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Scope of symptoms and self-management strategies for chemotherapy-induced peripheral neuropathy in breast cancer patients

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Abstract

Purpose

This study explored the self-management strategies utilized by female breast cancer patients to cope with the impact of chemotherapy-induced peripheral neuropathy (CIPN) symptoms. We also examined the variety of taxane-related side effects in women with and without CIPN in order to discriminate the CIPN symptom experience.

Methods

A purposive sample of 25 patients treated with docetaxel or paclitaxel were recruited, half with and half without CIPN. Semistructured interviews and patient level data were utilized for this exploratory, descriptive study. Interview data were analyzed with the constant comparative method; patient level data were abstracted from the electronic medical record.

Results

Participants were aged 24–60 years, were currently receiving chemotherapy or within 6 months of having completed treatment, and 14 had CIPN. CIPN impacted routine activities, functions, and behaviors in the areas of domestic, work, and social/leisure life. Multiple self-management and coping strategies to minimize the impact of CIPN symptoms were reported; the focus was on movement to reduce symptoms, attitude awareness, logistics to simplify demands, and environmental change. Women with and without CIPN were similar in the quantity and type of other reported side effects.

Conclusions

CIPN affects breast cancer patients’ routine activities, functions, and behaviors, but they develop management strategies to reduce the impact. The management strategies reported in this study suggest breast cancer patients may adopt interventions that focus on exercise, mindfulness, occupational therapy, and environmental planning toward the goal of reducing the impact of CIPN symptoms on their lives.

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References

  1. Cancer trends progress report—2009/2010 update (2010). National Cancer Institute, NIH, DHHS, Bethesda, MD. http://progressreport.cancer.gov. Accessed 3 June 2011

  2. Budman DR, Berry DA, Cirrincione CT, Henderson IC, Wood WC, Weiss RB et al (1998) Dose and dose intensity as determinants of outcome in the adjuvant treatment of breast cancer. The Cancer and Leukemia Group B. J Natl Cancer Inst 90:1205–1211

    Article  PubMed  CAS  Google Scholar 

  3. Early Breast Cancer Trialists’ Collaborative Group (1998) Polychemotherapy for early breast cancer: an overview of the randomised trials. Lancet 352:930–942

    Article  Google Scholar 

  4. Chirivella I, Bermejo B, Insa A, Perez-Fidalgo A, Magro A, Rosello S et al (2009) Optimal delivery of anthracycline-based chemotherapy in the adjuvant setting improves outcome of breast cancer patients. Breast Cancer Res Trial 114:479–484

    Article  CAS  Google Scholar 

  5. Chang J (2000) Chemotherapy dose reduction and delay in clinical practice. evaluating the risk to patient outcome in adjuvant chemotherapy for breast cancer. Eur J Cancer 36(Suppl 1):S11–S14

    Article  PubMed  CAS  Google Scholar 

  6. Basch E (2010) The missing voice of patients in drug-safety reporting. N Engl J Med 362:865–869

    Article  PubMed  CAS  Google Scholar 

  7. Wang J, Huang Y (2007) Pharmacogenomics of sex difference in chemotherapeutic toxicity. Curr Drug Discov Technol 4:59–68

    Article  PubMed  CAS  Google Scholar 

  8. Erban JK, Lau J (2006) On the toxicity of chemotherapy for breast cancer—the need for vigilance. J Natl Cancer Inst 98:1096–1097

    Article  PubMed  Google Scholar 

  9. Hassett MJ, O’Malley AJ, Pakes JR, Newhouse JP, Earle CC (2006) Frequency and cost of chemotherapy-related serious adverse effects in a population sample of women with breast cancer. J Natl Cancer Inst 98:1108–1117

    Article  PubMed  Google Scholar 

  10. Citron ML, Berry DA, Cirrincione C, Hudis C, Winer EP, Gradishar WJ (2003) Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol 21:1431–1439

    Article  PubMed  CAS  Google Scholar 

  11. Moore S (2007) Managing treatment side effects in advanced breast cancer. Semin Oncol Nurs 23:S23–S30

    Article  PubMed  Google Scholar 

  12. Nahleh Z, Tabbara IA (2003) Complementary and alternative medicine in breast cancer patients. Palliat Support Care 1:267–273

    Article  PubMed  Google Scholar 

  13. Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH (2010) An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 4:87–100

    Article  PubMed  Google Scholar 

  14. Cavaletti G, Marmiroli P (2010) Chemotherapy-induced peripheral neurotoxicity. Nat Rev Neurol 6:657–666

    Article  PubMed  Google Scholar 

  15. Wolf S, Barton D, Kottschade L, Grothey A, Loprinzi C (2008) Chemotherapy-induced peripheral neuropathy: prevention and treatment strategies. Eur J Cancer 44:1507–1515

    Article  PubMed  CAS  Google Scholar 

  16. Visovsky C, Collins M, Abbott L, Aschenbrenner J, Hart C (2007) Putting evidence into practice: evidence-based interventions for chemotherapy-induced peripheral neuropathy. Clin J Oncol Nurs 11:901–913

    Article  PubMed  Google Scholar 

  17. Bakitas MA (2007) Background noise: the experience of chemotherapy-induced peripheral neuropathy. Nurs Res 56:323–331

    Article  PubMed  Google Scholar 

  18. Boehmke MM, Dickerson SS (2005) Symptom, symptom experiences, and symptom distress encountered by women with breast cancer undergoing current treatment modalities. Cancer Nurs 28:382–389

    Article  PubMed  Google Scholar 

  19. Tofthagen C (2010) Patient perceptions associated with chemotherapy-induced peripheral neuropathy. Clin J Oncol Nurs 14:E22–E28

    Article  PubMed  Google Scholar 

  20. In: Bickman L, Rog DJ (eds) Handbook of applied social research methods. Sage Publications, Thousand Oaks, CA, pp 69–100

  21. Patton M (2002) Qualitative research and evaluation methods. Sage Publications, London

    Google Scholar 

  22. Kemper EA, Stringfield S, Teddlie C (2003) Mixed methods sampling strategies in social science research. In: Tashakkori A, Teddlie C (eds) Handbook of mixed methods in social and behavioral research. Sage Publications, Thousand Oaks, CA, pp 273–296

    Google Scholar 

  23. Paice JA (2009) Clinical challenges: chemotherapy-induced peripheral neuropathy. Semin Oncol Nurs 25:S8–S19

    Article  PubMed  Google Scholar 

  24. Dunlap B, Paice JA (2006) Chemotherapy-induced peripheral neuropathy: a need for standardization in measurement. J Support Oncol 4:398–399

    PubMed  Google Scholar 

  25. Kuroi K, Shimozuma K, Ohashi Y, Takeuchi A, Aranishi T, Morita S et al (2008) A questionnaire survey of physicians’ perspectives regarding the assessment of chemotherapy-induced peripheral neuropathy in patients with breast cancer. Jpn J Clin Oncol 38:748–754

    Article  PubMed  Google Scholar 

  26. National Cancer Institute (2009) Common Terminology Criteria for Adverse Events v4.0. NCI, NIH, DHHS. http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf. Accessed 10 August 2011

  27. QSR International (2008) Nvivo qualitative data analysis software version 8 edn. QSR International

  28. Boeije H (2002) A purposeful approach to the constant comparative method in the analysis of qualitative interviews. Qual Quant 36:391–409

    Article  Google Scholar 

  29. Velos I (2011) Velos eResearch. Velos, Fremont, CA

    Google Scholar 

  30. Sasane M, Tencer T, French A, Maro T, Beusterien KM (2010) Patient-reported outcomes in chemotherapy-induced peripheral neuropathy: a review. J Support Oncol 8:E15–E21

    Article  Google Scholar 

  31. National Cancer Institute Symptom Management and Quality of Life Steering Committee: chemotherapy-induced peripheral neuropathy (2009) National Cancer Institute, Rockville, MD. http://transformingtrials.cancer.gov/files/CIPN_CTPM_Final_Executive_Summary_for_CCCT_Aug_2010.pdf. Accessed 3 June 2011

  32. Rothman M, Burke L, Erickson P, Leidy NK, Patrick DL, Petrie CD (2009) Use of existing patient-reported outcome (PRO) instruments and their modification: the ISPOR good research practices for evaluating and documenting content validity for the use of existing instruments and their Modification PRO task force report. Value Health 12:1075–1083

    Article  PubMed  Google Scholar 

  33. Webb TL, Sheeran P (2006) Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence. Psychol Bull 132:249–268

    Article  PubMed  Google Scholar 

  34. Klesges LM, Estabrooks PA, Dzewaltowski DA, Bull SS, Glasgow RE (2005) Beginning with the application in mind: designing and planning health behavior change interventions to enhance dissemination. Ann Behav Med 29(Suppl):66–75

    Article  PubMed  Google Scholar 

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Conflicts of Interest

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Authors and Affiliations

  1. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA

    Rebecca M. Speck, Angela DeMichele, John T. Farrar, Sean Hennessy & Margaret G. Stineman

  2. Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA

    Rebecca M. Speck & John T. Farrar

  3. Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA, USA

    Angela DeMichele

  4. Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA

    Jun J. Mao & Frances K. Barg

  5. Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA, USA

    Margaret G. Stineman

  6. 1121A Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA

    Rebecca M. Speck

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  1. Rebecca M. Speck
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  2. Angela DeMichele
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  3. John T. Farrar
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Correspondence to Rebecca M. Speck.

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Speck, R.M., DeMichele, A., Farrar, J.T. et al. Scope of symptoms and self-management strategies for chemotherapy-induced peripheral neuropathy in breast cancer patients. Support Care Cancer 20, 2433–2439 (2012). https://doi.org/10.1007/s00520-011-1365-8

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  • DOI: https://doi.org/10.1007/s00520-011-1365-8

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