Circadian rhythms disruption in cancer

Background In oncology, the prevalence of symptoms is preferentially analyzed in isolation instead of being considered in clusters. However, clinical practice shows that symptoms rarely occur separately but rather form clusters that share common underlying mechanisms in terms of intensity and severity, creating a synergistic effect among them, which can even help predict the development of future symptoms. Objective To identify and gather evidence on the prevalence, composition, severity, and predictors of cancer symptom clusters in adult cancer patients undergoing chemotherapy. Methods This systematic review and meta-analysis protocol was developed in compliance with PRISMA-P. Observational and experimental study designs will be included. MEDLINE/PubMed, Cochrane Library, Embase, CINAHL, PsycINFO, Web of Science, Scopus, LILACS, clinical trials.gov-NIH, the British Library, Google Scholar, and preprints [medRXiv] will be searched with no restrictions on idioms, dates, or settings. Two investigators will independently select the studies, perform data extraction, and critically appraise the risk of bias of the included studies. Heterogeneity among the studies will be assessed using the I2 statistic. If meta-analysis was feasible, a random-effect model analysis will be carried out. For data analysis, the pooled effect will be estimated considering 95% confidence interval and α = 5%. In addition, the certainty of evidence will be rated based on Cochrane methods in accordance with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Discussion To the best of our knowledge, this systematic review and meta-analysis will be the first to identify and critically assess evidence regarding the prevalence, composition, severity, and predictors of cancer symptom clusters in adult cancer patients undergoing chemotherapy. We intend to provide health professionals with subsidies to reflect on a better understanding of symptom clusters in adult cancer patients, with the aim of contributing to the development of evidence-based therapeutic interventions and success in clinical practice. PROSPERO registration number CRD42021248406.

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“…pillars of research in oncology and for the advancement of science in symptom management in oncology [41][42][43][44][45].…”

Section: Plos Onementioning

confidence: 99%

Cancer symptom clusters in adult patients undergoing chemotherapy: A systematic review and meta-analysis protocol

et al. 2022

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Section: Cancer Symptom Clusters: From the Lab Bench To Clinical Prac...mentioning

confidence: 99%

“…Evidence suggests that individuals with CRF have dysregulated circadian rhythms of activity/rest and sleep/wakefulness (1,8,10,12,(15)(16) . Furthermore, the hypothalamic-pituitary-adrenal (HPA) axis disruption or activation is a potential mechanism for fatigue, which is supported by dysregulation of cortisol concentrations (8,(12)(13)(14)(15)(16) . During chronic exposure to HPA axis pro-inflammatory cytokines, sensitivity is likely to be abrogated and this decrease in cortisol production has been associated with CRF (10)(11)16) .…”

Section: Cancer Symptom Clusters: From the Lab Bench To Clinical Prac...mentioning

confidence: 99%

“…Furthermore, the hypothalamic-pituitary-adrenal (HPA) axis disruption or activation is a potential mechanism for fatigue, which is supported by dysregulation of cortisol concentrations (8,(12)(13)(14)(15)(16) . During chronic exposure to HPA axis pro-inflammatory cytokines, sensitivity is likely to be abrogated and this decrease in cortisol production has been associated with CRF (10)(11)16) . Furthermore, during chronic exposure to stress, the cytokine network is modulated, sensitizing the HPA axis (negative feedback) (8,16) .…”

Section: Cancer Symptom Clusters: From the Lab Bench To Clinical Prac...mentioning

confidence: 99%

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Cancer symptom clusters: from the lab bench to clinical practice

Lopes-Júnior

2022

Rev. Bras. Enferm.

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Objective: to present and discuss the advancement of science in symptom management through research involving oncological symptom clusters (OSC). Method: a reflective study, supported by the scientific literature on OSC. Results: five key points are crucial to advancing the science of symptom management through research involving OSC: definition of OSC characteristics; underlying mechanisms and priority symptom clusters; OSC measurement; targeted and personalized interventions; new analytical strategies. Final considerations: a better understanding of the complex connections between different systems and biobehavioral aspects in patients, especially in the field of oncology nursing, is urgent. The study of these interactions has become increasingly promising and emerging for oncology nursing, since therapeutic interventions, whose target is the neuroimmunoendocrine axis, are relevant for personalized care, translating into greater scientific and nurse autonomy to care for patients.

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“…Disruption of the immune balance can also lead to a chronic cascade of events mediated by pro-inflammatory cytokines (IL-1β, IL-6, TNF-α, and IFN), resulting in stress feedback loop, depression, anxiety, fatigue, sleep disorders, cognitive alterations, and subsequent negative impact on quality of life. [12][13][14][15][16] Briefly, stress, through the activation of the neuroimmunoendocrine axis, can negatively influence multiple biological pathways. [12] For instance, one study well-matched controls have examined cortisol in 82 mothers of children with psychiatric or developmental disorders.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers of stress in caregivers of children with special health care needs: A protocol for systematic review

et al. 2022

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Background: Children with Special Health Care Needs (CSHCN) require greater attention from family caregivers as they present temporary or permanent physical, developmental, behavioral, or emotional issues. This demand for care generates overload and stress among family caregivers. So far, there is no study that gathers the available literature regarding the use of biomarkers to assess stress among caregivers of CSHCN. Hence, we aimed to synthetize and to assess the scientific evidence on biomarkers associated with stress in caregivers of CSHCN.Methods: This systematic review and meta-analysis protocol was elaborated following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). The search strategy will be undertaken through 7 electronic bibliographic databases: Embase, MEDLINE/PubMed, Cochrane Library, Web of Science, CINAHL, Scopus, and PsycINFO. In addition, secondary searches in other sources, such as Clinical trials.gov-NIH, The British Library, Pro Quest Dissertations Database, Google Scholar, and medRXiv will be also carried out. The reference section of the included studies will be hand searched for additional relevant studies. There will be no restriction regarding the publication dates or languages for this systematic review. Moreover, in an independently manner, 2 investigators will select studies, perform data extraction, as well as perform a critical appraisal of the risk of bias and overall quality of the selected studies, based on their designs. The heterogeneity among the studies will be assessed using the I 2 statistic test. According to the results of this test, we will verify whether a meta-analysis is feasible. If feasibility is confirmed, a random-effect model analysis will be carried out. For data analysis, the calculation of the pooled effect estimates will consider a 95% CI and alpha will be set in 0.05 using the SPSS version 23.0.Results: This systematic review and meta-analysis will provide better insights regarding the biomarkers associated with stress in caregivers of CSHCN. Hence, consistent data and robust evidence will be provided to help practitioners and decision-makers in this area.Conclusions: To the best of our knowledge this study, will be the first to synthetize and critically evaluate the scientific evidence on biomarkers associated with stress in caregivers of CSHCN.

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Circadian rhythms disruption in cancer

Cited by 8 publications

References 153 publications

Cancer symptom clusters in adult patients undergoing chemotherapy: A systematic review and meta-analysis protocol

Cancer symptom clusters in adult patients undergoing chemotherapy: A systematic review and meta-analysis protocol

Cancer symptom clusters: from the lab bench to clinical practice

Biomarkers of stress in caregivers of children with special health care needs: A protocol for systematic review

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