Diabetes mellitus (DM) and cancer are considered among the diseases that can pose an additional clinical challenge to both patients and health-care providers alongside a significant deterioration of patient-related outcomes (Giovannucci et al., 2010). Earlier literature reports up to 18% of all cancer patients with pre-existing DM (Barone BB et al., 2010). Patients with diabetes developing cancer have lower response rates to the assigned treatment. This makes the management of both conditions difficult by increasing the incidence for developing glycaemic issues, risk of hospitalisation for chemotherapy-related complications and higher mortality rates compared
INTRODUCTIONPort-A catheter is the most common and preferable application device to be used because of ease of access, lower occurrence of complication rates, and significantly improved quality of life.1-2 However, it is not free from complications. Port-A catheter complications can be categorized into early-and late-related complications. Early-related complications usually detected between 24 h and 4 weeks after implantation; however, late complications can be observed after 4 weeks of implantation. Port-A catheter complications could also be followed up by the clinical pharmacist who might help in the assessment of the complications and provide further counselling and patient care services in collaboration with other healthcare professionals. Patient counselling by the clinical pharmacist is an essential part in the management of therapy-related problems as it involves provision of proper education to the patients regarding adverse effects, nutritional counselling and optimal lifestyle modification. It is principally aimed to minimize unnecessary hospital admissions, reducing and preventing therapy-related problems, achieving the desired therapeutic goals, and improving therapy outcomes. 4-5The objective of this study was to assess the incidence of early related -complications (ERCs) of port -A catheter insertion, and to evaluate the effective role of clinical pharmacist via the provision of appropriate counselling and patient care services on reducing those complications in cancer patients undergoing chemotherapy through port-A catheter application. MATERIALS AND METHODSA prospective pilot study, single centre analysis conducted from February through May 2015. Approval of the study protocol was granted from the Ethical Committee of Dr. Lütfi Kırdar Kartal Teaching and Research Hospital at the Anatolian side of Istanbul -Turkey. Patient recruitmentThe study was carried out on patients newly diagnosed with different types of cancers. Cancer patients attending for chemotherapy administration at the oncology centre of Dr. Lütfi Kırdar Kartal Teaching and Research Hospital were eligible for recruitment after meeting the inclusion criteria of the study. Several patients undergoing port-A catheter implementation and eligible for the inclusion criteria during the above period were used to estimate the sample size. Inclusion criteria included patients over the age of 18 years, patients with newly diagnosed cancer eligible for chemotherapy and have an indication for port A-catheter implantation. Patients who expressed willingness to take part in the study were provided with additional written information and were asked to sign the study consent form. Exclusion criteria included patients with pre-existing port A-catheter insertion and patients with skin disorders. Baseline data were collected from the medical records of the patients. The collected data were used to structure a detailed health report for the patients including socio-demographic and medical history data (age, gender, cancer family history, cigarette smok...
Background: Although it is considered as important part in cancer therapy, radiotherapy is associated with many acute side effects. The clinical pharmacist in clinical oncology practice provides a well-defined role in the assessment and monitoring of side effects during treatment. The aim of this study was to explore Radiotherapy-Related Acute Side Effects (RRASEs) in a real-life setting at the radiology unit and whether there is a possibility for providing radiology unit-based clinical pharmacy supportive services in collaboration with other healthcare professionals for cancer patients admitted for radiotherapy application. Methods: A retrospective descriptive study was carried out on cancer patients admitted for radiotherapy application at the radiology unit. During the study, detection of RRASEs incidence and their outlined treatments were assessed. Results: RRASEs observed was 494 with a mean number of 6.175±2.88 per patient. A high incidence of RRASEs was encountered among male patients 61.3%. Nausea and vomiting were the most common acute side effects encountered 82.5% followed by loss of appetite 73.8%. There was a significant correlation between the incidence of RRASEs and a number of factors that were related to age greater than 60 years (P=0.0003), cigarette smoking (P=0.0084), comorbidities (P=0.0328), carcinoma type and stage (P=0.0098) and (P=0.0001) respectively. Conclusion: Radiotherapy application is associated with the incidence of different acute side effects that require proper treatment and follow-up. This could be further achieved through the introduction of the clinical pharmacist services in collaboration with other healthcare professionals for better patient-related health outcomes.
Background Ado-trastuzumab emtansine is an antibody-drug conjugate that combines the cytotoxic activity of emtansine with human epidermal growth factor receptor 2-targeted antitumor features of trastuzumab. Objective We conducted a study of metastatic breast cancer patients treated with trastuzumab emtansine. By evaluating progression-free survival, overall survival, and response rates, we aimed to find prognostic factors of trastuzumab emtansine treatment. Methods Our study is a single-center, retrospective, observational study. We have clinical data from 78 patients treated with trastuzumab emtansine for metastatic breast cancer, from May 2016 through May 2019, at Kartal Dr Lutfi Kirdar Education and Research Hospital, Medical Oncology Department. Our objective is to assess the survival and response rates in trastuzumab emtansine-treated individuals and the factors associated with survival. The factors we analyzed were cancer antigen 15-3 sensitivity, Eastern Cooperative Oncology Group-Performance Status, presence or absence of visceral metastases, presence or absence of cranial metastases, and treatment-associated thrombocytopenia. Results Among 78 patients, median progression-free survival was 7.8 months, and overall survival was 21.1 months. Twenty of the patients had an objective tumor response. The results showed that trastuzumab emtansine was tolerable with a manageable safety profile and consistent with the results of the previous literature. Mostly seen adverse events were anemia, thrombocytopenia, fatigue, and increased levels of alkaline phosphatase. Patients with Eastern Cooperative Oncology Group-Performance Status = 2 had worse progression-free survival and overall survival compared to ones with Eastern Cooperative Oncology Group-Performance Status < 2; progression-free survival and overall survival are worse in cancer antigen 15-3-sensitive breast cancer patients. According to our findings, treatment-associated thrombocytopenia was a significant prognostic factor for survival. Patients with thrombocytopenia had 12 months progression-free survival, whereas patients without thrombocytopenia had only 4.1 months progression-free survival. In like manner, overall survival was much better in the thrombocytopenia-experienced patients as 29.5 versus 11.8 months. Conclusions Trastuzumab emtansine prolongs progression-free survival and overall survival with a manageable safety profile. Thrombocytopenia, Eastern Cooperative Oncology Group-Performance Status, and cancer antigen 15-3 are correlated with progression-free survival and/or overall survival.
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