#Acupuncture for chemotherapy

[suchananewsblog]

Care and Comfort During Stage III or IV Breast Cancer Treatment

“Advanced breast cancer doesn’t have to be a journey taken alone,” says Sony Sherpa, MD, a holistic doctor in Sacramento, CA. “Thankfully, you have vast support options and resources available to you.” Your Doctor and Medical Team Many cancer centers have a system of support in place that includes your doctor and other health care professionals. Keep in mind that they can’t help if you don’t…

[itmightrain]

"Hodgkin's Lymphoma was one of the first cancers that was shown to be really responsive to both chemotherapy and radiation, so even though chemotherapy sucks, I knew we were going to do that. [...] I was 100% on board with chemo, and it's definitely extended my life, it's probably saved my life and I'll die of some other thing.

And three of the four chemo drugs that I was on are natural. They're from nature. Vinblastine comes from the Madagascar Periwinkle. It's just in a cute little flower, it was known to the indigenous people of Madagascar, scientists checked it out and found that it had a bunch of anti-cancer properties. Another one, Adriamycin, also called Doxorubicin, was found in microbes in the soil at the base of an Italian castle. The third, Bleomycin, was also found in a soil microbe called Streptomyces Verticillus. [...] Streptomyces Verticillus was never used in traditional medicine as far as we know, but all three of these molecules are both natural compounds and very effective chemotherapies for Hodgkin's Lymphoma (and some of them for other things).

And they've been tested, not just to see if they're effective, but to see:

What doses are most effective

Which cancers they're most effective against

How dangerous they are

What side effects are most common

How they effect women vs men

How they effect people based on their age

Their efficacy at different stages of cancer

How long you can safely take them

Which side effects are most serious and how to minimize those complications, both in the short-term and the long-term [...]

Cancers are not chill! Treatments have to be high impact because these are high impact and sneaky diseases. And so it's kind of amazing that we're in this point in history where a lot of these medicines have been tested in a lot of different ways to see what their best dosing schedule is, to see how little you can take without increasing the chances that the cancer will come back, to know how to be prepared for potential side effects. This is the slow, careful, tedious work of medical research, and it made the cancer treatment that I have just been through way less awful than it would've been just ten years ago.

During the time when I was publicly living with cancer and talking about cancer treatment, I received almost universally good vibes. Like I just want to be clear about that, people were amazing. But I did get some folks who would come to me and say that I would have a better outcome and be healthier if I took a more natural route, by which they meant that I should not be doing chemotherapy. [...]

The question becomes: if most of my cancer treatments came from nature, what do they mean when they say that I should be doing more natural treatments?

I gotta be clear here too, when it comes to like Epsom salt baths and acupuncture during chemotherapy, yes I'm in favor of all of that. If you want to do it and your doctor is telling you it's not going to do any harm and you feel like it's going to do good? Do it. [...] And there are also supplements that we know don't hurt and we think might help. [...] As long as you're talking to your doctor about it and it doesn't look like there's negative consequences I say do it.

There are some things that look like they might have some positive effect, but nothing has a positive effect like actual cancer treatment. So skipping those actual cancer treatments in favor of natural treatment makes me wonder: what do you mean by "natural"?

And here it is. I'm not sugarcoating this. I don't know a nicer way to say it. When we say natural cancer treatment, what we mean is something that either we don't know it works, or we know that it doesn't work, or we know that it does more harm than good. That's the only things that we mean when we say "natural cancer treatment", because otherwise a "natural cancer treatment" would include the three compounds from nature that I put in my body to cure my cancer.

The majority of cancer cases on earth, and an even greater majority of cancer deaths on Earth, happen outside of high-income countries. Those people don't die of cancers because they don't have access to coffee enemas or cannabis oil or apricot pits. They die because they don't have access to chemotherapy, radiation, surgery, and screening.

- Hank Green, Did "Natural" Cancer Treatments Save My Life?

[unhonestlymirror]

I remembered that Red Cross or UN twitter scandal about "folk medicine". And it's funny. They wrote something about the benefits of herbs and acupuncture - and the people in comments went absolutely mad, yelling that folk medicine is not real medicine. It's funny because all those higher-ups that spread ideas that you can trust only pharmaceutical companies, got into their own trap. I'm still not sure, why they published that folk medicine thread, though.

Do you know what the main rule of a doctor is? Don't cause harm. If we know that, e.g., a person has a heart failure, and we know that digoxin treats heart failure, are we gonna prescribe a patient acupuncture and the camomile tea? Of course not. It would be torture of a patient. We must prescribe digoxin, AND we can add camomile tea to the list to improve the mood. Because we know that camomile tea does not cause harm. (In general...). However, absence of digoxin can cause more harm. It's in simple words because I don't count the drug-food, drug-drug interactions, pharmacokinetics, pharmacodynamics, medical history, etc.

HOWEVER! We have another case. Let's say, a patient with COVID-19 fell into coma due to... for example, virus caused thromboembolism because no one gave them Xarelto, or hospital aquired pneumonia, etc. The patient's inconsolable mother cries and says she doesn't know what to do because no medicine is helping anymore. The patient is already full of medications, and the situation overall is very pessimistic. You've heard somewhere on YT about Chinese hot baths with herbs. You have a choice:

give up and let the patient die slowly

try everything you can if nothing helps anymore, fight till the last.

I've heard this is what happened to a boy in China, who was bathed in hot water with some herbs after lying unconsciously in the hospital for several months... and it worked. He came out of the coma. Maybe it was a fake story, but I tend to believe it. Remember how you went home after the long, hard day of job you hate, you ruined your trousers because of rain and mud - and you come home and get yourself a bath with roses and candles. It feels pretty good, isn't it? For the body, which was in a comatose state for months, not moving, not bathing, not living the life, it must have felt like heaven.

A good doctor should not give up any possible medicine for moral reasons, if nothing helps and there is the slightest chance something will help. We should not completely avoid folk medicine, as well as we should not completely avoid medications, chemotherapy, etc. The modern medicine was born from the folk medicine, and the modern medicine has approximately the same chance of fail as the folk medicine (Thalidomide scandal, trans therapy scandals, etc). There should be balance.

[chemotherapyindelhi]

Chemotherapy Therapy In Delhi - Lyfe Medicare Cancer Centre

Chemotherapy therapy, while often a vital part of cancer treatment, can be an emotionally and physically daunting process for patients. The side effects of chemotherapy, such as fatigue, hair loss, and nausea, can take a toll on the body and mind. However, emerging research is shedding light on new approaches to minimize these side effects. From personalized dosing based on genetic factors to targeted drug delivery systems, the future of chemotherapy holds promise for reducing the impact on patients' quality of life.

Furthermore, the integration of complementary therapies alongside traditional chemotherapy is gaining traction within the medical community. Techniques like acupuncture, yoga, and meditation are being explored as potential allies in mitigating the adverse effects of chemotherapy. By adopting a more holistic approach that considers both physical and psychological well-being during treatment, healthcare providers are striving to enhance patient resilience and overall outcomes. As our understanding evolves and innovative strategies continue to emerge, the landscape of chemotherapy therapy is undergoing a transformation that offers hope and improved care for those battling cancer.

Tag = Chemotherapy Therapy In Delhi, Chemotherapy In Delhi, Chemotherapy Cost in Delhi

[jcrmhscasereports]

 Use of acupressure to reduce nausea and vomiting in cancer patients receiving chemotherapy (literature study) by Maher Battat in Journal of Clinical Case Reports Medical Images and Health Sciences

ABSTRACT

Nausea and vomiting are distressing and serious problems for cancer patients receiving chemotherapy despite the fact that they are receiving antiemetics according to the standard guidelines which this problem is a huge challenge to nurses involved in cancer care.

Purpose: To explore and assess the effectiveness of using acupressure as a non-pharmacological intervention in addition to pharmacological interventions in reducing nausea and vomiting in cancer patients receiving chemotherapy.

Method: A literature review was conducted of 8 articles published between 2006 and 2014. These included one study of a randomized, double-blind, placebo controlled trial; one quasi-experimental model with a control group; four articles reporting on randomized control trials (RCTs); one systematic review study; and one review study. Key Findings: Seven of the articles we read supported the effect of an acupressure P6 Wristband in reducing chemotherapy induced nausea and vomiting in cancer patients and other databases also supported that finding. The one article with neutral results showed that there was no difference between a combination of acupuncture and acupressure treatment at P6 and at the sham point for the nausea score, but the level of nausea was very low in both groups.

Conclusion: We conclude that the acupressure P6 wrist band when applied to acupuncture point P6 is effective, safe, convenient, cost effective, and provides an easy, self-administrated, non-pharmacological intervention that can be used to reduce chemotherapy induced nausea and vomiting.

Keywords: Acupressure, Chemotherapy, Nausea and Vomiting, Cancer patients, Chemotherapy-induced nausea and vomiting.

INTRODUCTION

Nausea and vomiting are serious and troublesome side effects of cancer therapy. We chose this research topic in order to become familiar with the topic of the nausea and vomiting facing cancer patients during their chemotherapy treatment, which we have observed during our experience in the Oncology departments.

As nurses, we normally use updated and standard guidelines for managing clinical challenges. We reviewed the literature to explore whether there are alternative approaches to pharmacological management that might reduce or eliminate this problem. We found there are many interventions, such as music, acupuncture, acupressure, and yoga. We decided to assess the effectiveness of using acupressure to reduce the nausea and vomiting in cancer patients receiving chemotherapy. Acupressure is a type of complementary and alternative medicine which the National Cancer Institute (NCI Dictionary of Cancer Terms) defines as follows: “Acupressure is the application of pressure or localized massage to specific sites on the body to control symptoms such as pain or nausea".

THE RESEARCH QUESTION

Can acupressure reduce nausea and vomiting in cancer patients receiving chemotherapy?

We have chosen to use the definitions of the NCI Dictionary of Cancer Terms:

“Nausea is an unpleasant wavelike feeling in the back of the throat and/or stomach that may lead to vomiting", and “Vomiting is throwing up the contents of the stomach through the mouth”.

Nausea and vomiting affect the patient’s whole life. These side effects lead to metabolic imbalance, fatigue, distress, and lowered quality of life. We would like to fine a simple, effective and cost effective way to manage these problems so we can put it to use in our hospital.

METHOD

A literature study is, “A critical presentation of knowledge from various academic written sources, and a discussion of the sources in view of a particular research question" (Synnes 2014). There are many challenges when doing a literature study. There are many databases and much literature and our search process had to find the correct, scientific and relevant databases. It required a lot of time and effort to find the full text of all relevant articles. Fortunately, we received excellent help from the librarian at the Betanien University High school.

We started the search process by making a PICO outline to narrow down the search and to find the correct key words and mesh terms.

P: (Population or participants) Cancer patients experiencing chemotherapy-induced nausea and vomiting.

I:  (Intervention or indicator) Acupressure.

C: (Comparator or control) No comparison or placebo.

O: (Outcome) Reduce nausea and vomiting.

We used PUBMED, Google scholar, scholar.najah.edu and other search engines. When we used Acupressure as a search word we found more than 800 studies. When we added chemotherapy, cancer patients, and nausea and vomiting, we brought this down to 14 articles. We read these and decided to use 8 articles only, one of which was a systematic review. We also used an unpublished Master’s thesis from An Najah National University. This thesis was cited in one of the articles that we decided to review. The key words used were: Acupressure, Chemotherapy, Nausea and Vomiting, Cancer patients, Chemotherapy-induced nausea and vomiting, with Acupressure as a mesh term.

We then critically appraised all the articles according to our checklist. We included only those articles that followed the IMRAD style (i.e. those including an introduction, method, results and discussion section). We excluded all articles that were more than ten years old (i.e. published before 2004), except for two articles: one was about the mechanism of acupressure, which seemed to be directly relevant to our research topic, while the second article was used in the discussion section to discuss certain factors related to the topic. We also excluded one of the review articles because its method appeared to be weak. One of the Cochran reviews was also dropped because it had not been updated.

Despite applying these strict criteria, we were still concerned lest we had left out some important articles or included an inappropriate one. However, we were reassured by the fact that the librarian at Betanien had guided us in our search.

THEORETICAL PART

Nursing Need Theory and basic human needs

The Nursing Need Theory was developed by Virginia A. Henderson to define the unique focus of nursing practice. The theory focuses on the importance of increasing the patients’ independence to hasten their progress in the hospital. Henderson’s theory emphasizes the basic human needs and how nurses can assist in meeting those needs.

The 14 components of Need Theory present a holistic approach to nursing that covers the patient’s physiological, psychological, spiritual and social needs.

Physiological components

Breathe normally.

Eat and drink adequately.

Eliminate body wastes.

Move and maintain desirable postures.

Sleep and rest.

Select suitable clothes – dress and undress.

Maintain body temperature within normal range by adjusting clothing and modifying the environment.

Keep the body clean and well groomed and protect the integument.

Avoid dangers in the environment and avoid injuring others.

Psychological aspects of communicating and learning

Communicate with others in expressing emotions, needs, fears, or opinions. Spiritual and moral

Worship according to one’s faith. Sociologically oriented to occupation and recreation

Work in such a way that there is sense of accomplishment.

Play or participate in various forms of recreation.

Learn, discover, or satisfy the curiosity that leads to normal development and health, and use the available health facilities.

There is much similarity between Henderson’s 14 components and Abraham Maslow’s Hierarchy of Needs. Henderson’s Components 1 to 9 are comparable to Maslow’s physiological needs, with the 9th component also being a safety need. Henderson’s 10th and 11th components are similar to Maslow’s love and belonging needs, while her 12th, 13th and 14th components match Maslow’s self-esteem needs (Vera 2014).

The second of Henderson’s physiological needs is the need to “Eat and drink adequately”. Only the need to breathe is given a higher priority than the need for adequate nutrition. For cancer patients receiving chemotherapy and suffering from chemotherapy-induced nausea and vomiting, this need is the most critical.

Cancer prevalence and treatment

Cancer is a group of diseases characterized by uncontrolled growth and the spread of abnormal cells. It may be caused by internal factors, such as an inherited mutation, or a hormonal or immune condition, or it may result from a mutation from metabolism, or from external sources, such as tobacco use, radiation, chemicals and infectious organisms. Cancer is prevalent all over the world, in both developed and developing nations; it affects both sexes at all ages (Said 2009). The American Cancer Society (2010) estimated that 1,529,560 new cases of cancer were diagnosed in 2010 and that 80 % would be treated with chemotherapy; this means more than 1 million patients will be undergoing chemotherapy in any given year (Lee et al. 2010).

Cancer treatment may be based on chemotherapy, radiotherapy and surgical interventions. Chemotherapy is an important treatment in cancer care but it is associated with several side effects, such as bone marrow suppression, increased susceptibility to infection, diarrhea, hair loss, appetite changes, nausea and vomiting, among others (NCI Chemotherapy Side Effects Series, 2014).

Chemotherapy-induced nausea and vomiting (CINV) is the most prevalent and one of the hardest side effects to manage (Suh 2012).

Nausea and vomiting

Nausea and vomiting (N&V) can be acute or delayed. The incidence of acute and delayed N&V was investigated in highly and moderately emetogenic chemotherapy treatment regimens. Patients were recruited from 14 oncology practices in six countries. Overall, more than 35% of patients experienced acute nausea, and 13% experienced acute emesis. In patients receiving highly emetogenic chemotherapy, 60% experienced delayed nausea and 50% experienced delayed emesis. In patients receiving moderately emetogenic chemotherapy, 52% experienced delayed nausea and 28% experienced delayed emesis. CINV was a substantial problem for patients receiving moderately emetogenic chemotherapy in ten community oncology clinics. Thirty-six percent of patients developed acute CINV, and 59% developed delayed CINV (NCI, Nausea and Vomiting, 2015).

Chemotherapy is the most common treatment-related cause of N&V. The incidence and severity of acute emesis in persons receiving chemotherapy varies according to many factors, including the particular drug, dose, schedule of administration, route, and individual patient variables.

Risk factors for acute emesis include:

Poor control with prior chemotherapy

Female gender

Younger age

Emetic classification:

The American Society of Clinical Oncology has developed a rating system for chemotherapeutic agents with their respective risk for acute and delayed emesis.

High risk: Emesis has been documented to occur in more than 90% of patients on the following chemotherapeutic agents:

Cisplatin (Platinol).

Mechlorethamine (Mustargen).

Streptozotocin (Zanosar).

Cyclophosphamide (Cytoxan), 1,500 mg/m2 or more.

Carmustine (BiCNU).

Dacarbazine (DTIC-Dome).

Moderate risk: Emesis has been documented to occur in 30% to 90% of patients on the following chemotherapeutic agents:

Carboplatin (Paraplatin).

Cyclophosphamide (Cytoxan), less than 1,500 mg/m2.

Daunorubicin (DaunoXome).

Doxorubicin (Adriamycin).

Epirubicin (Pharmorubicin).

Idarubicin (Idamycin).

Oxaliplatin (Eloxatin).

Cytarabine (Cytosar), more than 1 g/m2.

Ifosfamide (Ifex).

Irinotecan (Camptosar).

Low risk: Emesis that has been documented to occur in 10% to 30% of patients on the following chemotherapeutic agents:

Mitoxantrone (Novantrone).

Paclitaxel (Taxol).

Docetaxel (Taxotere).

Mitomycin (Mutamycin).

Topotecan (Hycamtin).

Gemcitabine (Gemzar).

Etoposide (Vepesid).

Pemetrexed (Alimta).

Methotrexate (Rheumatrex).

Cytarabine (Cytosar), less than 1,000 mg/m2.

Fluorouracil (Efudex).

Bortezomib (Velcade).

Cetuximab (Erbitux).

Trastuzumab (Herceptin).

Minimal risk: Emesis that has been documented to occur in fewer than 10% of patients on the following chemotherapeutic agents:

Vinorelbine (Navelbine).

Bevacizumab (Avastin).

Rituximab (Rituxan).

Bleomycin (Blenoxane).

Vinblastine (Velban).

Vincristine (Oncovin).

Busulphan (Myleran).

Fludarabine (Fludara).

2-Chlorodeoxyadenosine (Leustatin).

In addition to the emetogenic potential of the agent, the dose and schedule used are also extremely important factors. For example, prescribing a drug with a low emetogenic potential to be given in high doses may cause a dramatic increase in its potential to induce N&V. For example, standard doses of cytarabine rarely produce N&V, but these often occur with high doses of this drug. Another factor to consider is the use of drug combinations. Because most patients receive combination chemotherapy, the emetogenic potential of all of the drugs combined needs to be considered, and not only that of individual drug doses.

Delayed (or late) N&V is that which occurs more than 24 hours after chemotherapy administration. Delayed N&V is associated with cisplatin and cyclophosphamide, and with other drugs (e.g., doxorubicin and ifosfamide) when given at high doses, or if given on 2 or more consecutive days.

Delayed emesis: Patients who experience acute emesis with chemotherapy are significantly more likely to have delayed emesis as well.

Risk factors: All the predicative characteristics for acute emesis are also considered risk factors for delayed emesis (NCI, Nausea and Vomiting, 2015).

The nausea and vomiting that are often associated with chemotherapy are a serious problem for cancer patients. Despite recent improvements in pharmaceutical technology, about 60% of cancer patients who receive antiemetic medications with their chemotherapy still suffer from nausea and vomiting, and as many as 20% of patients refuse to continue chemotherapy due to the severity of the nausea and vomiting (Shin et al. 2004). Early studies reported that patients cited nausea and vomiting as the most distressing symptoms when receiving chemotherapy. The distressing effect of severe nausea and vomiting can lead to nutritional deficiencies, dehydration, electrolyte imbalance, fatigue, depression and anxiety; they can also disrupt the activities of daily living and cause a lot of work time to be lost (Said 2009).

Uncontrolled nausea and vomiting can interfere with adherence to treatment regimens, and may cause the oncologists to reduce chemotherapy doses. Chemotherapy-induced nausea and vomiting is classified as being either “acute” if it happens within 24 hours post chemotherapy, or “delayed” if it occurs on days 2–5 of the chemotherapy cycle. The latter is particularly troublesome because there is no reliable pharmacological treatment for this problem. The American Society of Clinical Oncology’s (ASCO) recommendations include giving 5-HT3 (5-hydroxytryptamine, or serotonin) receptor antagonists plus corticosteroids before chemotherapy to patients who are at high risk for emesis. Nevertheless, many patients still experience nausea and vomiting related to chemotherapy, and approximately one-third of patients have nausea of at least moderate intensity, resulting in a significant reduced quality of life (QOL). Therefore, the experts emphasize the need for an evaluation of additional ways to reduce these symptoms (Said 2009).

Pharmacological interventions for the management of nausea and vomiting

Historically, antiemetic treatment has steadily improved since the introduction, in 1981, of high-dose metoclopramide which reduced the amount of emesis. This was followed by the development of serotonin (5-HT3) antagonist in the early 1990s, and the 5-HT3 antagonists proved to be more effective than the prior medications in preventing CINV. The concomitant use of corticosteroids was found to further improve the control of emesis. Despite these improvements, nausea and vomiting still remain a problem for many patients. Recently, a new drug, the neurokinin NK (1) receptor antagonist has been shown to be more effective at preventing both acute and delayed CINV for patients treated with highly emetogenic chemotherapy (Said 2009).

Non-pharmacological intervention for management of nausea and vomiting

Traditional Chinese medicine offers a possible intervention for the non-pharmacological treatment of nausea and vomiting in cancer patients. Traditional Chinese medicine (TCM) is a system of medical care that was developed in China over thousands of years. It looks at the interaction between mind, body and environment, and aims to both prevent and cure illness and disease.

TCM is based on Chinese views and beliefs about the universe and the natural world. It is a very complex system. In this essay we can only give a brief overview of what TCM involves. It is very different from Western medicine; Chinese medicine practitioners believe there is no separation between the mind and body and that illness of every kind can be treated through the body. They use a combination of various practices that may include:

Herbal remedies (traditional Chinese medicines).

Acupuncture or acupressure.

Moxibustion (burning moxa – a cone or stick of dried herb).

Massage therapy.

Feng shui.

Breathing and movement exercises called qi gong (pronounced chee goong).

Movement exercises called tai chi (pronounced tie chee).

TCM practitioners say that TCM can help to:

Prevent and heal illness.

Enhance the immune system.

Improve creativity.

Improve the ability to enjoy life and work in general.

Beliefs behind TCM

According to traditional Chinese belief, humans are interconnected with nature and affected by its forces. The human body is seen as an organic whole in which the organs, tissues, and other parts have distinct functions but are all interdependent. In this view, health and disease relate to the balance or imbalance between the various functions. TCM treatments aim to cure problems by restoring the balance of energies.

There are important components that underlie the basis of TCM:

Yin-yang theory is the concept of two opposing but complementary forces that shape the world and all life. A balance of yin and yang maintains harmony in the body, the mind and the universe.

Qi (pronounced chee) energy or vital life force flows through the body along pathways known as meridians, and it is affected by the balance of yin and yang. It regulates spiritual, emotional, mental, and physical health. If there is a blockage or an imbalance in the energy flow, the individual becomes ill. TCM aims to restore the balance of qi energy.

The five elements – fire, earth, metal, water, and wood – is a concept that explains how the body works, with the elements corresponding to particular organs and tissues in the body.

The TCM approach uses 8 principles to analyse symptoms and puts particular conditions into groups: cold and heat, inside and outside, too much and not enough, and yin and yang (Cancer Research, UK, 2015).

In summary, chemotherapy related nausea is not well controlled by pharmacological agents and identifying methods to prevent and alleviate treatment-related nausea remains a major clinical challenge. Non-pharmacological interventions such as music, progressive muscle relaxation (Said 2009), and ginger herbal therapy (Montazeri A et al. 2013) have all been shown to reduce CINV. Among the non-pharmacological interventions that reduce CINV are acupuncture and acupressure, based on the assumption that the individual’s welfare depends on a balance of energy in the body and their overall energy level (Said 2009). Yarbro et al. (2011, p. 645) also indicate in Cancer nursing: principles and practice book that acupuncture and acupuncture-related interventions (electroacupoint stimulation, acupressure, acustimulation wrist bands, and electroacupuncture) can be used to control nausea and vomiting in cancer patients.

Molassiotis et al. (2007) claim that the need for additional relief has led to the interest in non-pharmacological adjuncts to drugs, such as acupuncture or acupressure, since combining anti-emetics with other non-pharmacological treatments may prove to be more effective, safe and convenient in decreasing nausea than antiemetics alone.

From the National Cancer Institute website we found that acupressure is recognised as one of the non-pharmacologic strategies used to manage nausea and vomiting (Nausea and Vomiting, 3 September 2014). We used this website to get up to date, relevant information.

Acupressure

Acupressure involves putting pressure with the fingers, or with bands, on the body’s acupoints and is easy to perform, painless, inexpensive, and is effective. The P6 (Pericardium 6) point (Nei-Guan) refers to a point located on the anterior surface of the forearm, 3-finger widths up from the first wrist crease and between the tendons of flexor carpiradialis and Palmaris longus (figure1). P6 can be stimulated by various methods. The most well-known technique is manual stimulation by the insertion and manual rotation of a very fine needle (manual acupuncture). An electrical current can be passed through the inserted needle (electroacupuncture). Electrical stimulation can also be applied via electrodes on the skin surface or by a ReliefBand, a wristwatch-like device providing non-invasive electrostimulation. Pressure can be applied either by pressing the acupoint with the fingers or by wearing an elastic wristband with an embedded stud (acupressure).

Figure 1: Done by M.Battat & I.Amro 2015 The Acupressure P6 point determined in the picture And showing the SEA BAND acupressure

Acupressure is based on the ancient Eastern concept that Chi energy travels through pathways known as meridians. Along the meridians are acu-points, which are controlling points for the Chi energy flow. If the energy flow in meridians is slowed, blocked, or hyper-stimulated, it can be rebalanced or re-stimulated either by applying pressure (acupressure) or by inserting a needle (acupuncture) into one or more of these acupoints. Two points are known for relieving nausea and vomiting: the Nei-Guan point (P6) and the Joksamly point (ST36, located at 4-finger breadths below the knee depression lateral to the tibia).

Patients tend to prefer the P6 point over the ST36 point, Because of its ease of access and the freedom from restriction. When these points are correctly located and pressure applied, either through acupressure or acupuncture, the Chi energy flow is rebalanced, resulting in relief from nausea and vomiting.

The practice of acupressure requires some training and experience, but the technique is widely accessible to any healthcare professionals, particularly to clinical nurses. This acupressure technique is an approach that should be tried not only by healthcare professionals but also by family members or the patients themselves (Shin et al. 2004).

According to the teaching of traditional Chinese medicine, illness results from an imbalance in the flow of energy through the body. This energy or Qi (chee) is restored through the use of acupuncture and acupressure at certain points on the body that have been identified through critical observation and testing over 4000 years. In scientific terms, the neurochemicals that are released after needling or pressure at a specific point may be responsible for this effect. The most commonly used point for nausea and vomiting is Pericardium 6 (Neiguan or P6), located above the wrist (Molassiotis et al. 2007).

The literature review on acupressure

Acupressure for chemotherapy-induced nausea and vomiting in breast cancer patients: a multicentre, randomised, double-blind, placebo-controlled clinical trial. (Said 2009)

For a master degree in public health from An-najah National University, Said (2009) described a randomized, double-blind, placebo controlled trial that was done in Palestine with 126 women on chemotherapy for breast cancer. In this study the researcher divided the patients into 3 groups: the first group (n=42) received acupressure with bilateral stimulation of P6, the second group (n=42) received bilateral placebo stimulation, and the third group (n=42), which served as a control group, received no acupressure wrist band, but all groups received pharmacological management of their nausea and vomiting. Acupressure was applied using a Sea-Band (Sea-Band UK Ltd, Leicestershire, England) that patients had to wear for five days following the administration of chemotherapy. Assessment of acute and delayed nausea and emesis, quality of life, patients’ satisfaction, recommendation of treatment and requests for a rescue antiemetic were obtained. Said (2009) concluded that the acupressure showed benefits for delayed nausea and the mean number of delayed emetic episodes. Acupressure may therefore offer an inexpensive, convenient, and self-administered intervention for patients on chemotherapy to reduce nausea and vomiting at home during days 2-5 after chemotherapy. In addition, the percentage of patients who were satisfied with the treatment (≥ 3 on a 0-6 scale) was 81% (35/42) in the P6-acupressure group, and 64% (27/42) in the placebo group (p= 0.0471). The percentage of patients who would recommend acupressure treatment was 79% (34/42) in the P6-acupressure group, and 62% (26/42) in the placebo group (p= 0.0533). We used this study because it had a lot of essential information, it used the IMRAD system and was also mentioned in the literature (Genç and Tan 2014). This study demonstrated that the mean scores for the acupressure group were lower for both acute and delayed nausea.

Review of Acupressure Studies for Chemotherapy-Induced Nausea and Vomiting Control. (Lee et al. 2008)

In the Journal of Pain and Symptom Management Jiyeon Lee et al. (2008) reviewed ten controlled studies on acupressure in order to evaluate the effects of a non-invasive intervention, acupressure, when combined with antiemetics for the control of CINV. The review evaluated one quasi-experimental and nine randomized clinical trials, which included two specific acupressure modalities, namely, an acupressure band and finger acupressure. The effects of the acupressure modalities were compared study by study. Four of the seven acupressure band trials supported the positive effects of acupressure, whereas three acupressure band trials did not support the effects of acupressure. However, all the studies with negative results had methodological issues. In contrast, the one quasi-experimental and two of the randomized finger acupressure trials all supported the positive effects of acupressure on CINV control. The reported effects of the two acupressure modalities produced variable results at each stage of CINV. Acupressure bands were most effective in controlling acute nausea, whereas finger acupressure controlled delayed nausea and vomiting. The overall effect of acupressure was strongly indicative but not conclusive. We used this article because it is relevant, a review study, and is from a known journal.

The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. (Molassiotis et al. 2007)

As reported in the journal Complementary Therapies in Medicine, acupressure was applied using wristbands (Sea-Band™) in a randomized controlled trial conducted in two centres in the UK. Patients in the experimental group had to wear these bands for the five days following their chemotherapy administration. Assessments of nausea, retching and vomiting were obtained from all patients, daily, for five days. Molassiotis et al. (2007) evaluated the effectiveness of using acupressure on the Pericardium 6 (Neiguan) acupoint in managing CINV. Thirty-six patients took part in the study, with 19 patients allocated to the control group and 17 to the experimental group. The results showed that nausea with retching, nausea, and vomiting with retching, and the accompanying distress were all significantly lower in the experimental group as compared to the control group (p < 0.05). The only exception was the vomiting, where the difference was close to significance (p = 0.06). We used this article because it had a strong study design and also used an IMRAD system.

Acupuncture and acupressure for the prevention of chemotherapy-induced nausea- a randomized cross-over pilot study. (Melchart et al. 2006)

In a randomized, cross-over trial, Melchart et al. (2006) studied 28 patients receiving moderately or highly emetogenic chemotherapy and a conventional standard antiemetic for one chemotherapy cycle, followed by a combination of acupuncture and acupressure at point P6 for one cycle, and for another cycle a combination of acupuncture and acupressure at a close sham point. The results showed that there was no difference in the nausea score between the combined acupuncture treatment at P6 and at the sham point, but the level of nausea was very low in both cases. We used this study because the article had neutral results and because we trusted the source of article, coming as it did from a cancer support care journal.

The efficacy of acupoint stimulation for the management of therapy adverse events in patients with breast cancer: a systematic review. (Chao et al. 2009)

This is a systematic review of 26 articles published between 1999 to 2008 examining the efficacy of acupressure, acupuncture or acupoint stimulation (APS) for the management of adverse events due to the treatment of breast cancer. Published online on 17 September 2009 in the Breast Cancer Research and Treatment journal, 23 trials reported revealed that APS on P6 was beneficial in treating CINV. Chao et al. (2009) also presented the findings from three high quality studies comparing APS groups with control groups, which indicated that APS is beneficial in the management of CINV and especially in the acute phase, even with the non-invasive intervention. Health care professionals should consider using APS, and in particular acupressure on the P6 acupoint, as an option for the management of CINV. Furthermore, as a cost effective intervention, it warrants further investigation. We used this article because it used the IMRAD structure.

'Until the trial is complete you can’t really say whether it helped you or not, can you?’: exploring cancer patients’ perceptions of taking part in a trial of acupressure wristbands. (Hughes et al. 2013)

In Complementary and Alternative Medicine, Hughes et al. report on qualitative research undertaken with patients receiving chemotherapy in the UK. A convenience sample of 26 patients volunteered to participate in the clinical trial and to explore their experiences of using acupressure wristbands. Participants were recruited from three geographical sites: nine were recruited from Manchester, nine from Liverpool, and eight from Plymouth and the surrounding regions. Ten of the participating patients received true acupressure during the trial, 9 received sham acupressure, and 7 received no acupressure. Hughes et al. (2013) concluded that the research provided insights into cancer patients’ motivations and experience of taking part in a clinical trial for a complementary alternative medicine intervention, in which the participants perceived acupressure wristbands to reduce the level of nausea and vomiting experienced during their chemotherapy treatment. This article is important because it includes the benefits experienced by the patients taking part in the trial. This is also the first qualitative study to explore patients’ experiences of using acupressure wristbands and their perceptions of the effects. In the study, the patients perceived the wristbands as reducing their level of nausea and vomiting experienced due to their chemotherapy treatment. The study was an RCT.

The effect of acupressure application on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer. (Genç and Tan 2014)

Genç and Tan (2014) reported on a quasi-experimental study in Turkey with 64 patients with stages 1–3 breast cancer who received two or more cycles of advanced chemotherapy. Thirty two patients were in the experimental group, and thirty two in the control group. To determine the effect of acupressure P6 on CINV and anxiety in these patients, the P6 acupressure wristband was applied to the experimental group. Genç and Tan (2014) concluded that the total mean scores for patients in the experimental group, for nausea, vomiting and retching, were lower than those of the patients in the control group over the five days of application. We used this article because it is a recent and quasi-experimental study and used the IMRAD system.

The effects of P6 acupressure and nurse-provided counselling on chemotherapy-induced nausea and vomiting in patients with breast cancer. (Suh 2012)

Suh (2012) reported in the Oncology Nursing Forum on a RCT in South Korea with 120 women who were receiving chemotherapy for breast cancer. These patients had all had more than mild levels of nausea and vomiting during their first cycle of chemotherapy. The participants were assigned randomly to one of four groups: a control group (a placebo on a specific location on the hand); a counselling only group; a P6 acupressure only group; and a P6 acupressure plus nurse-provided counselling group. The purpose of the study was to evaluate the effects of pericardium 6 (P6) acupressure and nurse-provided counselling on CINV in patients with breast cancer. Suh (2012) concluded that nurse-provided counselling and P6 acupressure were together the most effective in reducing CINV in patients with breast cancer. We used this article because it is the first RCT evaluating the isolated and combined effects of P6 acupressure and counselling in reducing CINV among non-Western patients. The findings of the study support the use of P6 acupressure together with counselling that is focused on cognitive awareness, affective readiness, symptom acceptance, and the use of available resources as an adjunct to antiemetic medicine for the control of CINV. The article used the IMRAD system.

DISCUSSION

Can acupressure reduce nausea and vomiting in cancer patients receiving chemotherapy?

In our experience, we have usually used metoclopramide (pramin) plus serotonin (5-HT3) antagonist (as Ondansetron and Granisetron), plus Dexamethasone plus neurokinin NK (1) (as Emend - aprepitant) for moderate to high ematogenic chemotherapy, yet some of the patients have still suffered from nausea and vomiting. After reviewing the literature we would like to use the acupressure P6 wrist band to solve this problem as the findings of our literature review confirm that the acupressure P6 wrist band reduces CINV in cancer patients receiving chemotherapy. This result is corroborated by 7 of the articles reviewed.

The National Cancer Institute website supports the finding that acupressure is one of the non-pharmacologic strategies that may be used to manage nausea and vomiting (NCI Dictionary of Cancer Terms). Said (2009) adds that acupressure may offer an inexpensive, convenient, and self-administered intervention for patients on chemotherapy, helping to reduce nausea and vomiting at home on days 2-5 of chemotherapy. Genç and Tan (2014) conclude that the total mean scores for CINV in patients in the experimental group to whom they applied the P6 acupressure wristband were lower compared to patients in the control group over the five days of application. Lee et al. (2008) found that the two acupressure modalities produced variable results in each phase of CINV: acupressure bands were effective in controlling acute nausea, whereas acupressure controlled delayed nausea and vomiting. Molassiotis et al. (2007) showed that the experience of nausea and vomiting was significantly lower in the experimental group than in the control group. Chao et al. (2009) found that P6 acupoint stimulation was an option for the management of CINV. In the study reported by Hughes et al. (2013) the participants perceived that acupressure wristbands reduced the levels of nausea and vomiting experienced during chemotherapy treatment. Suh (2012) concluded that the synergistic effects of P6 acupressure together with nurse-provided counselling appeared to be effective in reducing CINV in patients with breast cancer.

Five of the seven articles investigating breast cancer patients, namely Said (2009), Chao et al.( 2009), Molassiotis et al. (2007), Suh (2012) and Genç and Tan (2014), involved breast cancer patients receiving highly ematogenic chemotherapy (e.g. Cisplatin and cyclophosphamide), and moderate risk ematogenic chemotherapy (like doxorubicin).

It is necessary to mention other therapeutic regimens that can also be used in cancer treatment that contain other types of chemotherapy that cause nausea and vomiting, for example, doxorubicin-containing regimens like ABVD (Adriamycin, Bleomycin, Vinblastine, Dacarbazine), CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisone) and FAC (5-Fluorouracil, Adriamycin, Cyclophosphamide), and ACT (Adriamycin, Cyclophosphamide, Taxol) (Said 2009) and from our experience cisplatin-containing regimens which that classified as highly ematogenic chemotherapy we noticed the patients still experienced nausea and vomiting after they received the antiemitecs. We think it is necessary to use additional intervention like acupressure to be included in the nausea and vomiting management.

Based on the reviewed findings we plan to use acupressure for cancer patients receiving chemotherapy, because the acupressure in the studies conducted in breast cancer patients reported was used with highly ematogenic chemotherapy in addition to the standard antiemetic treatment, so it is reasonable to conclude that it will work equally well with other less ematogenic types of chemotherapy.

We prefer the use of the acupressure wrist band at P6 acupoint because it is an inexpensive, convenient, and self-administered intervention involving pressure instead of needles at the same point as that used in acupuncture. Furthermore it is safer than acupuncture and patients can easily learn to put pressure on their own wrists, whereas the acupuncture involves using needles that are about the diameter of a hair and can cause temporary discomfort during insertion (Said 2009; Molassiotis et al. 2007). Acupressure seems to be a good way to complement antiemetic pharmacotherapy as it is safe and convenient, with minimal (with bands) or no (finger acupressure) costs involved. It is thus an easy to use, cost-effective, non-invasive intervention (Lee et al. 2008; Melchart et al. 2006).

There was no study result that showed any negative effect from the acupressure wrist band at P6 point, except the review by Lee et al. (2008), which mentioned that three of the ten reported acupressure band trials did not support the possible positive effects of acupressure, but these studies all had methodological issues, such as a small sample size, no true control group, and a concern about the sham acupressure band having a possible antiemetic effect. Melchart et al. (2006) said that no difference was detected in the nausea score between the acupuncture treatment at P6 acupoint, and that at the sham point. Said (2009) mentioned that the acupressure showed no benefit in relation to the incidence of delayed vomiting, early vomiting, or acute nausea, but Melchart and Said’s studies were done with breast cancer patients and it could be that the acupressure benefits were not evident due to the breast cancer patients having had axillary lymph node resection that may have affected the meridian pathway or caused damage to the median nerve as mentioned by Roscoe et al. (2003). Consequently, we think that the evidence suggesting that there is no benefit from the acupressure method for reducing CINV is weak.

Regarding the placebo effect in the articles reviewed here, Melchart et al. (2006) indicated that there was no difference in the nausea score for the combined acupuncture treatment at p6 or that at the sham point, although the level of nausea was very low in both cases. Molassiotis et al. (2007), Said (2009) and Roscoe et al. (2003) all suggested that the placebo effect may be the result of psychological factors.

Application of acupressure in clinical practice

It is important to put this theory into practice, and health care professionals could consider using APS, in particular acupressure on the P6 acupoint, as an option in the management of CINV (Chao et al. 2009). Melchart et al. (2006) said acupressure bands can easily be used in busy oncological wards, while Suh (2012) supported the use of P6 acupressure with counselling focused on cognitive awareness, affective readiness, symptom acceptance, and the use of available resources as an adjunct to antiemetic medications for the control of CINV. Hughes et al. (2013) concluded that the research provides an insight into cancer patients’ motivations for and experiences of taking part in a clinical trial for a complementary alternative medical intervention in which the participants perceived the acupressure wristbands as reducing their level of CINV. Said (2009) suggests that oncology nurses should include acupressure in their list of options for the management of CINV, and especially delayed nausea and vomiting. Special recommendations by oncology nurses are not only useful but are also much appreciated by patients as shown in a study in which the patients were satisfied with the antiemetic treatment given by both P6-acupressure, and placebo-acupressure. The percentage of patients who were satisfied (≥ 3 on 0-6 scale) with their treatment was 81% (35/42) in the P6-acupressure group, which was in agreement with Roscoe et al. (2003), and 64% (27/42) in the placebo group (p= 0.0471). The percentage of the patients who would recommend acupressure treatment was 79% (34/42) in the P6-acupressure group, which again was in agreement with the results of Roscoe et al. (2003) and Hughes et al. (2013), compared to 62% (26/42) in the placebo group (p= 0.0533). This study presented the patients’ compliance with the use of acupressure. Acupressure is easily learnt and taught and patients should be informed about its potential role and taught how to apply it. Leaflets about acupressure for the management of nausea and vomiting could be available in chemotherapy units so that patients who are interested to use such a technique would be encouraged to come forward and learn more from nurses or other health professionals. This could add to the patients’ options for antiemetic approaches and empower them to be involved in the management of these distressing side effects. Acupressure offers a no-cost, convenient, self-administered intervention for chemotherapy patients to reduce acute nausea. Acupressure devices (i.e. Wrist Bands, travel bands, and acupressure bands) have been developed to provide passive acupressure on P6. Acupressure can be administered by healthcare providers, family members, or patients themselves, and does not involve puncture of the skin.

We therefore found that the acupressure wristband is a good way to reduce nausea and vomiting for cancer patients receiving chemotherapy by applying it in the correct position with the stud over the pericardium 6 acupoint located on the anterior surface of the forearm, 3-finger widths up from the first wrist crease, and between the tendons of flexor carpiradialis and Palmaris longus.

Lee et al. (2008) encourage the application of acupressure bilaterally, rather than unilaterally, in CINV control. They recommend three minutes of finger acupressure once daily, with additional acupressure as needed, as the optimal intervention, because both three and five minute trials have succeeded in achieving positive effects. On the other hand, Molassiotis et al. (2007) claimed that there is no correlation between the frequency of pressing the studs and the level of nausea and vomiting. Lee et al. (2008) and Molassiotis et al. (2007) therefore claim opposite results in the relationship between CINV and the frequency of pressing the stud of an acupressure P6 wrist band. But when applying the acupressure P6 wrist band bilaterally, Lee et al. (2008), Said (2009), Molassiotis et al. (2007), Suh (2012), and Genç and Tan (2014) all reported a positive effect with P6 stimulation in reducing CINV.

We would like to discuss some factors related to CINV in relation to nausea and vomiting: expectancy and gender: Roscoe et al. (2003) argued that patients who received the acustimulation bands and expected them to be effective did report having a higher quality of life and less nausea, and in relation to gender, that women are more likely to experience nausea when receiving chemotherapy. Lee et al. (2008) say this may be caused by classical conditioning and also that breast cancer patients may have had a damaged median nerve due to axillary lymph node removal, but Lee et al. (2008) also mention that P6 acupressure in younger women had a significantly greater positive effect on delayed nausea than those on a placebo or those in the no-intervention control group. On the other hand, Molassiotis et al. (2007) mentioned that younger age is associated with greater nausea. We think that men may have tolerated greater stimulation of the acupressure points, and therefore experienced greater symptom relief, so it may be that the acupressure is more effective for men than for women, but these questions of gender, age and the frequency of pressing the studs would need further investigation.

Based on the reported studies, we support the belief that acupressure on P6 is applicable in clinical practice for CINV for cancer patients provided the required education, training and counselling is given to maintain the acupressure benefits.

Acupressure side effects

The study by Molassiotis et al. (2007) found that there were no side effects from the use of the wristbands, but one patient reported that she had to take the bands off because they were too tight and left her with marks for a few days. Chao et al. (2009) also mentioned that very few minor adverse events were observed.

Melchart et al. (2006) did report adverse effects from the treatment in five cases. One suffered a hematoma when wearing the acupressure band at P6. In the sham group, one hematoma was reported after acupuncture, and another three adverse effects from the acupressure band were reported (one hematoma, one skin irritation, one eczema). Hughes et al. (2013) also reported that participants had not experienced any restrictions from wearing the wristbands in terms of everyday activities, other than when washing and bathing. As one female participant commented, for most participants the wristbands were found to be comfortable to wear. However, a few participants reported that they had experienced minor irritation, such as the wristbands feeling tight or painful, or their wrists becoming itchy. Reported adverse side effects were generally deemed minor and acceptable. In the study by Said (2009), no side effect or discomfort was noticed from wearing the acupressure wristband. Said told the patients that if the bands caused discomfort, they could be removed for 30 minutes every two hours. In this way, by taking it off for regular periods, we can prevent the side effects of acupressure, even its minor and rare effects.

Acupressure reduces CINV in cancer patients, in addition it reduces anxiety (Genç and Tan 2014) and that affects overall quality of life (Said 2009). Quality of life is defined by the NCI Dictionary of Cancer Terms as “The overall enjoyment of life and the individual’s sense of well-being and ability to carry out various activities”. Based on the physiological components of the Virginia Henderson’s theory of basic human needs and Abraham Maslow’s Hierarchy of Needs, the patient needs to eat and drink adequately, and sleep and rest (Vera, 2014). This means that when we are providing the required management for distressing symptoms, such as nausea and vomiting, by including the acupressure wrist band in addition to standard antiemetics, the patient’s appetite will improve, leading the patient to eat and drink adequately and improve their sleeping pattern. These may then also improve other aspects of the cancer patient’s life. According to the Henderson Nursing Need Theory, when we meet a patient’s needs, it results in an improved quality of life for the cancer patient receiving chemotherapy. Another way of expressing this is that it restores the balance of Yin and Yang energy that leads to reduced nausea and vomiting and improves the patient’s ability to enjoy life and work in general through a maintaining of the harmony of body and mind, as described in traditional Chinese medicine (Cancer Research UK, 2015).

We believe that it is essential for cancer patients undergoing chemotherapy treatment to have adequate nutrition to maintain their strength to fight the cancer. Different nursing actions are necessary to maintain adequate nutrition including the relieving of CINV. From this we extrapolate that using the acupressure P6 wrist band to reduce CINV improves the patient’s quality of life.

CONCLUSION

Chemotherapy-induced nausea and vomiting may be life threatening and is therefore a huge challenge to nurses involved in cancer care. Even with the best pharmacological management of CINV, patients continue to experience nausea and vomiting.

From a review of eight articles with strong methodology, seven supported the positive effect of an acupressure P6 wristband in reducing CINV for cancer patients. This was also supported by other databases. The one article with neutral results showed that there was no difference between a combined acupuncture and acupressure treatment at P6 and at a sham point in relation to the nausea score, but the level of nausea was very low in both groups. We conclude that the acupressure wrist band applied to acupuncture point P6 is effective, safe, convenient, cost effective, an easy and self-administrated non-pharmacological intervention from traditional Chinese medicine that reduces CINV. Solving the problem of CINV is a fundamental nursing task that can lead to improved quality of life and nutritional status, reduced anxiety and increases patient compliance. In the light of these results, and due to the effectiveness and inexpensiveness of acupressure, together with its ease of use, we suggest that it should be used in conjunction with pharmacological agents for CINV prophylaxis. To maintain the effectiveness of the acupressure, special education and training is needed to reassure the patient that the acupressure is at the correct point (P6) and counselling by the nurse is required.

We recommend the use of acupressure P6 in oncology departments and that future research should be conducted to include cancer patients receiving radiotherapy, and to investigate more about the relationship between the frequency of pressing the stud on the wrist band for acupressure P6 and CINV, and the relationship between gender and CINV, and whether it is better to apply it unilaterally or bilaterally.

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[iccaglobal]

Integrative Cancer Treatment in California: A Holistic Approach to Healing

Cancer treatment has evolved significantly over the years, with advancements in medical technology and a growing focus on holistic care. Integrative cancer treatment in California combines the best of conventional medicine with complementary therapies to address not only the physical aspects of the disease but also the emotional, mental, and spiritual needs of patients. This comprehensive approach is gaining recognition for its ability to enhance treatment outcomes and improve quality of life during one of life’s most challenging journeys.

Integrative cancer treatment is rooted in the philosophy of treating the whole person, not just the disease. While traditional methods like surgery, chemotherapy, and radiation remain essential, they are complemented by therapies that focus on boosting the body’s natural defenses and addressing side effects. In California, where innovation and wellness often intersect, many treatment centers offer state-of-the-art integrative care that reflects the latest research and practices in oncology.

One of the cornerstones of integrative cancer treatment california is personalized care. Each patient’s journey with cancer is unique, and their treatment plan should reflect that individuality. Physicians specializing in integrative care assess a patient’s medical history, lifestyle, and personal preferences to craft a treatment strategy that aligns with their specific needs. This tailored approach not only addresses the biological complexities of cancer but also empowers patients by giving them an active role in their healing process.

Complementary therapies play a vital role in integrative cancer treatment. Nutritional counseling, for example, focuses on providing the body with the nutrients it needs to stay strong during treatment. A diet rich in antioxidants, vitamins, and minerals can support the immune system and help combat the fatigue and weakness often associated with traditional cancer therapies. Many centers in California employ nutritionists who work closely with patients to create meal plans that promote healing while accommodating dietary restrictions or preferences.

Mind-body practices are another essential component of integrative care. Techniques such as meditation, yoga, and acupuncture have been shown to reduce stress, alleviate pain, and improve overall well-being. These therapies are particularly valuable for managing the emotional toll of a cancer diagnosis, providing patients with tools to cope with anxiety and depression. In California, where mindfulness and wellness are integral to the culture, patients often have access to some of the best practitioners in these fields.

Physical rehabilitation is also emphasized in integrative cancer center. Regular exercise, tailored to a patient’s abilities and energy levels, can improve strength, reduce fatigue, and enhance mood. Many centers offer personalized fitness programs that incorporate gentle activities like walking, stretching, or swimming. These exercises not only help patients regain physical vitality but also provide a sense of accomplishment and normalcy in their daily lives.

Another hallmark of integrative cancer treatment is the focus on immune system support. Therapies such as intravenous vitamin C, herbal supplements, and probiotics are often used alongside conventional treatments to enhance the body’s ability to fight cancer. These approaches are carefully monitored by medical professionals to ensure they complement rather than interfere with mainstream therapies.

California is home to many leading centers for integrative cancer treatment, where innovation meets patient-centered care. These facilities often incorporate advanced diagnostic tools to monitor treatment progress and adjust strategies as needed. By integrating traditional and complementary therapies, they offer a comprehensive care model that addresses the complexities of cancer from every angle.

Emotional and spiritual support are integral to the integrative approach. A cancer diagnosis can be an overwhelming and isolating experience, and providing patients with a strong support network is essential. Many integrative care centers offer counseling, support groups, and spiritual guidance to help patients and their families navigate the emotional challenges of treatment. These resources foster a sense of community and resilience, reminding patients that they are not alone in their journey.

Research has shown that integrative cancer treatment can improve outcomes and enhance quality of life. Patients often report experiencing fewer side effects, faster recovery times, and a greater sense of control over their health. This holistic approach not only targets the disease but also empowers patients to live with hope and dignity, regardless of the stage of their diagnosis.

California’s reputation for innovation, diversity, and wellness makes it an ideal place for integrative cancer treatment. With access to world-class medical professionals, cutting-edge therapies, and a supportive community, patients can find the care they need to heal on all levels. By combining the best of modern medicine with holistic practices, integrative treatment offers a path to recovery that prioritizes the whole person, not just their diagnosis.

For those seeking a compassionate and comprehensive approach to cancer care, integrative cancer treatment in California provides a promising option. It is a testament to the power of combining science and empathy to create a treatment experience that fosters healing, hope, and resilience.

[jcsmicasereports]

Use of acupressure to reduce nausea and vomiting in cancer patients receiving chemotherapy (literature study) by Maher Battat in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

Nausea and vomiting are distressing and serious problems for cancer patients receiving chemotherapy despite the fact that they are receiving antiemetics according to the standard guidelines which this problem is a huge challenge to nurses involved in cancer care.

Purpose: To explore and assess the effectiveness of using acupressure as a non-pharmacological intervention in addition to pharmacological interventions in reducing nausea and vomiting in cancer patients receiving chemotherapy.

Method: A literature review was conducted of 8 articles published between 2006 and 2014. These included one study of a randomized, double-blind, placebo controlled trial; one quasi-experimental model with a control group; four articles reporting on randomized control trials (RCTs); one systematic review study; and one review study. Key Findings: Seven of the articles we read supported the effect of an acupressure P6 Wristband in reducing chemotherapy induced nausea and vomiting in cancer patients and other databases also supported that finding. The one article with neutral results showed that there was no difference between a combination of acupuncture and acupressure treatment at P6 and at the sham point for the nausea score, but the level of nausea was very low in both groups.

Conclusion: We conclude that the acupressure P6 wrist band when applied to acupuncture point P6 is effective, safe, convenient, cost effective, and provides an easy, self-administrated, non-pharmacological intervention that can be used to reduce chemotherapy induced nausea and vomiting.

Keywords: Acupressure, Chemotherapy, Nausea and Vomiting, Cancer patients, Chemotherapy-induced nausea and vomiting.

Introduction

Nausea and vomiting are serious and troublesome side effects of cancer therapy. We chose this research topic in order to become familiar with the topic of the nausea and vomiting facing cancer patients during their chemotherapy treatment, which we have observed during our experience in the Oncology departments.

As nurses, we normally use updated and standard guidelines for managing clinical challenges. We reviewed the literature to explore whether there are alternative approaches to pharmacological management that might reduce or eliminate this problem. We found there are many interventions, such as music, acupuncture, acupressure, and yoga. We decided to assess the effectiveness of using acupressure to reduce the nausea and vomiting in cancer patients receiving chemotherapy. Acupressure is a type of complementary and alternative medicine which the National Cancer Institute (NCI Dictionary of Cancer Terms) defines as follows: “Acupressure is the application of pressure or localized massage to specific sites on the body to control symptoms such as pain or nausea".

The Research Question

Can acupressure reduce nausea and vomiting in cancer patients receiving chemotherapy?

We have chosen to use the definitions of the NCI Dictionary of Cancer Terms:

“Nausea is an unpleasant wavelike feeling in the back of the throat and/or stomach that may lead to vomiting", and “Vomiting is throwing up the contents of the stomach through the mouth”.

Nausea and vomiting affect the patient’s whole life. These side effects lead to metabolic imbalance, fatigue, distress, and lowered quality of life. We would like to fine a simple, effective and cost effective way to manage these problems so we can put it to use in our hospital.

Method

A literature study is, “A critical presentation of knowledge from various academic written sources, and a discussion of the sources in view of a particular research question" (Synnes 2014). There are many challenges when doing a literature study. There are many databases and much literature and our search process had to find the correct, scientific and relevant databases. It required a lot of time and effort to find the full text of all relevant articles. Fortunately, we received excellent help from the librarian at the Betanien University High school.

We started the search process by making a PICO outline to narrow down the search and to find the correct key words and mesh terms.

P: (Population or participants) Cancer patients experiencing chemotherapy-induced nausea and vomiting.

I:  (Intervention or indicator) Acupressure.

C: (Comparator or control) No comparison or placebo.

O: (Outcome) Reduce nausea and vomiting.

We used PUBMED, Google scholar, scholar.najah.edu and other search engines. When we used Acupressure as a search word we found more than 800 studies. When we added chemotherapy, cancer patients, and nausea and vomiting, we brought this down to 14 articles. We read these and decided to use 8 articles only, one of which was a systematic review. We also used an unpublished Master’s thesis from An Najah National University. This thesis was cited in one of the articles that we decided to review. The key words used were: Acupressure, Chemotherapy, Nausea and Vomiting, Cancer patients, Chemotherapy-induced nausea and vomiting, with Acupressure as a mesh term.

We then critically appraised all the articles according to our checklist. We included only those articles that followed the IMRAD style (i.e. those including an introduction, method, results and discussion section). We excluded all articles that were more than ten years old (i.e. published before 2004), except for two articles: one was about the mechanism of acupressure, which seemed to be directly relevant to our research topic, while the second article was used in the discussion section to discuss certain factors related to the topic. We also excluded one of the review articles because its method appeared to be weak. One of the Cochran reviews was also dropped because it had not been updated.

Despite applying these strict criteria, we were still concerned lest we had left out some important articles or included an inappropriate one. However, we were reassured by the fact that the librarian at Betanien had guided us in our search.

Theoretical part

Nursing Need Theory and basic human needs

The Nursing Need Theory was developed by Virginia A. Henderson to define the unique focus of nursing practice. The theory focuses on the importance of increasing the patients’ independence to hasten their progress in the hospital. Henderson’s theory emphasizes the basic human needs and how nurses can assist in meeting those needs.

The 14 components of Need Theory present a holistic approach to nursing that covers the patient’s physiological, psychological, spiritual and social needs.

Physiological components

Breathe normally.

Eat and drink adequately.

Eliminate body wastes.

Move and maintain desirable postures.

Sleep and rest.

Select suitable clothes – dress and undress.

Maintain body temperature within normal range by adjusting clothing and modifying the environment.

Keep the body clean and well groomed and protect the integument.

Avoid dangers in the environment and avoid injuring others.

Psychological aspects of communicating and learning

Communicate with others in expressing emotions, needs, fears, or opinions. Spiritual and moral

Worship according to one’s faith. Sociologically oriented to occupation and recreation

Work in such a way that there is sense of accomplishment.

Play or participate in various forms of recreation.

Learn, discover, or satisfy the curiosity that leads to normal development and health, and use the available health facilities.

There is much similarity between Henderson’s 14 components and Abraham Maslow’s Hierarchy of Needs. Henderson’s Components 1 to 9 are comparable to Maslow’s physiological needs, with the 9th component also being a safety need. Henderson’s 10th and 11th components are similar to Maslow’s love and belonging needs, while her 12th, 13th and 14th components match Maslow’s self-esteem needs (Vera 2014).

The second of Henderson’s physiological needs is the need to “Eat and drink adequately”. Only the need to breathe is given a higher priority than the need for adequate nutrition. For cancer patients receiving chemotherapy and suffering from chemotherapy-induced nausea and vomiting, this need is the most critical.

Cancer prevalence and treatment

Cancer is a group of diseases characterized by uncontrolled growth and the spread of abnormal cells. It may be caused by internal factors, such as an inherited mutation, or a hormonal or immune condition, or it may result from a mutation from metabolism, or from external sources, such as tobacco use, radiation, chemicals and infectious organisms. Cancer is prevalent all over the world, in both developed and developing nations; it affects both sexes at all ages (Said 2009). The American Cancer Society (2010) estimated that 1,529,560 new cases of cancer were diagnosed in 2010 and that 80 % would be treated with chemotherapy; this means more than 1 million patients will be undergoing chemotherapy in any given year (Lee et al. 2010).

Cancer treatment may be based on chemotherapy, radiotherapy and surgical interventions. Chemotherapy is an important treatment in cancer care but it is associated with several side effects, such as bone marrow suppression, increased susceptibility to infection, diarrhea, hair loss, appetite changes, nausea and vomiting, among others (NCI Chemotherapy Side Effects Series, 2014).

Chemotherapy-induced nausea and vomiting (CINV) is the most prevalent and one of the hardest side effects to manage (Suh 2012).

Nausea and vomiting

Nausea and vomiting (N&V) can be acute or delayed. The incidence of acute and delayed N&V was investigated in highly and moderately emetogenic chemotherapy treatment regimens. Patients were recruited from 14 oncology practices in six countries. Overall, more than 35% of patients experienced acute nausea, and 13% experienced acute emesis. In patients receiving highly emetogenic chemotherapy, 60% experienced delayed nausea and 50% experienced delayed emesis. In patients receiving moderately emetogenic chemotherapy, 52% experienced delayed nausea and 28% experienced delayed emesis. CINV was a substantial problem for patients receiving moderately emetogenic chemotherapy in ten community oncology clinics. Thirty-six percent of patients developed acute CINV, and 59% developed delayed CINV (NCI, Nausea and Vomiting, 2015).

Chemotherapy is the most common treatment-related cause of N&V. The incidence and severity of acute emesis in persons receiving chemotherapy varies according to many factors, including the particular drug, dose, schedule of administration, route, and individual patient variables.

Risk factors for acute emesis include:

Poor control with prior chemotherapy

Female gender

Younger age

Emetic classification:

The American Society of Clinical Oncology has developed a rating system for chemotherapeutic agents with their respective risk for acute and delayed emesis.

High risk: Emesis has been documented to occur in more than 90% of patients on the following chemotherapeutic agents:

Cisplatin (Platinol).

Mechlorethamine (Mustargen).

Streptozotocin (Zanosar).

Cyclophosphamide (Cytoxan), 1,500 mg/m2 or more.

Carmustine (BiCNU).

Dacarbazine (DTIC-Dome).

Moderate risk: Emesis has been documented to occur in 30% to 90% of patients on the following chemotherapeutic agents:

Carboplatin (Paraplatin).

Cyclophosphamide (Cytoxan), less than 1,500 mg/m2.

Daunorubicin (DaunoXome).

Doxorubicin (Adriamycin).

Epirubicin (Pharmorubicin).

Idarubicin (Idamycin).

Oxaliplatin (Eloxatin).

Cytarabine (Cytosar), more than 1 g/m2.

Ifosfamide (Ifex).

Irinotecan (Camptosar).

Low risk: Emesis that has been documented to occur in 10% to 30% of patients on the following chemotherapeutic agents:

Mitoxantrone (Novantrone).

Paclitaxel (Taxol).

Docetaxel (Taxotere).

Mitomycin (Mutamycin).

Topotecan (Hycamtin).

Gemcitabine (Gemzar).

Etoposide (Vepesid).

Pemetrexed (Alimta).

Methotrexate (Rheumatrex).

Cytarabine (Cytosar), less than 1,000 mg/m2.

Fluorouracil (Efudex).

Bortezomib (Velcade).

Cetuximab (Erbitux).

Trastuzumab (Herceptin).

Minimal risk: Emesis that has been documented to occur in fewer than 10% of patients on the following chemotherapeutic agents:

Vinorelbine (Navelbine).

Bevacizumab (Avastin).

Rituximab (Rituxan).

Bleomycin (Blenoxane).

Vinblastine (Velban).

Vincristine (Oncovin).

Busulphan (Myleran).

Fludarabine (Fludara).

2-Chlorodeoxyadenosine (Leustatin).

In addition to the emetogenic potential of the agent, the dose and schedule used are also extremely important factors. For example, prescribing a drug with a low emetogenic potential to be given in high doses may cause a dramatic increase in its potential to induce N&V. For example, standard doses of cytarabine rarely produce N&V, but these often occur with high doses of this drug. Another factor to consider is the use of drug combinations. Because most patients receive combination chemotherapy, the emetogenic potential of all of the drugs combined needs to be considered, and not only that of individual drug doses.

Delayed (or late) N&V is that which occurs more than 24 hours after chemotherapy administration. Delayed N&V is associated with cisplatin and cyclophosphamide, and with other drugs (e.g., doxorubicin and ifosfamide) when given at high doses, or if given on 2 or more consecutive days.

Delayed emesis: Patients who experience acute emesis with chemotherapy are significantly more likely to have delayed emesis as well.

Risk factors: All the predicative characteristics for acute emesis are also considered risk factors for delayed emesis (NCI, Nausea and Vomiting, 2015).

The nausea and vomiting that are often associated with chemotherapy are a serious problem for cancer patients. Despite recent improvements in pharmaceutical technology, about 60% of cancer patients who receive antiemetic medications with their chemotherapy still suffer from nausea and vomiting, and as many as 20% of patients refuse to continue chemotherapy due to the severity of the nausea and vomiting (Shin et al. 2004). Early studies reported that patients cited nausea and vomiting as the most distressing symptoms when receiving chemotherapy. The distressing effect of severe nausea and vomiting can lead to nutritional deficiencies, dehydration, electrolyte imbalance, fatigue, depression and anxiety; they can also disrupt the activities of daily living and cause a lot of work time to be lost (Said 2009).

Uncontrolled nausea and vomiting can interfere with adherence to treatment regimens, and may cause the oncologists to reduce chemotherapy doses. Chemotherapy-induced nausea and vomiting is classified as being either “acute” if it happens within 24 hours post chemotherapy, or “delayed” if it occurs on days 2–5 of the chemotherapy cycle. The latter is particularly troublesome because there is no reliable pharmacological treatment for this problem. The American Society of Clinical Oncology’s (ASCO) recommendations include giving 5-HT3 (5-hydroxytryptamine, or serotonin) receptor antagonists plus corticosteroids before chemotherapy to patients who are at high risk for emesis. Nevertheless, many patients still experience nausea and vomiting related to chemotherapy, and approximately one-third of patients have nausea of at least moderate intensity, resulting in a significant reduced quality of life (QOL). Therefore, the experts emphasize the need for an evaluation of additional ways to reduce these symptoms (Said 2009).

Pharmacological interventions for the management of nausea and vomiting

Historically, antiemetic treatment has steadily improved since the introduction, in 1981, of high-dose metoclopramide which reduced the amount of emesis. This was followed by the development of serotonin (5-HT3) antagonist in the early 1990s, and the 5-HT3 antagonists proved to be more effective than the prior medications in preventing CINV. The concomitant use of corticosteroids was found to further improve the control of emesis. Despite these improvements, nausea and vomiting still remain a problem for many patients. Recently, a new drug, the neurokinin NK (1) receptor antagonist has been shown to be more effective at preventing both acute and delayed CINV for patients treated with highly emetogenic chemotherapy (Said 2009).

Non-pharmacological intervention for management of nausea and vomiting

Traditional Chinese medicine offers a possible intervention for the non-pharmacological treatment of nausea and vomiting in cancer patients. Traditional Chinese medicine (TCM) is a system of medical care that was developed in China over thousands of years. It looks at the interaction between mind, body and environment, and aims to both prevent and cure illness and disease.

TCM is based on Chinese views and beliefs about the universe and the natural world. It is a very complex system. In this essay we can only give a brief overview of what TCM involves. It is very different from Western medicine; Chinese medicine practitioners believe there is no separation between the mind and body and that illness of every kind can be treated through the body. They use a combination of various practices that may include:

Herbal remedies (traditional Chinese medicines).

Acupuncture or acupressure.

Moxibustion (burning moxa – a cone or stick of dried herb).

Massage therapy.

Feng shui.

Breathing and movement exercises called qi gong (pronounced chee goong).

Movement exercises called tai chi (pronounced tie chee).

TCM practitioners say that TCM can help to:

Prevent and heal illness.

Enhance the immune system.

Improve creativity.

Improve the ability to enjoy life and work in general.

Beliefs behind TCM

According to traditional Chinese belief, humans are interconnected with nature and affected by its forces. The human body is seen as an organic whole in which the organs, tissues, and other parts have distinct functions but are all interdependent. In this view, health and disease relate to the balance or imbalance between the various functions. TCM treatments aim to cure problems by restoring the balance of energies.

There are important components that underlie the basis of TCM:

Yin-yang theory is the concept of two opposing but complementary forces that shape the world and all life. A balance of yin and yang maintains harmony in the body, the mind and the universe.

Qi (pronounced chee) energy or vital life force flows through the body along pathways known as meridians, and it is affected by the balance of yin and yang. It regulates spiritual, emotional, mental, and physical health. If there is a blockage or an imbalance in the energy flow, the individual becomes ill. TCM aims to restore the balance of qi energy.

The five elements – fire, earth, metal, water, and wood – is a concept that explains how the body works, with the elements corresponding to particular organs and tissues in the body.

The TCM approach uses 8 principles to analyse symptoms and puts particular conditions into groups: cold and heat, inside and outside, too much and not enough, and yin and yang (Cancer Research, UK, 2015).

In summary, chemotherapy related nausea is not well controlled by pharmacological agents and identifying methods to prevent and alleviate treatment-related nausea remains a major clinical challenge. Non-pharmacological interventions such as music, progressive muscle relaxation (Said 2009), and ginger herbal therapy (Montazeri A et al. 2013) have all been shown to reduce CINV. Among the non-pharmacological interventions that reduce CINV are acupuncture and acupressure, based on the assumption that the individual’s welfare depends on a balance of energy in the body and their overall energy level (Said 2009). Yarbro et al. (2011, p. 645) also indicate in Cancer nursing: principles and practice book that acupuncture and acupuncture-related interventions (electroacupoint stimulation, acupressure, acustimulation wrist bands, and electroacupuncture) can be used to control nausea and vomiting in cancer patients.

Molassiotis et al. (2007) claim that the need for additional relief has led to the interest in non-pharmacological adjuncts to drugs, such as acupuncture or acupressure, since combining anti-emetics with other non-pharmacological treatments may prove to be more effective, safe and convenient in decreasing nausea than antiemetics alone.

From the National Cancer Institute website we found that acupressure is recognised as one of the non-pharmacologic strategies used to manage nausea and vomiting (Nausea and Vomiting, 3 September 2014). We used this website to get up to date, relevant information.

Acupressure

Acupressure involves putting pressure with the fingers, or with bands, on the body’s acupoints and is easy to perform, painless, inexpensive, and is effective. The P6 (Pericardium 6) point (Nei-Guan) refers to a point located on the anterior surface of the forearm, 3-finger widths up from the first wrist crease and between the tendons of flexor carpiradialis and Palmaris longus (figure1). P6 can be stimulated by various methods. The most well-known technique is manual stimulation by the insertion and manual rotation of a very fine needle (manual acupuncture). An electrical current can be passed through the inserted needle (electroacupuncture). Electrical stimulation can also be applied via electrodes on the skin surface or by a ReliefBand, a wristwatch-like device providing non-invasive electrostimulation. Pressure can be applied either by pressing the acupoint with the fingers or by wearing an elastic wristband with an embedded stud (acupressure).

Acupressure is based on the ancient Eastern concept that Chi energy travels through pathways known as meridians. Along the meridians are acu-points, which are controlling points for the Chi energy flow. If the energy flow in meridians is slowed, blocked, or hyper-stimulated, it can be rebalanced or re-stimulated either by applying pressure (acupressure) or by inserting a needle (acupuncture) into one or more of these acupoints. Two points are known for relieving nausea and vomiting: the Nei-Guan point (P6) and the Joksamly point (ST36, located at 4-finger breadths below the knee depression lateral to the tibia).

Patients tend to prefer the P6 point over the ST36 point, Because of its ease of access and the freedom from restriction. When these points are correctly located and pressure applied, either through acupressure or acupuncture, the Chi energy flow is rebalanced, resulting in relief from nausea and vomiting.

The practice of acupressure requires some training and experience, but the technique is widely accessible to any healthcare professionals, particularly to clinical nurses. This acupressure technique is an approach that should be tried not only by healthcare professionals but also by family members or the patients themselves (Shin et al. 2004).

According to the teaching of traditional Chinese medicine, illness results from an imbalance in the flow of energy through the body. This energy or Qi (chee) is restored through the use of acupuncture and acupressure at certain points on the body that have been identified through critical observation and testing over 4000 years. In scientific terms, the neurochemicals that are released after needling or pressure at a specific point may be responsible for this effect. The most commonly used point for nausea and vomiting is Pericardium 6 (Neiguan or P6), located above the wrist (Molassiotis et al. 2007).

The literature review on acupressure

Acupressure for chemotherapy-induced nausea and vomiting in breast cancer patients: a multicentre, randomised, double-blind, placebo-controlled clinical trial. (Said 2009)

For a master degree in public health from An-najah National University, Said (2009) described a randomized, double-blind, placebo controlled trial that was done in Palestine with 126 women on chemotherapy for breast cancer. In this study the researcher divided the patients into 3 groups: the first group (n=42) received acupressure with bilateral stimulation of P6, the second group (n=42) received bilateral placebo stimulation, and the third group (n=42), which served as a control group, received no acupressure wrist band, but all groups received pharmacological management of their nausea and vomiting. Acupressure was applied using a Sea-Band (Sea-Band UK Ltd, Leicestershire, England) that patients had to wear for five days following the administration of chemotherapy. Assessment of acute and delayed nausea and emesis, quality of life, patients’ satisfaction, recommendation of treatment and requests for a rescue antiemetic were obtained. Said (2009) concluded that the acupressure showed benefits for delayed nausea and the mean number of delayed emetic episodes. Acupressure may therefore offer an inexpensive, convenient, and self-administered intervention for patients on chemotherapy to reduce nausea and vomiting at home during days 2-5 after chemotherapy. In addition, the percentage of patients who were satisfied with the treatment (≥ 3 on a 0-6 scale) was 81% (35/42) in the P6-acupressure group, and 64% (27/42) in the placebo group (p= 0.0471). The percentage of patients who would recommend acupressure treatment was 79% (34/42) in the P6-acupressure group, and 62% (26/42) in the placebo group (p= 0.0533). We used this study because it had a lot of essential information, it used the IMRAD system and was also mentioned in the literature (Genç and Tan 2014). This study demonstrated that the mean scores for the acupressure group were lower for both acute and delayed nausea.

Review of Acupressure Studies for Chemotherapy-Induced Nausea and Vomiting Control. (Lee et al. 2008)

In the Journal of Pain and Symptom Management Jiyeon Lee et al. (2008) reviewed ten controlled studies on acupressure in order to evaluate the effects of a non-invasive intervention, acupressure, when combined with antiemetics for the control of CINV. The review evaluated one quasi-experimental and nine randomized clinical trials, which included two specific acupressure modalities, namely, an acupressure band and finger acupressure. The effects of the acupressure modalities were compared study by study. Four of the seven acupressure band trials supported the positive effects of acupressure, whereas three acupressure band trials did not support the effects of acupressure. However, all the studies with negative results had methodological issues. In contrast, the one quasi-experimental and two of the randomized finger acupressure trials all supported the positive effects of acupressure on CINV control. The reported effects of the two acupressure modalities produced variable results at each stage of CINV. Acupressure bands were most effective in controlling acute nausea, whereas finger acupressure controlled delayed nausea and vomiting. The overall effect of acupressure was strongly indicative but not conclusive. We used this article because it is relevant, a review study, and is from a known journal.

The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. (Molassiotis et al. 2007)

As reported in the journal Complementary Therapies in Medicine, acupressure was applied using wristbands (Sea-Band™) in a randomized controlled trial conducted in two centres in the UK. Patients in the experimental group had to wear these bands for the five days following their chemotherapy administration. Assessments of nausea, retching and vomiting were obtained from all patients, daily, for five days. Molassiotis et al. (2007) evaluated the effectiveness of using acupressure on the Pericardium 6 (Neiguan) acupoint in managing CINV. Thirty-six patients took part in the study, with 19 patients allocated to the control group and 17 to the experimental group. The results showed that nausea with retching, nausea, and vomiting with retching, and the accompanying distress were all significantly lower in the experimental group as compared to the control group (p < 0.05). The only exception was the vomiting, where the difference was close to significance (p = 0.06). We used this article because it had a strong study design and also used an IMRAD system.

Acupuncture and acupressure for the prevention of chemotherapy-induced nausea- a randomized cross-over pilot study. (Melchart et al. 2006)

In a randomized, cross-over trial, Melchart et al. (2006) studied 28 patients receiving moderately or highly emetogenic chemotherapy and a conventional standard antiemetic for one chemotherapy cycle, followed by a combination of acupuncture and acupressure at point P6 for one cycle, and for another cycle a combination of acupuncture and acupressure at a close sham point. The results showed that there was no difference in the nausea score between the combined acupuncture treatment at P6 and at the sham point, but the level of nausea was very low in both cases. We used this study because the article had neutral results and because we trusted the source of article, coming as it did from a cancer support care journal.

The efficacy of acupoint stimulation for the management of therapy adverse events in patients with breast cancer: a systematic review. (Chao et al. 2009)

This is a systematic review of 26 articles published between 1999 to 2008 examining the efficacy of acupressure, acupuncture or acupoint stimulation (APS) for the management of adverse events due to the treatment of breast cancer. Published online on 17 September 2009 in the Breast Cancer Research and Treatment journal, 23 trials reported revealed that APS on P6 was beneficial in treating CINV. Chao et al. (2009) also presented the findings from three high quality studies comparing APS groups with control groups, which indicated that APS is beneficial in the management of CINV and especially in the acute phase, even with the non-invasive intervention. Health care professionals should consider using APS, and in particular acupressure on the P6 acupoint, as an option for the management of CINV. Furthermore, as a cost effective intervention, it warrants further investigation. We used this article because it used the IMRAD structure.

'Until the trial is complete you can’t really say whether it helped you or not, can you?’: exploring cancer patients’ perceptions of taking part in a trial of acupressure wristbands. (Hughes et al. 2013)

In Complementary and Alternative Medicine, Hughes et al. report on qualitative research undertaken with patients receiving chemotherapy in the UK. A convenience sample of 26 patients volunteered to participate in the clinical trial and to explore their experiences of using acupressure wristbands. Participants were recruited from three geographical sites: nine were recruited from Manchester, nine from Liverpool, and eight from Plymouth and the surrounding regions. Ten of the participating patients received true acupressure during the trial, 9 received sham acupressure, and 7 received no acupressure. Hughes et al. (2013) concluded that the research provided insights into cancer patients’ motivations and experience of taking part in a clinical trial for a complementary alternative medicine intervention, in which the participants perceived acupressure wristbands to reduce the level of nausea and vomiting experienced during their chemotherapy treatment. This article is important because it includes the benefits experienced by the patients taking part in the trial. This is also the first qualitative study to explore patients’ experiences of using acupressure wristbands and their perceptions of the effects. In the study, the patients perceived the wristbands as reducing their level of nausea and vomiting experienced due to their chemotherapy treatment. The study was an RCT.

The effect of acupressure application on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer. (Genç and Tan 2014)

Genç and Tan (2014) reported on a quasi-experimental study in Turkey with 64 patients with stages 1–3 breast cancer who received two or more cycles of advanced chemotherapy. Thirty two patients were in the experimental group, and thirty two in the control group. To determine the effect of acupressure P6 on CINV and anxiety in these patients, the P6 acupressure wristband was applied to the experimental group. Genç and Tan (2014) concluded that the total mean scores for patients in the experimental group, for nausea, vomiting and retching, were lower than those of the patients in the control group over the five days of application. We used this article because it is a recent and quasi-experimental study and used the IMRAD system.

The effects of P6 acupressure and nurse-provided counselling on chemotherapy-induced nausea and vomiting in patients with breast cancer. (Suh 2012)

Suh (2012) reported in the Oncology Nursing Forum on a RCT in South Korea with 120 women who were receiving chemotherapy for breast cancer. These patients had all had more than mild levels of nausea and vomiting during their first cycle of chemotherapy. The participants were assigned randomly to one of four groups: a control group (a placebo on a specific location on the hand); a counselling only group; a P6 acupressure only group; and a P6 acupressure plus nurse-provided counselling group. The purpose of the study was to evaluate the effects of pericardium 6 (P6) acupressure and nurse-provided counselling on CINV in patients with breast cancer. Suh (2012) concluded that nurse-provided counselling and P6 acupressure were together the most effective in reducing CINV in patients with breast cancer. We used this article because it is the first RCT evaluating the isolated and combined effects of P6 acupressure and counselling in reducing CINV among non-Western patients. The findings of the study support the use of P6 acupressure together with counselling that is focused on cognitive awareness, affective readiness, symptom acceptance, and the use of available resources as an adjunct to antiemetic medicine for the control of CINV. The article used the IMRAD system.

Discussion

Can acupressure reduce nausea and vomiting in cancer patients receiving chemotherapy?

In our experience, we have usually used metoclopramide (pramin) plus serotonin (5-HT3) antagonist (as Ondansetron and Granisetron), plus Dexamethasone plus neurokinin NK (1) (as Emend - aprepitant) for moderate to high ematogenic chemotherapy, yet some of the patients have still suffered from nausea and vomiting. After reviewing the literature we would like to use the acupressure P6 wrist band to solve this problem as the findings of our literature review confirm that the acupressure P6 wrist band reduces CINV in cancer patients receiving chemotherapy. This result is corroborated by 7 of the articles reviewed.

The National Cancer Institute website supports the finding that acupressure is one of the non-pharmacologic strategies that may be used to manage nausea and vomiting (NCI Dictionary of Cancer Terms). Said (2009) adds that acupressure may offer an inexpensive, convenient, and self-administered intervention for patients on chemotherapy, helping to reduce nausea and vomiting at home on days 2-5 of chemotherapy. Genç and Tan (2014) conclude that the total mean scores for CINV in patients in the experimental group to whom they applied the P6 acupressure wristband were lower compared to patients in the control group over the five days of application. Lee et al. (2008) found that the two acupressure modalities produced variable results in each phase of CINV: acupressure bands were effective in controlling acute nausea, whereas acupressure controlled delayed nausea and vomiting. Molassiotis et al. (2007) showed that the experience of nausea and vomiting was significantly lower in the experimental group than in the control group. Chao et al. (2009) found that P6 acupoint stimulation was an option for the management of CINV. In the study reported by Hughes et al. (2013) the participants perceived that acupressure wristbands reduced the levels of nausea and vomiting experienced during chemotherapy treatment. Suh (2012) concluded that the synergistic effects of P6 acupressure together with nurse-provided counselling appeared to be effective in reducing CINV in patients with breast cancer.

Five of the seven articles investigating breast cancer patients, namely Said (2009), Chao et al.( 2009), Molassiotis et al. (2007), Suh (2012) and Genç and Tan (2014), involved breast cancer patients receiving highly ematogenic chemotherapy (e.g. Cisplatin and cyclophosphamide), and moderate risk ematogenic chemotherapy (like doxorubicin).

It is necessary to mention other therapeutic regimens that can also be used in cancer treatment that contain other types of chemotherapy that cause nausea and vomiting, for example, doxorubicin-containing regimens like ABVD (Adriamycin, Bleomycin, Vinblastine, Dacarbazine), CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisone) and FAC (5-Fluorouracil, Adriamycin, Cyclophosphamide), and ACT (Adriamycin, Cyclophosphamide, Taxol) (Said 2009) and from our experience cisplatin-containing regimens which that classified as highly ematogenic chemotherapy we noticed the patients still experienced nausea and vomiting after they received the antiemitecs. We think it is necessary to use additional intervention like acupressure to be included in the nausea and vomiting management.

Based on the reviewed findings we plan to use acupressure for cancer patients receiving chemotherapy, because the acupressure in the studies conducted in breast cancer patients reported was used with highly ematogenic chemotherapy in addition to the standard antiemetic treatment, so it is reasonable to conclude that it will work equally well with other less ematogenic types of chemotherapy.

We prefer the use of the acupressure wrist band at P6 acupoint because it is an inexpensive, convenient, and self-administered intervention involving pressure instead of needles at the same point as that used in acupuncture. Furthermore it is safer than acupuncture and patients can easily learn to put pressure on their own wrists, whereas the acupuncture involves using needles that are about the diameter of a hair and can cause temporary discomfort during insertion (Said 2009; Molassiotis et al. 2007). Acupressure seems to be a good way to complement antiemetic pharmacotherapy as it is safe and convenient, with minimal (with bands) or no (finger acupressure) costs involved. It is thus an easy to use, cost-effective, non-invasive intervention (Lee et al. 2008; Melchart et al. 2006).

There was no study result that showed any negative effect from the acupressure wrist band at P6 point, except the review by Lee et al. (2008), which mentioned that three of the ten reported acupressure band trials did not support the possible positive effects of acupressure, but these studies all had methodological issues, such as a small sample size, no true control group, and a concern about the sham acupressure band having a possible antiemetic effect. Melchart et al. (2006) said that no difference was detected in the nausea score between the acupuncture treatment at P6 acupoint, and that at the sham point. Said (2009) mentioned that the acupressure showed no benefit in relation to the incidence of delayed vomiting, early vomiting, or acute nausea, but Melchart and Said’s studies were done with breast cancer patients and it could be that the acupressure benefits were not evident due to the breast cancer patients having had axillary lymph node resection that may have affected the meridian pathway or caused damage to the median nerve as mentioned by Roscoe et al. (2003). Consequently, we think that the evidence suggesting that there is no benefit from the acupressure method for reducing CINV is weak.

Regarding the placebo effect in the articles reviewed here, Melchart et al. (2006) indicated that there was no difference in the nausea score for the combined acupuncture treatment at p6 or that at the sham point, although the level of nausea was very low in both cases. Molassiotis et al. (2007), Said (2009) and Roscoe et al. (2003) all suggested that the placebo effect may be the result of psychological factors.

Application of acupressure in clinical practice

It is important to put this theory into practice, and health care professionals could consider using APS, in particular acupressure on the P6 acupoint, as an option in the management of CINV (Chao et al. 2009). Melchart et al. (2006) said acupressure bands can easily be used in busy oncological wards, while Suh (2012) supported the use of P6 acupressure with counselling focused on cognitive awareness, affective readiness, symptom acceptance, and the use of available resources as an adjunct to antiemetic medications for the control of CINV. Hughes et al. (2013) concluded that the research provides an insight into cancer patients’ motivations for and experiences of taking part in a clinical trial for a complementary alternative medical intervention in which the participants perceived the acupressure wristbands as reducing their level of CINV. Said (2009) suggests that oncology nurses should include acupressure in their list of options for the management of CINV, and especially delayed nausea and vomiting. Special recommendations by oncology nurses are not only useful but are also much appreciated by patients as shown in a study in which the patients were satisfied with the antiemetic treatment given by both P6-acupressure, and placebo-acupressure. The percentage of patients who were satisfied (≥ 3 on 0-6 scale) with their treatment was 81% (35/42) in the P6-acupressure group, which was in agreement with Roscoe et al. (2003), and 64% (27/42) in the placebo group (p= 0.0471). The percentage of the patients who would recommend acupressure treatment was 79% (34/42) in the P6-acupressure group, which again was in agreement with the results of Roscoe et al. (2003) and Hughes et al. (2013), compared to 62% (26/42) in the placebo group (p= 0.0533). This study presented the patients’ compliance with the use of acupressure. Acupressure is easily learnt and taught and patients should be informed about its potential role and taught how to apply it. Leaflets about acupressure for the management of nausea and vomiting could be available in chemotherapy units so that patients who are interested to use such a technique would be encouraged to come forward and learn more from nurses or other health professionals. This could add to the patients’ options for antiemetic approaches and empower them to be involved in the management of these distressing side effects. Acupressure offers a no-cost, convenient, self-administered intervention for chemotherapy patients to reduce acute nausea. Acupressure devices (i.e. Wrist Bands, travel bands, and acupressure bands) have been developed to provide passive acupressure on P6. Acupressure can be administered by healthcare providers, family members, or patients themselves, and does not involve puncture of the skin.

We therefore found that the acupressure wristband is a good way to reduce nausea and vomiting for cancer patients receiving chemotherapy by applying it in the correct position with the stud over the pericardium 6 acupoint located on the anterior surface of the forearm, 3-finger widths up from the first wrist crease, and between the tendons of flexor carpiradialis and Palmaris longus.

Lee et al. (2008) encourage the application of acupressure bilaterally, rather than unilaterally, in CINV control. They recommend three minutes of finger acupressure once daily, with additional acupressure as needed, as the optimal intervention, because both three and five minute trials have succeeded in achieving positive effects. On the other hand, Molassiotis et al. (2007) claimed that there is no correlation between the frequency of pressing the studs and the level of nausea and vomiting. Lee et al. (2008) and Molassiotis et al. (2007) therefore claim opposite results in the relationship between CINV and the frequency of pressing the stud of an acupressure P6 wrist band. But when applying the acupressure P6 wrist band bilaterally, Lee et al. (2008), Said (2009), Molassiotis et al. (2007), Suh (2012), and Genç and Tan (2014) all reported a positive effect with P6 stimulation in reducing CINV.

We would like to discuss some factors related to CINV in relation to nausea and vomiting: expectancy and gender: Roscoe et al. (2003) argued that patients who received the acustimulation bands and expected them to be effective did report having a higher quality of life and less nausea, and in relation to gender, that women are more likely to experience nausea when receiving chemotherapy. Lee et al. (2008) say this may be caused by classical conditioning and also that breast cancer patients may have had a damaged median nerve due to axillary lymph node removal, but Lee et al. (2008) also mention that P6 acupressure in younger women had a significantly greater positive effect on delayed nausea than those on a placebo or those in the no-intervention control group. On the other hand, Molassiotis et al. (2007) mentioned that younger age is associated with greater nausea. We think that men may have tolerated greater stimulation of the acupressure points, and therefore experienced greater symptom relief, so it may be that the acupressure is more effective for men than for women, but these questions of gender, age and the frequency of pressing the studs would need further investigation.

Based on the reported studies, we support the belief that acupressure on P6 is applicable in clinical practice for CINV for cancer patients provided the required education, training and counselling is given to maintain the acupressure benefits.

Acupressure side effects

The study by Molassiotis et al. (2007) found that there were no side effects from the use of the wristbands, but one patient reported that she had to take the bands off because they were too tight and left her with marks for a few days. Chao et al. (2009) also mentioned that very few minor adverse events were observed.

Melchart et al. (2006) did report adverse effects from the treatment in five cases. One suffered a hematoma when wearing the acupressure band at P6. In the sham group, one hematoma was reported after acupuncture, and another three adverse effects from the acupressure band were reported (one hematoma, one skin irritation, one eczema). Hughes et al. (2013) also reported that participants had not experienced any restrictions from wearing the wristbands in terms of everyday activities, other than when washing and bathing. As one female participant commented, for most participants the wristbands were found to be comfortable to wear. However, a few participants reported that they had experienced minor irritation, such as the wristbands feeling tight or painful, or their wrists becoming itchy. Reported adverse side effects were generally deemed minor and acceptable. In the study by Said (2009), no side effect or discomfort was noticed from wearing the acupressure wristband. Said told the patients that if the bands caused discomfort, they could be removed for 30 minutes every two hours. In this way, by taking it off for regular periods, we can prevent the side effects of acupressure, even its minor and rare effects.

Acupressure reduces CINV in cancer patients, in addition it reduces anxiety (Genç and Tan 2014) and that affects overall quality of life (Said 2009). Quality of life is defined by the NCI Dictionary of Cancer Terms as “The overall enjoyment of life and the individual’s sense of well-being and ability to carry out various activities”. Based on the physiological components of the Virginia Henderson’s theory of basic human needs and Abraham Maslow’s Hierarchy of Needs, the patient needs to eat and drink adequately, and sleep and rest (Vera, 2014). This means that when we are providing the required management for distressing symptoms, such as nausea and vomiting, by including the acupressure wrist band in addition to standard antiemetics, the patient’s appetite will improve, leading the patient to eat and drink adequately and improve their sleeping pattern. These may then also improve other aspects of the cancer patient’s life. According to the Henderson Nursing Need Theory, when we meet a patient’s needs, it results in an improved quality of life for the cancer patient receiving chemotherapy. Another way of expressing this is that it restores the balance of Yin and Yang energy that leads to reduced nausea and vomiting and improves the patient’s ability to enjoy life and work in general through a maintaining of the harmony of body and mind, as described in traditional Chinese medicine (Cancer Research UK, 2015).

We believe that it is essential for cancer patients undergoing chemotherapy treatment to have adequate nutrition to maintain their strength to fight the cancer. Different nursing actions are necessary to maintain adequate nutrition including the relieving of CINV. From this we extrapolate that using the acupressure P6 wrist band to reduce CINV improves the patient’s quality of life.

Conclusion

Chemotherapy-induced nausea and vomiting may be life threatening and is therefore a huge challenge to nurses involved in cancer care. Even with the best pharmacological management of CINV, patients continue to experience nausea and vomiting.

From a review of eight articles with strong methodology, seven supported the positive effect of an acupressure P6 wristband in reducing CINV for cancer patients. This was also supported by other databases. The one article with neutral results showed that there was no difference between a combined acupuncture and acupressure treatment at P6 and at a sham point in relation to the nausea score, but the level of nausea was very low in both groups. We conclude that the acupressure wrist band applied to acupuncture point P6 is effective, safe, convenient, cost effective, an easy and self-administrated non-pharmacological intervention from traditional Chinese medicine that reduces CINV. Solving the problem of CINV is a fundamental nursing task that can lead to improved quality of life and nutritional status, reduced anxiety and increases patient compliance. In the light of these results, and due to the effectiveness and inexpensiveness of acupressure, together with its ease of use, we suggest that it should be used in conjunction with pharmacological agents for CINV prophylaxis. To maintain the effectiveness of the acupressure, special education and training is needed to reassure the patient that the acupressure is at the correct point (P6) and counselling by the nurse is required.

We recommend the use of acupressure P6 in oncology departments and that future research should be conducted to include cancer patients receiving radiotherapy, and to investigate more about the relationship between the frequency of pressing the stud on the wrist band for acupressure P6 and CINV, and the relationship between gender and CINV, and whether it is better to apply it unilaterally or bilaterally.

[checkhweb]

Wellness Treatments for Cancer Patients: A Holistic Approach to Healing

 Cancer treatment can be an arduous journey, marked by challenging physical and emotional hurdles. While traditional treatments like chemotherapy, radiation, and surgery remain the pillars of cancer care, integrative wellness treatments offer essential support, helping patients enhance their overall well-being. Here’s an overview of some effective wellness treatments that can complement conventional cancer therapies and promote healing of both the body and mind.

1. Mindfulness and Meditation

Stress and anxiety are common during cancer treatment, making mindfulness and meditation invaluable. These practices encourage patients to focus on the present moment, reducing negative emotions and improving mental clarity. Research suggests that regular mindfulness meditation can lower stress hormones, decrease pain perception, and enhance the overall quality of life for cancer patients.

2. Nutritional Support

Eating well is critical for anyone battling cancer. Dieticians specializing in oncology can provide personalized nutrition plans that strengthen the immune system, maintain energy levels, and counteract treatment side effects like nausea or weight loss. Emphasizing anti-inflammatory foods, adequate hydration, and balanced nutrients plays a vital role in recovery.

3. Acupuncture

Acupuncture has gained traction for its potential to alleviate symptoms such as pain, nausea, fatigue, and hot flashes caused by cancer treatment. By targeting specific points on the body, acupuncture can promote better energy flow and help reduce discomfort, offering relief without additional medication.

4. Massage Therapy

Gentle massage can be a powerful ally in managing cancer-related symptoms. It helps reduce stress, relieve muscle tension, and improve circulation. Oncology massage therapists are specially trained to tailor their techniques to meet the unique needs and conditions of cancer patients, ensuring safety and efficacy.

5. Exercise and Movement Therapies

Appropriate exercise has been shown to enhance physical function, decrease treatment-related fatigue, and boost mood. Movement therapies such as yoga, tai chi, and gentle stretching exercises offer a mindful approach to maintaining mobility and strength. These activities can be tailored to a patient’s specific energy levels and needs, making them accessible and enjoyable.

6. Art and Music Therapy

Creative expression can be a therapeutic outlet for emotions often suppressed during cancer treatment. Art and music therapy help patients process their experiences, foster relaxation, and improve overall emotional well-being. Engaging with music or creating art can bring moments of joy, resilience, and self-discovery during difficult times.

7. Psychological Counseling and Support Groups

Navigating the emotional toll of cancer can feel overwhelming. Psychological counseling, either individually or through group therapy, provides a safe space to explore fears, cope with anxiety, and share experiences. Support groups offer connection, strength, and solidarity, reminding patients they are not alone.

8. Herbal and Supplement Support (With Caution)

Certain supplements and herbal remedies may help boost immunity or reduce treatment side effects. However, patients must consult their healthcare provider to avoid potential interactions with their cancer treatment plan. An integrative approach ensures safety and maximizes benefits.

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Embracing Whole-Person Healing: The Transformative Power of Holistic Cancer Therapy

Holistic cancer therapy offers a compassionate, integrative approach to treatment, emphasizing the connection between mind, body, and spirit. Unlike conventional cancer treatments that focus solely on eradicating cancer cells, holistic therapy aims to support the entire person, fostering a state of health and balance that empowers the body to fight the disease. This approach brings together medical treatments with complementary therapies such as nutrition, exercise, stress management, and emotional support, creating a comprehensive treatment plan tailored to each individual’s unique needs.

At the core of holistic cancer therapy is the belief that a person’s physical, emotional, and mental states play an integral role in the healing process. Patients undergoing traditional treatments like chemotherapy and radiation often experience debilitating side effects that impact their quality of life. Holistic therapy seeks to address these side effects through natural methods, making the treatment process more manageable and supporting the body’s ability to heal. For example, dietary adjustments, guided meditation, and gentle exercise can improve energy levels, boost immune function, and reduce nausea and fatigue, enabling patients to better tolerate conventional therapies.

Nutrition plays a pivotal role in holistic cancer therapy. By nourishing the body with nutrient-dense foods, patients can fortify their immune system and promote overall vitality. Specialized diets focusing on whole, organic foods, plant-based proteins, and natural anti-inflammatory ingredients are often recommended to support the body in detoxifying and healing itself. Many practitioners of holistic cancer therapy also incorporate herbal supplements, vitamins, and antioxidants, which may help reduce inflammation and protect against oxidative stress, a factor known to contribute to cancer growth. These nutritional strategies are tailored to each person’s individual needs, ensuring that patients receive the specific support their bodies require during treatment.

Holistic cancer therapy also addresses the psychological and emotional impact of a cancer diagnosis. Many patients experience fear, anxiety, and depression, which can take a toll on mental well-being and potentially hinder the healing process. By incorporating techniques like mindfulness meditation, yoga, and counseling, holistic cancer therapy supports emotional health and resilience. Mindfulness practices help patients manage stress and remain present, reducing worry and enabling them to focus on positive steps toward healing. In addition, having access to counseling or support groups offers patients a safe space to share their feelings, find community, and build emotional strength.

Physical therapies such as acupuncture, massage, and gentle exercise are also commonly used in holistic cancer treatment. These therapies can alleviate pain, improve circulation, and support physical recovery, enhancing patients' quality of life. Acupuncture, for instance, has been shown to relieve chemotherapy-induced nausea, fatigue, and neuropathy, while massage therapy can help reduce stress, muscle tension, and anxiety. Light physical activities like yoga or tai chi not only help maintain strength and flexibility but also promote a sense of relaxation and connection with the body, fostering a deeper sense of well-being.

Detoxification is another important aspect of holistic cancer therapy. Since the body is exposed to various toxins from the environment, food, and even certain medications, detoxifying can support the liver and kidneys in eliminating harmful substances. Detoxification strategies may include drinking purified water, increasing fiber intake, practicing intermittent fasting, or using natural supplements under professional guidance. These gentle detoxification techniques help reduce the body's toxic load, enhancing cellular health and promoting an environment less hospitable to cancer cells.

Spiritual support is a unique aspect of Arizona Holistic Cancer Treatment that focuses on cultivating hope, purpose, and a positive outlook. For many, a cancer diagnosis brings about profound questions about life’s purpose and meaning. Incorporating spiritual practices such as meditation, prayer, or connecting with nature can bring inner peace and comfort, supporting the healing journey. Regardless of religious beliefs, finding purpose and inner peace can have a powerful impact on mental resilience and physical health.

The benefits of holistic cancer therapy are becoming increasingly recognized as complementary to conventional treatments. While holistic therapies are not replacements for medical treatments like surgery or chemotherapy, they are valuable in improving quality of life, reducing side effects, and empowering patients to take an active role in their healing. Many patients find that by addressing their lifestyle, nutrition, stress levels, and mindset, they experience greater resilience, vitality, and a renewed sense of hope.

Holistic cancer therapy provides an integrative path that embraces the whole person, not just the disease. By combining evidence-based medical treatments with complementary therapies, patients can approach their journey with a sense of empowerment and support. Holistic therapy creates a healing environment that respects and nurtures every aspect of a person, giving patients the tools to not only fight cancer but also to reclaim their lives with strength, purpose, and peace.

[neuronpainspineclinic]

Cancer Pain Management in Odisha: Expert Care at Neuron Pain & Spine Clinic

Cancer pain is one of the most distressing aspects of cancer treatment. While advances in medical science have improved cancer care, managing the pain associated with cancer remains a crucial part of the healing process. At Neuron Pain & Spine Clinic in Bhubaneswar, we specialize in providing comprehensive cancer pain management, ensuring that patients can maintain their quality of life during the whole cancer treatment. Our expert cancer pain doctors in Odisha are dedicated to offering compassionate and personalized care for each patient.

Understanding Cancer Pain

Cancer pain can result from various factors, including the tumor itself, treatments like surgery, chemotherapy, or radiation, and even nerve damage. Each patient’s experience with cancer pain is unique, and it requires specialized care to address the individual needs of patients.

Tumor-related pain: This occurs when the tumor presses against bones, nerves, abdominal organs or other body parts.

Treatment-related pain: Chemotherapy, radiation, and surgeries can sometimes lead to painful side effects.

Pre-existing chronic pain or other disease: Some patients may be having long-standing arthritis, sciatica, spondylitis or other musculoskeletal pain independent of their cancer status and/or treatment. These pre-existing conditions can independently cause pain.

Debility from Cancer: Cancer leads to loss of appetite, muscle mass, weakness, fatigue and consequent debility, which itself can lead to pain.

Why Specialized Cancer Pain Management is Essential

Managing cancer pain is more than just prescribing painkillers. A specialized approach ensures that the pain is managed safely and effectively in addition to the overall treatment plan. At Neuron Pain & Spine Clinic, our cancer pain specialists in Bhubaneswar understand the complexities of cancer pain and work closely with oncologists to create an integrated pain management plan.

Our Approach to Cancer Pain Relief

At Neuron Pain & Spine Clinic, our cancer pain management is focused on:

Personalized Pain Assessment: Every patient is different, and we begin with a thorough evaluation to understand the nature and intensity of the pain. This includes identifying the sources of pain and assessing the patient’s medical history and current treatment plan.

Advanced Pain Relief Techniques:

Medications: From non-opioid pain relievers to advanced opioids like morphine or fentanyl, we carefully select medications based on the patient's pain severity and overall health. We follow the WHO analgesic ladder for effective medical management of cancer pain.

Nerve Blocks and neurolysis: For more localized pain, nerve blocks can effectively numb the area and provide relief, ranging from short-term to long-term.

Epidural Injections: For cancer patients experiencing severe pain in the spine or nearby areas, epidural steroid injections may be recommended.

Intrathecal Pain Pump: In cases where oral medications are insufficient, we may recommend a pain pump that delivers medication directly to the spinal cord.

Non-Pharmacological Treatments: Along with medications, our clinic also offers alternative therapies, including physical therapy, acupuncture, and psychological counseling. These treatments help address not just the physical but also the emotional aspects of cancer pain.

Palliative Care and Support: For patients in the later stages of cancer, our focus is on providing comfort and improving the quality of life. Our cancer pain doctors in Odisha are trained to offer compassionate care that addresses both pain and the emotional toll cancer can take on a patient and their family.

Why Choose Neuron Pain & Spine Clinic for Cancer Pain Management?

Expert Team of Specialists: Our team comprises highly trained cancer pain specialists in Bhubaneswar, with extensive experience in managing complex pain conditions. We stay updated with the latest pain management techniques to ensure that our patients receive the best care possible.

Patient-Centered Care: We believe in a holistic approach to cancer pain management, considering not just the physical pain but also the emotional and psychological well-being of our patients. Our compassionate approach ensures that every patient feels supported through their journey.

State-of-the-Art Facilities: At Neuron Pain & Spine Clinic, we utilize cutting-edge technology and pain management techniques to provide effective and long-lasting relief. Our clinic in Bhubaneswar is equipped with the latest medical infrastructure, including fluoroscopy (X-ray machine), Radiofrequency Ablation machine and ultrasound which ensures that patients receive top-notch care.

Convenient Access to Care: Located in Bhubaneswar, we offer accessible cancer pain management services for patients across Odisha. Whether you’re in Bhubaneswar or elsewhere in the state, our clinic is dedicated to providing the best care for cancer pain relief.

Testimonials from Our Patients

"After months of struggling with unbearable pain, I visited Neuron Pain & Spine Clinic. The doctors here understood my condition and provided a treatment plan that finally gave me relief. I am now able to focus more on my recovery, thanks to their expert care." – Rajesh K., Bhubaneswar

"I was anxious about managing my cancer pain, but the specialists at Neuron Pain & Spine Clinic gave me the confidence and relief I needed. Their holistic approach helped me both physically and emotionally during my treatment." – Sunita P., Cuttack

Reach Out for Expert Cancer Pain Management

If you or a loved one is battling cancer pain, it’s important to seek help from specialists who understand the complexities of this condition. At Neuron Pain & Spine Clinic, our cancer pain doctors in Bhubaneswar are here to support you with personalized and compassionate care. Our goal is to help you live as comfortably as possible during your treatment.

Schedule Your Appointment Today

Don’t let cancer pain control your life. Contact Neuron Pain & Spine Clinic today to schedule an appointment with our expert cancer pain specialists. We are committed to providing the best cancer pain management in Odisha, helping you regain control and improve your quality of life.

Call and WhatsApp us or visit our website Neuron Pain & Spine Clinic to learn more about our services and book your consultation with our cancer pain doctors in Bhubaneswar.

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[actioncancerhospital24]

Top 5 Side Effects of Breast Cancer Treatment (and How to Manage Them)

Breast cancer treatment, while often life-saving, can come with various side effects. These side effects vary depending on the type of treatment a patient receives, such as surgery, chemotherapy, radiation therapy, hormone therapy, or targeted therapy. Understanding these side effects and learning how to manage them can help patients maintain their quality of life throughout their treatment journey. At Action Cancer Hospital, our comprehensive care team is dedicated to supporting patients both medically and emotionally, ensuring that they receive the best possible guidance to navigate their treatment experience.

Here are the top five common side effects of breast cancer treatment and strategies to manage them effectively.

1. Fatigue

Fatigue is one of the most commonly reported side effects of breast cancer treatment, especially following chemotherapy, radiation, or surgery. Unlike typical tiredness, cancer-related fatigue can be overwhelming and persistent, sometimes lasting for weeks or months after treatment.

How to Manage Fatigue:

Rest and Pace Yourself: Prioritize rest but also balance it with light activities. Short naps or rest periods throughout the day can be helpful without interfering with nighttime sleep.

Exercise: Moderate physical activity, such as walking or yoga, can boost energy levels and reduce fatigue over time.

Stay Hydrated and Eat Nutritious Foods: Drinking enough water and consuming a balanced diet rich in fruits, vegetables, and proteins can help maintain energy levels.

Ask for Help: Don’t hesitate to ask family members or friends to assist with daily tasks to conserve energy for essential activities.

At Action Cancer Hospital, patients are provided with personalized guidance on energy conservation techniques and access to physical therapy programs designed to combat treatment-induced fatigue.

2. Hair Loss (Alopecia)

Hair loss is a common and often distressing side effect of chemotherapy, although it can also occur with some forms of hormone therapy. While hair usually grows back after treatment, the emotional impact of losing hair can be significant for many patients.

How to Manage Hair Loss:

Prepare Before Treatment: Consider cutting your hair short before treatment begins to ease the transition if hair loss occurs.

Cold Caps: Cold caps, which cool the scalp during chemotherapy, may help reduce hair loss by limiting the amount of chemotherapy that reaches hair follicles.

Use Gentle Hair Care Products: Opt for gentle, sulfate-free shampoos and conditioners to reduce scalp irritation and hair damage.

Explore Alternatives: Many women choose to wear wigs, scarves, or hats during treatment. Action Cancer Hospital provides access to resources and support groups where patients can explore options for managing hair loss.

The psychosocial team at Action Cancer Hospital also offers counseling services to help patients cope with the emotional impact of hair loss.

3. Nausea and Vomiting

Nausea and vomiting are side effects primarily associated with chemotherapy, though they can also occur after surgery or radiation therapy. These symptoms can significantly affect a patient’s appetite, hydration, and overall well-being.

How to Manage Nausea and Vomiting:

Medications: Anti-nausea medications (antiemetics) can be prescribed by your doctor to control or prevent nausea. Always take them as directed.

Small, Frequent Meals: Eating small, bland meals more frequently throughout the day can help keep nausea at bay. Avoid fatty, fried, or spicy foods that may trigger nausea.

Stay Hydrated: Sip on clear liquids, such as water, herbal tea, or ginger ale, to stay hydrated. Ginger and peppermint are known for their soothing effects on the stomach.

Acupuncture: Some patients find relief from nausea through complementary therapies like acupuncture.

Action Cancer Hospital’s dietary specialists work closely with patients to tailor nutrition plans that minimize nausea while ensuring proper nutrition during treatment.

4. Lymphedema

Lymphedema is a swelling that occurs when lymph fluid builds up in the tissues, often in the arms or chest. It can happen after surgery or radiation therapy, particularly if lymph nodes are removed or damaged. Lymphedema can cause discomfort, restricted movement, and an increased risk of infections.

How to Manage Lymphedema:

Compression Garments: Wearing compression sleeves or garments can help reduce swelling by encouraging proper lymph fluid circulation.

Physical Therapy: Specialized physical therapy, known as manual lymphatic drainage, is an effective way to manage lymphedema. It involves gentle massage techniques that promote fluid drainage.

Exercise: Gentle, low-impact exercises such as swimming or stretching can help keep the lymphatic system functioning properly.

Prevent Infections: Take care of the affected limb by keeping the skin clean and moisturized, and avoid cuts, burns, or injuries that can lead to infections.

At Action Cancer Hospital, our physiotherapy and rehabilitation department provides tailored lymphedema management programs that include manual therapy, exercise routines, and patient education on prevention techniques.

5. Bone Loss and Joint Pain

Some breast cancer treatments, especially hormone therapy and chemotherapy, can lead to bone loss (osteoporosis) and joint pain. Estrogen-reducing treatments, such as aromatase inhibitors, increase the risk of weakened bones, which can lead to fractures. Joint stiffness or pain can also significantly affect mobility and quality of life.

How to Manage Bone Loss and Joint Pain:

Bone-Strengthening Medications: Bisphosphonates or other medications like denosumab may be prescribed to help maintain bone density and reduce the risk of fractures.

Calcium and Vitamin D: Ensure that you get enough calcium and vitamin D, either through diet or supplements, to support bone health.

Weight-Bearing Exercises: Regular exercise, particularly weight-bearing activities like walking, dancing, or light resistance training, can help strengthen bones and improve joint function.

Pain Relief: Over-the-counter pain relievers, such as acetaminophen or NSAIDs (non-steroidal anti-inflammatory drugs), may help relieve joint pain. In some cases, physical therapy may also be recommended.

At Action Cancer Hospital, we offer comprehensive bone health assessments, personalized exercise programs, and consultations with dietitians to help patients manage bone loss and maintain joint health during and after treatment.

Conclusion

Breast cancer treatment can present a range of physical and emotional challenges, but many of the side effects are manageable with the right strategies and support. At Action Cancer Hospital, our holistic approach to cancer care ensures that patients receive not only the best medical treatments but also comprehensive support to manage side effects and maintain quality of life.

By working closely with your healthcare team, taking advantage of available therapies, and adopting lifestyle changes, you can mitigate many of the side effects of breast cancer treatment and improve your overall well-being. For more information or to consult with a specialist at Action Cancer Hospital, reach out to our expert care team today.

[eastacupuncturewbusa]

Why do you need fertility treatment?

Fertility treatment is often needed when a couple or individual is unable to conceive naturally after trying for a certain period, typically 12 months for women under 35, and 6 months for women over 35. Fertility treatment may also be necessary for people who have known medical conditions or factors that affect their ability to conceive or carry a pregnancy. Here are some common reasons why fertility acupuncture might be needed:

1. Ovulation Problems:

Irregular or Absent Ovulation: Conditions like polycystic ovary syndrome (PCOS) or hormonal imbalances can prevent regular ovulation, making it difficult to conceive.

Premature Ovarian Insufficiency (POI): Women who experience early menopause or diminished ovarian function may need help with fertility.

2. Blocked or Damaged Fallopian Tubes:

Fertility treatment may be needed when the fallopian tubes, which carry the eggs from the ovaries to the uterus, are blocked or damaged due to:

Pelvic Inflammatory Disease (PID) from infections such as chlamydia or gonorrhea.

Endometriosis, which causes tissue similar to the uterine lining to grow outside the uterus.

Surgical Procedures that result in scar tissue or damage.

3. Male Infertility:

Low Sperm Count or Poor Sperm Quality: Fertility treatments like intrauterine insemination (IUI) or in vitro fertilization (IVF) may be needed to help overcome issues with sperm count, motility (movement), or morphology (shape).

Erectile Dysfunction or Ejaculation Issues: Some men may require assistance if they have trouble with ejaculation or if there are blockages in the reproductive tract.

4. Age-Related Fertility Decline:

As women age, particularly after 35, fertility declines significantly due to a reduction in both the quantity and quality of eggs. Fertility treatments can help increase the chances of conception by stimulating the ovaries or using donor eggs.

Men can also experience a decline in sperm quality with age, though it is generally less pronounced.

5. Endometriosis:

Endometriosis is a condition in which the tissue that normally lines the uterus grows outside it, causing pain, inflammation, and scar tissue, which can affect fertility by damaging reproductive organs or causing blockages.

6. Unexplained Infertility:

Sometimes, after all fertility tests, no clear cause is identified. In these cases, couples may still need fertility treatments like IUI or IVF to conceive.

7. Uterine or Cervical Issues:

Uterine Fibroids or Polyps: Benign growths in the uterus can interfere with implantation of an embryo.

Cervical Mucus Problems: If the mucus in the cervix is too thick or hostile, sperm may have difficulty passing through to fertilize the egg.

8. Genetic Conditions:

Couples with a known genetic disorder may opt for fertility treatments like IVF with preimplantation genetic testing (PGT) to prevent passing on genetic conditions to their children.

9. Same-Sex Couples or Single Parents:

LGBTQ+ couples and single individuals may seek fertility treatments to conceive using donor sperm, donor eggs, surrogacy, or assisted reproductive technologies like IVF.

10. Previous Cancer Treatments:

Cancer treatments such as chemotherapy and radiation can damage reproductive organs or reduce fertility. Some cancer survivors may require fertility treatment if they wish to conceive after their recovery.

11. Recurrent Miscarriages:

If a woman experiences multiple miscarriages, fertility treatment may be needed to investigate and address potential underlying causes such as uterine abnormalities or chromosomal issues.

12. Medical Conditions:

Thyroid Disorders: Both hyperthyroidism and hypothyroidism can interfere with ovulation and fertility.

Diabetes: Poorly controlled diabetes can affect both male and female fertility.

Autoimmune Disorders: Conditions like lupus or rheumatoid arthritis may impact fertility and pregnancy.

When to Seek Help:

Under Age 35: If you've been trying to conceive for one year without success.

Over Age 35: If you've been trying for six months without success.

Known Conditions: Seek help earlier if you have known issues like PCOS, endometriosis, or male factor infertility.

Conclusion:

Fertility treatment is needed when there are medical, genetic, or age-related factors preventing natural conception or sustaining a pregnancy. These treatments help address a wide range of issues from ovulation problems and blocked fallopian tubes to low sperm count and unexplained infertility, allowing couples or individuals to achieve their goal of having a child.

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Chemotherapy In Delhi

Chemotherapy, while often a vital part of cancer treatment, can be an emotionally and physically daunting process for patients. The side effects of chemotherapy, such as fatigue, hair loss, and nausea, can take a toll on the body and mind. However, emerging research is shedding light on new approaches to minimize these side effects. From personalized dosing based on genetic factors to targeted drug delivery systems, the future of chemotherapy holds promise for reducing the impact on patients' quality of life.

Furthermore, the integration of complementary therapies alongside traditional chemotherapy is gaining traction within the medical community. Techniques like acupuncture, yoga, and meditation are being explored as potential allies in mitigating the adverse effects of chemotherapy. By adopting a more holistic approach that considers both physical and psychological well-being during treatment, healthcare providers are striving to enhance patient resilience and overall outcomes. As our understanding evolves and innovative strategies continue to emerge, the landscape of chemotherapy is undergoing a transformation that offers hope and improved care for those battling cancer.

Chemotherapy Treatment in Delhi

Chemotherapy treatment in Delhi has witnessed significant advancements in recent years, offering patients access to cutting-edge treatments and technologies. With the rising prevalence of cancer cases in the region, leading hospitals and healthcare facilities in Delhi have invested heavily in state-of-the-art chemotherapy facilities and experienced medical professionals. This focus on providing top-notch care has contributed to Delhi's reputation as a premier destination for chemotherapy treatment.

Moreover, the holistic approach to chemotherapy in Delhi encompasses not only medical intervention but also emotional support and counseling for patients and their families. The integration of complementary therapies such as yoga, meditation, and nutrition counseling alongside conventional chemotherapy treatments sets the standard for comprehensive cancer care. Additionally, clinical trials and research initiatives in Delhi are pioneering new avenues for targeted chemotherapy, personalized medicine, and immunotherapy, offering hope for more effective and less invasive treatments. As a result, patients seeking chemotherapy treatment in Delhi can find solace in knowing that they are being cared for by experts at the forefront of cancer care innovation.

Cost of Chemotherapy Treatment in Delhi

The chemotherapy cost in Delhi can be influenced by various factors, including the type and stage of cancer, duration of treatment, and the specific drugs used. Additionally, the choice of hospital or medical facility can also impact the overall cost, with renowned private hospitals often charging more for their services than public or non-profit institutions or standalone chemotherapy daycare centre in Delhi. It's important to note that specialized tests, consultations with oncologists, and potential side-effect management are all integral components of chemotherapy treatment that can significantly contribute to its overall expense.

Moreover, the availability and pricing of chemotherapy drugs within Delhi play a substantial role in determining treatment costs. As many chemotherapy medications are imported or patented, their prices may fluctuate based on international market dynamics and patent rights. Furthermore, ancillary expenses such as accommodation for out-of-town patients, transportation to and from medical facilities, and supportive care services can further amplify the financial burden associated with undergoing chemotherapy treatment in Delhi. Understanding these multifaceted cost factors is pivotal for individuals seeking to undergo this essential form of cancer care while navigating its financial implications. For more info on the chemotherapy costs in Delhi, you can contact our help center.

At LYFE Medicare Cancer Center, we believe that the chemotherapy and other treatments should be available to all the cancer patients at affordable prices.

[iccaglobal]

Finding Hope in Global Cancer Care: A Holistic Perspective

Cancer diagnosis often feels like an overwhelming journey, but today, patients have access to a world of possibilities. With advanced medical technology and innovative approaches, finding the right treatment involves exploring global options. Facilities like Cancer Centers Treatment of America and specialized care abroad, such as consulting a Cancer Doctor in Mexico, have become vital pillars in the fight against cancer. These options combine world-class expertise and personalized care to ensure that patients receive the best possible support.

The Rise of Comprehensive Cancer Treatment Facilities

Modern cancer treatment centers provide far more than chemotherapy and radiation. They integrate comprehensive strategies, including holistic therapies, psychological counseling, and nutritional support, to tackle cancer from every angle. Many patients turn to Cancer Centers Treatment of America for their multidisciplinary care teams, cutting-edge technology, and patient-focused approach. These centers have redefined cancer care by treating not just the disease but also addressing the emotional and physical well-being of patients.

Meanwhile, facilities around the globe are also carving a niche in cancer care. Seeking treatment outside one’s home country, such as from a Cancer Doctor in Mexico, offers opportunities to access unique therapies and approaches that may not yet be available domestically. This international perspective broadens options for patients who might feel constrained by the limitations of their local healthcare systems.

Why Seek Cancer Care Abroad?

Medical tourism has seen a surge in recent years, especially in regions offering specialized cancer care. Patients often explore options like consulting a Cancer Doctor in Mexico to benefit from innovative treatments, shorter waiting times, and personalized care plans. Mexican oncology specialists frequently offer treatments aligned with global standards, sometimes incorporating alternative or integrative therapies to enhance outcomes.

The appeal lies not just in affordability but also in the accessibility of treatments tailored to individual needs. Unlike the one-size-fits-all approach common in some healthcare systems, oncologists in Mexico prioritize building strong patient relationships and crafting solutions that respect both science and patient preferences.

The Role of Cutting-Edge Technology in Cancer Treatment

The fight against cancer demands relentless innovation. Facilities like Cancer Centers Treatment of America emphasize the importance of integrating the latest medical technologies, such as precision medicine, immunotherapy, and robotic-assisted surgeries. These advancements ensure that treatments are not only more effective but also less invasive, reducing recovery times and improving quality of life for patients.

Similarly, Mexican cancer doctors have adopted various state-of-the-art technologies while maintaining an emphasis on personalized care. Their ability to combine modern treatments with patient-centric approaches makes them a popular choice for those seeking international care. By combining traditional methods with progressive techniques, these professionals offer a holistic approach that many patients find invaluable.

Holistic Care: A Global Perspective

The emotional toll of cancer is as significant as its physical challenges. This is where holistic care comes into play. Institutions like Cancer Centers Treatment of America excel in offering counseling services, support groups, and mindfulness practices to address the emotional needs of patients. These centers recognize that healing is not just about destroying cancer cells but also nurturing the spirit and mind.

A similar ethos can be seen in the approach of many oncologists abroad. A Cancer Doctor in Mexico, for instance, often integrates wellness therapies such as yoga, acupuncture, and dietary changes into their treatment plans. These complementary practices enhance traditional treatments, helping patients feel more empowered and engaged in their recovery.

Bridging the Gap: Access and Affordability

One of the most pressing issues in global healthcare is affordability. Advanced treatments are often prohibitively expensive, leaving many patients unable to access the care they need. This is where facilities abroad, including those led by a Cancer Doctor in Mexico, play a transformative role. They offer high-quality care at a fraction of the cost seen in many other countries. For those exploring treatment options, this affordability can be a life-changing factor.

Moreover, these international options often eliminate long waiting times, which is crucial for diseases like cancer, where early intervention significantly impacts outcomes. Patients can start treatments sooner, which can make a critical difference in their journey toward recovery.

Choosing the Right Path for Treatment

Every cancer journey is unique, requiring thoughtful decision-making and thorough research. Whether considering the multidisciplinary expertise of Cancer Centers Treatment of America or the innovative care of a Cancer Doctor in Mexico, patients should evaluate their options based on their specific needs, budgets, and treatment goals. Consulting multiple specialists and seeking second opinions can also provide clarity and confidence in selecting the right path.

Ultimately, the key is to approach this journey with hope and determination. With the combined resources of global facilities and specialized international care, patients have a powerful arsenal in the fight against cancer.

[medicalhealth10]

Understanding Nausea and Vomiting: Insights from My Article

Nausea and vomiting are common gastrointestinal symptoms that can arise from a variety of underlying causes, ranging from minor issues to more serious health conditions. In my article, "Study In Detail About Nausea and Vomiting," I delve into the complexities of these symptoms, exploring their mechanisms, causes, and potential treatments. This article is essential for anyone looking to understand the nuances of nausea and vomiting, especially in the context of gastrointestinal diseases. Study In Detail About Nausea and Vomiting

The Mechanisms Behind Nausea and Vomiting

Nausea is a subjective sensation that often precedes vomiting. It is typically triggered by signals sent from the brain in response to various stimuli, including hormonal changes, gastrointestinal distress, and emotional factors. The vomiting reflex is a protective mechanism designed to expel harmful substances from the stomach. Understanding these mechanisms is crucial for identifying the root causes of these symptoms, which can lead to more effective management strategies.

Common Causes

My article outlines a comprehensive list of potential causes for nausea and vomiting, which can range from simple to complex. Common causes include:

Gastroenteritis: Inflammation of the stomach and intestines often caused by viral or bacterial infections.

Motion sickness: A disturbance in the inner ear, leading to a mismatch between visual input and the body's sense of balance.

Pregnancy: Hormonal changes during pregnancy can lead to morning sickness, characterized by nausea and vomiting.

Medications: Certain medications can have side effects that include nausea and vomiting, particularly chemotherapy agents and opioids.

Food intolerances: Consuming foods that the body cannot properly digest can lead to gastrointestinal distress.

By identifying the cause, patients can work with healthcare providers to develop a tailored treatment plan. Study In Detail About Nausea and Vomiting

Diagnosis and Evaluation

Accurate diagnosis is vital in addressing nausea and vomiting. In my article, I discuss various diagnostic methods that healthcare professionals may use, such as:

Patient history and physical examination: Understanding the patient’s symptoms and medical history is often the first step in diagnosing the underlying cause.

Laboratory tests: Blood tests, urine tests, and imaging studies may be utilized to rule out serious conditions and identify potential causes.

Early diagnosis and appropriate evaluation are critical in preventing complications that can arise from persistent nausea and vomiting, such as dehydration and electrolyte imbalances. Study In Detail About Nausea and Vomiting

Treatment Options

My article emphasizes the importance of individualized treatment plans based on the underlying cause. Treatment options can include:

Medications: Antiemetics are commonly prescribed to help alleviate nausea and vomiting, particularly in cases related to motion sickness or chemotherapy.

Lifestyle changes: Simple adjustments, such as eating smaller meals, avoiding trigger foods, and staying hydrated, can help manage symptoms.

Alternative therapies: Acupuncture and ginger supplements have shown promise in reducing nausea, particularly in pregnancy and post-operative settings.

Conclusion

Nausea and vomiting are complex symptoms that can significantly impact an individual's quality of life. In my article, "Study In Detail About Nausea and Vomiting," I provide a thorough exploration of the mechanisms, causes, diagnosis, and treatment options available for these gastrointestinal symptoms. Understanding these aspects is essential for anyone experiencing nausea and vomiting, whether occasional or chronic.

I encourage readers to visit my article to gain deeper insights and knowledge about these symptoms. By understanding the underlying causes and potential treatments, individuals can take proactive steps towards managing their health and seeking the appropriate care. Your journey to understanding nausea and vomiting starts here, and I'm excited to share this valuable information with you!https://diseases8804.blogspot.com/2022/05/study-in-detail-about-nausea-and.html