Three complementary approaches for managing physical and psychological symptoms related to chemotherapy-induced peripheral neuropathy were evaluated against an education-only control arm. This study included 26 participants who were randomly assigned to weekly, hour-long sessions of yoga, Reiki, meditation, or an educational control experience for 6 weeks. Each participant completed pre-post measures of neurotoxicity, quality of life, psychological distress, and mindfulness. Descriptive analysis of the data indicated that all experimental group participants demonstrated improved within-group scores on quality of life and neurotoxicity outcomes following intervention; however, the improvements were not statistically significant. Neurotoxicity worsened significantly in the control group, but there were no pre-post changes with respect to quality of life, psychological distress, or mindfulness. Effect sizes were large with respect to meditation and mindfulness and with Reiki and psychological distress. Moderate effect sizes with respect to yoga and neurotoxicity and quality of life offer promise for all 3 interventions in managing chemotherapy-induced peripheral neuropathy. KeywordsReiki, yoga, meditation, complementary and alternative medicine, neuropathy Chemotherapy-induced peripheral neuropathy is a side effect that occurs with many of the most common chemotherapeutic agents used to treat cancer. 1,2 It is the result of damage caused to the peripheral nervous system by chemotherapy and can affect sensory, motor, and autonomic neurons. 3,4 Chemotherapyinduced peripheral neuropathy can produce sensory symptoms that range from bothersome to disabling tingling, burning, numbness, loss of balance, pain, and loss of motor function that can include weakness in muscles in the upper and lower extremities. 5 Although the actual prevalence of chemotherapy-induced peripheral neuropathy is unknown, it is generally estimated at 30% to 40% in patients who have received the classes of chemotherapeutic agents used to treat breast, colon, and lung cancers, and lymphomas. 1,6-8 Typically, symptoms of chemotherapy-induced peripheral neuropathy are considered along with other pain symptoms and treated with opioids and analgesics. 9 However, these options yield limited results. With few alternatives for attenuating the symptoms of unremitting chemotherapy-induced peripheral neuropathy, people living with them have few options other than to endure them.Massage, yoga, and other complementary and alternative medical modalities have proven successful with pain and quality-of-life issues related to cancer and its treatment. [10][11][12][13] Given the limited effectiveness of allopathic intervention, the purpose of this pilot study was to determine the feasibility of using 3 complementary interventions in relieving the physical and emotional symptoms associated with chemotherapyinduced peripheral neuropathy while increasing capacity for mindfulness or self-focused attention. Of specific interest in this proposed study are 1 putative energy...
218 Background: Androgen deprivation therapy (ADT) increases the risk of numerous metabolic toxicities, including weight and body fat gain, insulin resistance, and osteoporosis. Many of these toxicities can be mitigated with lifestyle changes and monitoring of cardiovascular and diabetes risk factors, however, these are not routinely implemented in clinical practice. We designed a pilot study to evaluate whether a structured multidisciplinary (multi-D) clinic can lessen the metabolic impact of ADT. Methods: Patients who started ADT within the past 6 months were enrolled in the year-long multi-D clinic consisting of monthly face-to-face visits and individualized counseling from registered dietitian, certified exercise physiologist, and symptom management specialist, and assessment of weight, body mass index, percent body fat, fasting glucose, lipids, and hemoglobin A1c on an every 3 month schedule. The primary endpoint for this pilot study was the patient adherence rate to the clinic visit schedule, with a targeted goal of greater than 80%. Secondary endpoints included maximal percent change from baseline in metabolic parameters as outlined above. Results: 22 patients were enrolled between November 2013 and May 2014. Participation in the multi-D clinic was high, with a 95% adherence rate to the clinic schedule. The mean maximal percent change from baseline in metabolic parameters is shown below in the Table. Conclusions: Conducting a multi-D clinic for men receiving ADT was feasible, with an adherence rate of over 90%. The metabolic impact of ADT during the 12-month clinic participation was minimal and compares favorably to historical controls, but may be due to selection bias. A randomized phase 2 study comparing multi-D clinic to usual standard of care is ongoing to validate these findings. [Table: see text]
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