Komal Singh1, Steven M Paul2, Kord M Kober2, Yvette P Conley3, Fay Wright4, Jon D Levine5, Paule V Joseph6, Christine Miaskowski7. 1. Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA. 2. School of Nursing, University of California, San Francisco, California, USA. 3. School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 4. Rory Meyers College of Nursing, New York University, New York, New York, USA. 5. School of Medicine, University of California, San Francisco, California, USA. 6. Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, Department of Health and Human Services, National Institutes of Health, Bethesda, Maryland, USA. 7. School of Nursing, University of California, San Francisco, California, USA. Electronic address: chris.miaskowski@ucsf.edu.
Abstract
CONTEXT: Although chemotherapy-induced vomiting is well controlled with evidence-based antiemetic regimens, chemotherapy-induced nausea (CIN) remains a significant clinical problem. OBJECTIVES: Study purposes, in a sample of outpatients with breast, gastrointestinal, gynecological, or lung cancer who received two cycles of chemotherapy (CTX, n = 1251), were to evaluate for interindividual differences in the severity of CIN and to determine which demographic, clinical, symptom, and stress characteristics are associated with higher initial levels as well as with the trajectories of CIN. METHODS: Patients were recruited during their first or second cycle of CTX. Patients completed self-report questionnaires a total of six times over two cycles of CTX. Hierarchical linear modeling was used to evaluate for interindividual differences in and characteristics associated with the severity of CIN. RESULTS: Across the two cycles of CTX, higher levels of sleep disturbance, depression, and morning fatigue, as well as higher levels of intrusive thoughts, were associated with higher initial levels of CIN. In addition, lower functional status scores and shorter cycle lengths were associated with higher initial levels of CIN, and younger age and higher emetogenicity of the CTX regimen were associated with both higher initial levels as well as worse trajectories of CIN severity. CONCLUSION: These findings suggest that common symptoms associated with cancer and its treatment are associated with increased severity of CIN. Targeted interventions for these symptoms may reduce the burden of unrelieved CIN.
CONTEXT: Although chemotherapy-induced vomiting is well controlled with evidence-based antiemetic regimens, chemotherapy-induced nausea (CIN) remains a significant clinical problem. OBJECTIVES: Study purposes, in a sample of outpatients with breast, gastrointestinal, gynecological, or lung cancer who received two cycles of chemotherapy (CTX, n = 1251), were to evaluate for interindividual differences in the severity of CIN and to determine which demographic, clinical, symptom, and stress characteristics are associated with higher initial levels as well as with the trajectories of CIN. METHODS:Patients were recruited during their first or second cycle of CTX. Patients completed self-report questionnaires a total of six times over two cycles of CTX. Hierarchical linear modeling was used to evaluate for interindividual differences in and characteristics associated with the severity of CIN. RESULTS: Across the two cycles of CTX, higher levels of sleep disturbance, depression, and morning fatigue, as well as higher levels of intrusive thoughts, were associated with higher initial levels of CIN. In addition, lower functional status scores and shorter cycle lengths were associated with higher initial levels of CIN, and younger age and higher emetogenicity of the CTX regimen were associated with both higher initial levels as well as worse trajectories of CIN severity. CONCLUSION: These findings suggest that common symptoms associated with cancer and its treatment are associated with increased severity of CIN. Targeted interventions for these symptoms may reduce the burden of unrelieved CIN.
Authors: F Roila; A Molassiotis; J Herrstedt; M Aapro; R J Gralla; E Bruera; R A Clark-Snow; L L Dupuis; L H Einhorn; P Feyer; P J Hesketh; K Jordan; I Olver; B L Rapoport; J Roscoe; C H Ruhlmann; D Walsh; D Warr; M van der Wetering Journal: Ann Oncol Date: 2016-09 Impact factor: 32.976
Authors: Komal P Singh; Anand Dhruva; Elena Flowers; Steven M Paul; Marilyn J Hammer; Fay Wright; Frances Cartwright; Yvette P Conley; Michelle Melisko; Jon D Levine; Christine Miaskowski; Kord M Kober Journal: J Pain Symptom Manage Date: 2020-01-08 Impact factor: 3.612
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Authors: Stephanie G Cheung; Ariel R Goldenthal; Anne-Catrin Uhlemann; J John Mann; Jeffrey M Miller; M Elizabeth Sublette Journal: Front Psychiatry Date: 2019-02-11 Impact factor: 4.157
Authors: Komal Singh; Keenan Pituch; Qiyun Zhu; Haiwei Gu; Brenda Ernst; Cindy Tofthagen; Melanie Brewer; Kord M Kober; Bruce A Cooper; Steven M Paul; Yvette P Conley; Marilyn Hammer; Jon D Levine; Christine Miaskowski Journal: Cancer Nurs Date: 2022-03-02 Impact factor: 2.760
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