategy to present nutritional status and level of physical activity in cancer patients with CRF at the same time. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: P. Jahn: Research grant / Funding (institution): Chugai. C. Leithold: Honoraria (self): Fresenius. All other authors have declared no conflicts of interest.
CN97
Catheter related necrotizing fascitiis in haematological patients: Case report and implications for nursing
A. Rosich Soteras, A. Serrahima Mackay, N. Borras - Maixenchs, J. Arcarons Martı Haematology and Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain Background: Necrotizing fasciitis (NF) is a live-treating acute skin infection of soft tissues and muscles, extended from a trivial skin lesion, with rapid progression to necrosis. It is relatively uncommon and has a high mortality rate (32.2%) approaching 100% without treatment. Most cases present an anaerobic bacterium that produce gas, accumulated in the soft tissue spaces giving the characteristic image of gas gangrene on X rays (1). Site inspection reveals inflammation, oedema, and discoloration or gangrene and anaesthesia. A distinguishing clinical feature is the induration of the subcutaneous tissues (2). Early diagnosis is mandatory. Delay is associated with more extensive surgery and higher rates of amputation and mortality (1). Therapy includes radical surgical debridement with empirical broad-spectrum antibiotic coverage (2,3). Immunosuppressed patients or suffering from haematological malignancies are particularly at risk presenting an atypical etiopathology (3).
Volume 30 | Supplement 5 | October 2019
Background: Studies describe that up to 90 % of all patients develop chemotherapy induced peripheral neuropathy (CIPN) during and after treatment for colorectal cancer with the chemotherapeutic drug oxaliplatin. Patients may struggle with CIPN many years after treatment completion, and in worst case live with it permanently with deep impact on their everyday life. Until date, there is no treatment to prevent or treat CIPN. Thus, it is urgent to understand the influence of CIPN and detect early signs of this side effect. Still, no golden standard method of assessment and evaluation of CIPN exists. The study aims to answer: 1. What questionnaire is deemed suitable by patients and nurses regarding reporting and sharing the experience of side effects during and after oxaliplatin treatment? 2. How does chemotherapy CIPN progresses and impact everyday life among patients receiving oxaliplatin from initiation of adjuvant chemotherapy until 3 years follow up? 3. How do patients experience and cope with CIPN and how does it influence on their perception of body and self in everyday life during and after adjuvant chemotherapy for colorectal cancer? Methods: The study applies a multi-methods design. To ensure the practicability and meaningfulness of the questionnaire, the questionnaire are chosen in collaboration with patients and nurses in the clinical setting. Two questionnaires are tested; functional assessment of cancer treatment gynecological oncology group neurotoxicity (FACT/GOG-Ntx) and Oxaliplatin associated neurotoxicity questionnaire (OANQ). To explore a more precise and a common understanding and perception of the grade of CIPN, a three-year follow up with the chosen questionnaires will be conducted. The patients’ experiences of side effects are explored within a phenomenological frame of reference and individual in-depth interviews. Results: The study contributes to identification of early and late signs of CIPN and provides insight into the challenges patients experience. It may assist healthcare providers to address the specific needs of these patients. Conclusions: The study is ongoing. Legal entity responsible for the study: Marlene Ægidiussen Jensen. Funding: The Novo Nordisk Foundation - Nursing research. Disclosure: All authors have declared no conflicts of interest.
CN99
Scalp cooler is effective in reducing chemotherapy-induced alopecia among breast cancer patients: A single institution experience
E. Gianotti, A. Righi Ausl Modena, Ospedale Ramazzini, Carpi, Italy Background: Chemotherapy-induced temporary hair loss is one of the most common and distressing side-effects of cancer therapy. Scalp cooling is a long known method to reduce chemotherapy-induced alopecia in cancer patients, especially when antracycline or taxanes are used. However scalp cooling to reduce hair loss is still a controversial issue. Methods: We included 210 breast cancer patients receiving chemotherapy both in (neo) adjuvant and palliative setting. Evaluation was focused on the quantification of chemotherapy-induced alopecia (CIA), satisfaction and side effects of the scalp cooling system. the severity of hair loss was assessed according to CTCAE version 4.0 by the nurses team together with the patient. Nurses completed questionnaires on patients
doi:10.1093/annonc/mdz276 | v843
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz276.030/5576614 by guest on 24 October 2019
from the mean values of symptoms (physical symptoms: 14.85610.25, emotional symptoms: 6.8465.24, well-being 3.7362.61). There is a statistically significant difference between type of cancer and shortness of breath (p ¼ 0.015) between gender and nausea (p ¼ 0.013) gender and shortness of breath (p ¼ 0.013). In addition, there is statistically difference between drowsiness and how is chemotherapy given (p ¼ 0.0017). The rest of the comparisons revealed that there is a statistical significant difference between pain and type of chemotherapy regimen (p ¼ 0.014), nausea and type of chemotherapy regimen (p ¼ 0.012), well-being and type of chemotherapy regimen (p ¼ 0.003) as well as between total symptoms and type of chemotherapy regimen (p ¼ 0.025). Conclusions: Edmonton Symptom Assessment Scale was an important clinical instrument for assessing symptoms in clinical practice. There is a need for further research in order to use this tool in a daily clinical practice in one day chemotherapy clinic. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
abstracts
CN100
Results: The mean age of the nursing students was 20.05 6 2.04; most of the students were female (82.6%). The knowledge level of warning signs of cancer of the students who were female was significantly higher than male students; as following; the symptoms of change in bowel or bladder habits (p ¼ 0.001); unusual bleeding or discharge (p ¼ 0.01); thickening or lump in the breast or elsewhere (p ¼ 0.004); indigestion or difficulty in swallowing (p ¼ 0.002); obvious change in a wart or mole (p ¼ 0.003); nagging cough or hoarseness (p ¼ 0.04). The knowledge level of warning signs of cancer of the students who took ’Internal Medicine Nursing’ lesson was significantly higher than others; as following; the symptoms of change in bowel or bladder habits (p ¼ 0.000); a sore that doesn’t heal (p ¼ 0.002); unusual bleeding or discharge (p ¼ 0.03); indigestion or difficulty in swallowing (p ¼ 0.000); obvious change in a wart or mole (p ¼ 0.000); nagging cough or hoarseness (p ¼ 0.001). Conclusions: It is thought that the majority of nursing students know warning signs of the cancer and are associated with the education given in ’Internal Medicine Nursing’. It is recommended that nursing students take part in early diagnosis and screening programs in cancer. Female nursing students more aware than male students. Because; cancer prevention campaigns have focused breast and cervical cancer which involves only females. Cancer prevention campaigns should be organized for lung, prostate and colorectal cancer which are more common in men. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Nursing management of fatigue in cancer patients: Mixed methods study
A. Tolotti1, L. Bonetti2, A. Bordoni3, N. Prieto-Casais4, L. Moser1, D. Sari5, D. Valcarenghi2 Nursing Development and Research Unit, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland, 2Nursing Development and Research Unit, EOC Ospedale Regionale Bellinzona e Valli - Istituto Oncologico della Svizzera Italiana (IOSI), Bellinzona, Switzerland, 3Radiotherapy and Palliative Care Unit, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland, 4Haematology Unit, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland, 5Nursing Department, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
CN102
1
Background: Fatigue represents a complex and frequent symptom in cancer patients and influences their quality of life. Although nurses consider the initial evaluation of the patient to be fundamental, this problem is underestimated in clinical practice and often leads to under-treatment. In addition, the patients and their families still often do not report the symptom because they fear that it will lead to a reduction or suspension of treatment or they think that the symptom is inevitable. Methods: Mixed methods study. Data were collected using Brief Fatigue Inventory, patients’ interviews, focus groups with nurses and analysis of patients’ records. The setting is represented by two impatient departments of Oncology Institute of Southern Switzerland. Quantitative data were analysed with SPSS 22.0. For the interviews and focus groups, the analysis processes were conducted according to conventional content analysis using Nvivo 10 software. Results: 71 questionnaires were analysed, 39 males and 32 females. The mean age was 65,7614 years. Fatigue was reported 5 times (7%) in nursing documents and 17 times problems fatigue was reported by nurses 5 times (7%) in patients’ records, while in 17 cases (23.9%) related problems were reported. 12 patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses’ gesture, to be informed. Three themes were identified from nurses focus group: objectivity and subjectivity in the assessment of asthenia, nursing contribution in the multidisciplinary management of asthenia and difficulty in evaluating outcomes. Conclusions: A not systematic approach to the management of fatigue emerges. Patients are satisfied with the care received but would like more information and specific interventions. Quantitative and qualitative results seem converge. Fatigue is still an underestimated problem in clinical practice. Specific training interventions for health professionals are needed. Legal entity responsible for the study: The authors. Funding: Scientific Research Advisory Board (ABREOC). Disclosure: All authors have declared no conflicts of interest.
CN101
S. Michalopoulou1, K. Kazakos1, E. Vlachou2, D-A. Owens2, I. Chatzi3, I. Boutziona4, M. Lavdaniti1 1 Nursing Department, Postgraduate Program "Diabetes Melllitus Care", Alexander Technological Educational Institute, Thessaloniki, Greece, 2Nursing, University of West Attica, Athens, Greece, 32nd Pathology Department, Konstantopouleio General Hospital, Athens, Greece, 4Oncology Department, Papageorgiou Hospital, Thessaloniki, Greece Background: Cancer and diabetes are prevalent diseases worldwide. The purpose of this study was to assess quality of life and the factors influence it in the individuals with coexistence diabetes type 2 and cancer. Methods: A cross-sectional study was conducted in a large hospital in a major Greek city. Convenience sample of 101 patients with cancer and diabetes type 2 undergoing chemotherapy constituted the study group. Quality of life was measured by the Audit of Diabetes Depedent-QoL-Questionnaire (ADDQoL-19). Information on social-demographic, treatment of tumors and diabetes, and other clinical characteristics were collected by other questionnaire. Descriptive statistics were used for demographic characteristics. For data that were not normally distributed, nonparametric tests (Mann-Whitney U test, Kruskal-Wallis test) were applied. Results: The majority of patients had cancer stage II (n ¼ 52, 51,5%) and diabetes 2 for almost seven years. Individuals with coexistence of diabetes 2 and cancer reported that disease affected the overall quality of life (1.8461.18). Also, there is a negative score in other subscale as freedom to eat (-1.43 60.80) and financial situation (-1.2560,84). It was found that cancer’s stage influences the general quality of life domain (p ¼ 0.023). Also, there were statistical significant differences between type of regimen for diabetes and several domains of quality of life. More particular, working life (p ¼ 0.004), family life (p ¼ 0.003), friendship and social life (p ¼ 0.005), physical health (p ¼ 0.003), leisure activities (p ¼ 0.004) and financial situation (p ¼ 0.004) are some of these domains that they are further influenced. Additionally the family status influences self-confidence (p ¼ 0.001) and motivation (p ¼ 0.007). Conclusions: Taking all the above under consideration, we conclude that social-demographic and clinical characteristics were associated with quality of life in patients with cancer and diabetes 2. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Awareness of nursing students about the warning signs of cancer
H.K. Yakar, S. Oguz, N. Kısır, S. Yuruk Nursing, Marmara Unıversity Faculty of Health Sciences, Istanbul, Turkey
Assessment of quality of life in patients with cancer and diabetes 2 in Northern Greece
CN103
Radiation dose variables related to the causes of skin toxicities in women with breast cancer: A study proposal
E. Pujol1, C.L. Puigmarti2, S. Pelaez3, S. Garcia1 Clinical Trial Department, Institut Catal a D’Oncologia (ICO Girona), Girona, Spain, 2 Haematology, Catalan Institute of Oncology (ICO)-Hospital Universitari Josep Trueta, 3 a D’oncologia (ICO Girona), Girona, Spain Girona, Spain, Radiotherapy, Institut Catal
1
Background: Early diagnosis of cancer is an important factor in increasing success in treatment. Nursing and nursing students who take care of the patient in clinical area practices can have a major impact on the disease by providing early diagnosis of the cancer. Limited study was explored awareness of nursing student about the warning signs of cancer. Methods: A cross-sectional descriptive study was conducted from January-March 2019. The sample size was measured Raosoft online calculator programme. A total of 460 nursing students participated in this study. Data was was obtained from nursing student via self-report using the data collection form developed by researchers based on literature. The Chi-square test was performed to evaluate differences among groups.
v844 | Cancer Nursing: Symptom Management
Background: Dermatologic toxicities related to radiotherapy treatments affect substantially the patient’s quality of life. It is well stated that the causes are closely related to the radiotherapy treatment technique and to the individual genetic variation factors. More specifically, the received by each skin point is suggested as one of the most important among those causes. But there are still no studies proving this correlation as the skin radiation dose is only assessed within a 15% uncertainty using the current feasible procedures in a common department. On the contrary, we would expect a good
Volume 30 | Supplement 5 | October 2019
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baseline characteristics and type of chemotherapy received during each session of scalp-cooling The following chemotherapeutic treatments were included: doxorubicin alone or in combination with cyclophosphamide (AC); AC followed by paclitaxel,paclitaxel alone; FEC ; FEC followed by docetaxel. Results: The mean overall success rate of scalp cooling (<50% hair loss) was at 62%. In the final results, major hair loss was avoided in 85% patients given taxane treatment, in 79% of patients given FEC treatment and in 32% of patients given AC treatment. None of these patients needed to use a wig and all of them were satisfied about the results at the final evaluation. 87% of the patients considered the avoidance of hair loss to be important before starting the chemotherapy. 12 patients discontinued scalp cooling for side-effects or low compliance. Conclusions: Nurse team were properly trained and provided with higher experience; a standardized approach was used by the nurse staff for each patient with dedicated time. Our experience showed that scalp cooler provides a good chance for breast cancer patients to keep their hair during anthracyclines and/or taxane containing (neo-)adjuvant chemotherapy and could be integrated into daily practice of chemotherapy unit. Legal entity responsible for the study: Fabrizio Artioli. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Annals of Oncology