Comfort First: an evaluation of a procedural pain management programme for children with cancer

Retinoblastoma is a rare cancer of the infant retina, which forms when both RB1 alleles mutate in a susceptible retinal cell, likely a cone photoreceptor precursor. Loss of the tumour suppressor functions of the retinoblastoma protein, pRB, leads to uncontrolled cell division and recurrent genomic changes during tumour progression. Although pRB is expressed in virtually all tissues, cone precursors have biochemical and molecular features that may sensitize to RB1 loss to enable tumourigenesis. Retinoblastoma is diagnosed in ~8,000 children each year worldwide. Patient survival is >95% in high-income countries, but <30% globally. However, outcomes are improving through increasing awareness for earlier diagnosis, new guidelines and sharing of expertise. Intra-arterial and intravitreal chemotherapy have emerged as promising methods to salvage eyes. Ongoing international collaborations will replace the multiple different classifications of eye involvement with standardized definitions to consistently assess eligibility, efficacy and safety of treatment options. Life-long follow-up is warranted since survivors of heritable retinoblastoma are at risk for developing second cancers. Defining the molecular consequences of RB1 loss in diverse tissues may open new avenues for treatment and prevention of retinoblastoma as well as second cancers in patients with germline RB1 mutations.

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“…73,74 CT scans are now avoided because radiation induces second primary cancers in people carrying RB1 mutations. 75 …”

Section: Diagnosis Screening and Preventionmentioning

confidence: 99%

“…115,178–180 Child Life interventions at any age and with any treatment help children cope and even thrive during treatment, reduce treatment costs, ease family stress and improve long-term mental health (Figure 11). 5,75,181–184 …”

Section: Quality Of Lifementioning

confidence: 99%

Retinoblastoma

Dimaras

Corson

Cobrinik

et al. 2015

Nat Rev Dis Primers

454

390

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“…Interestingly, none of the parents or patients who participated in the study mentioned the tube insertion procedure as an area of concern prior to the tube being inserted. Although it is not possible to alter some of the negative aspects discussed above, such as the physical appearance of the tube, the introduction of psychological preparation, cognitive–behavioural techniques and utilisation of play therapists may lessen the distressing nature of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Parent, patient and health professional perspectives regarding enteral nutrition in paediatric oncology

Cohen

Wakefield

Tapsell

et al. 2017

Nutrition & Dietetics

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“…In addition, Cohen et al (1986) found that the characteristics of the treatment center strongly predicted the presence of AN, and suggested that some fine points pertaining to the chemotherapy room, such as being within sight of basins or the absence of entertainment or comfortable chairs, could facilitate the manifestation of emetic anticipatory symptoms. Further support for this suggestion comes from recent studies (e.g., McCarthy et al, 2012) claiming that cozy waiting and treatment rooms are necessary to reduce both anticipatory anxiety and pain in cancer patients.…”

Section: Identifying An Risk Factors Beyond Cs-us Contingenciesmentioning

confidence: 98%

Individual differences in chemotherapy-induced anticipatory nausea

Rodríguez¹

2013

Front. Psychol.

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Anticipatory Nausea (AN) is a severe side effect of chemotherapy that can lead cancer patients to discontinue their treatment. This kind of nausea is usually elicited by the re-exposure of the patients to the clinical context they need to attend to be treated. There has been considerable agreement that AN represents a paradigmatic example of Pavlovian conditioning, and within this framework, several behavioral interventions have been proposed in order to prevent this phenomenon. However, some studies have questioned the validity of the Pavlovian approach, suggesting that CS-US associations are neither necessary nor sufficient for AN to occur. The data and the alternative theories behind such criticisms are discussed. Additionally, it is suggested that animal models of AN could be enriched by taking into account rats' individual differences.

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Comfort First: an evaluation of a procedural pain management programme for children with cancer

Abstract: The CFP was found to be effectively implementing procedural pain guidelines. Regular audit is recommended to ensure adherence to pain management standards.

Cited by 24 publications

References 46 publications

Retinoblastoma

Retinoblastoma

Parent, patient and health professional perspectives regarding enteral nutrition in paediatric oncology

Individual differences in chemotherapy-induced anticipatory nausea

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