Effects of relaxation breathing exercise on fatigue and cortisol level among Indonesian gynecological cancer patients undergoing chemotherapy:a pilot study

Objective:This study aimed to determine the effect of the relaxation breathing exercise(RBE)on fatigue and cortisol levels among Indonesian women with gynecological cancer undergoing chemotherapy.Methods:This pilot study consecutively recruited 44 gynecological cancer patients to receive RBE(22)or usual care(22).Cortisol level was measured before and after completion of the intervention(day 8).Fatigue was measured using the Piper Fatigue Scale(PFS).Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale(HADS)at the baseline days of the study for days 1,4,and 8.The obtained data were analyzed using Fisher’s exact test,the independent t-test,and the Mann-Whitney U test.Results:There were significant increases in cortisol levels within the groups,either the intervention or control groups,respectively(P-value=0.0003 and 0.001).Despite there being no statistical significance between the intervention and control groups,there were noticeable differences in the cortisol levels,indicating the extreme increase in cortisol levels in the control group(Median[IQR1-IQR3]:2.30[0.99-9.09];Min-Max:0.43-23.38)compared with the intervention group(Median[IQR1-IQR3]=2.97[1.26-5.18];Min-Max=0.39-6.91).Conclusions:RBE helps prevent a significant increase in cortisol levels that can alleviate fatigue for women with gynecological cancer.Further research was recommended to compare several intervention modalities for fatigue and cancer-related symptom management based on cortisol level changes.

Nurses’ Role and Experiences as Group-Leaders in a Group Intervention for Women after Gynecological Cancer

Aim: The aim of this study is to provide insight into nurses’ role and their experiences of leading an education and counselling group intervention for women after gynecological cancer. Methods: A qualitative study, based on focus group interview and logs from nurses who led the intervention, was conducted. Findings: The group leaders were touched by the women’s community and were given a deeper understanding of lived experiences after cancer. These insights raised the group-leaders’ understanding of nursing and influenced them to sharpen focus on patient care and priorities in cancer care and follow-up. Being a group-leader meant creating a trusting and secure atmosphere in which the individual woman’s own coping resources was strengthened and empowered. Equally important, the nurses worked continuously and substantially on themselves to build strength and endurance related to situations that called for competent leadership. Conclusion: Being competent in group leadership and having knowledge in the field of cancer are important qualifications for group leaders. Practice Implications: The study shows that nurses gain valuable insight and knowledge about women’s lived experiences of going through gynecological cancer, cancer treatment and rehabilitation. As such, this intervention seems to be educational for nurses, as well as for participants.

Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic

Objective:Patients with gynecological cancer commonly use complementary and alternative medicine(CAM)methods to cope with the disease.However,despite the existence of treatment strategies,the effect of fear and anxiety caused by coronavirus disease 2019(COVID-19)pandemic on attitudes about CAM use is unclear.This study was carried out to investigate the effect of fear and anxiety experienced by patients with gynecological cancer during the COVID-19 pandemic on their attitudes towards the use of CAM.Methods:This is a cross-sectional and descriptive study that included 177 women with gynecological cancer;participants were recruited from a social networking site for cancer patients in Turkey between June and December 2021.Data were collected using an online survey that included the Personal Information Form,the Fear of COVID-19 Scale,the Coronavirus Anxiety Scale,and the Attitude Towards Holistic Complementary and Alternative Medicine Scale.Descriptive statistics,t-test,Pearson’s correlation test,and simple linear and multiple regression analyses were performed to analyze the data.Results:During the pandemic,55.4%of the participants reported using CAM methods,but only 22.6%were using CAM before the pandemic.The participants who used CAM during the pandemic also scored higher on the fear of COVID-19 and coronavirus anxiety scales(20.69±5.37 and 13.09±6.29,respectively)compared to the participants who did not use CAM(9.29±2.72 and 6.35±2.06,respectively).Fear of COVID-19 accounted for 52%of the CAM attitude score,while coronavirus anxiety accounted for 15%of the CAM attitude score.Fear of COVID-19 and coronavirus anxiety together accounted for 53%of CAM attitude.Conclusion:Gynecological cancer patients with high levels of COVID-19-related anxiety and fear during the pandemic used CAM more.Given that the psychological effects of the pandemic will continue in the coming years,CAM use should be evaluated as a coping strategy,especially due to the COVID-19-related anxiety and fear experienced by patients with gynecological cancer.While the rational and effective CAM methods should be supported,strategies should be developed to prevent misuse of CAM and its interference in prescribed medical treatments.

Fertility preservation in patients with gynecologic cancer

In this editorial we comment on the article by Gu et al.We focus and debate the necessity of fertility sparing surgery in young women’s with gynecologic cancers,specifically on those patients with the desire to conceive.This type of individu-alized treatment options is often very difficult,due to the risk of disease evolution and multiple disparities in fertility preservation services among women in di-fferent countries and societies.For this reason national policy interventions are mandatory in order to ensure equitable access this procedures,in women with cancer.

Ribavirin in Acute Hepatitis E Infection in Patients with Gynecological Cancer:A Case Series

Hepatitis E virus infection is usually a self-limited disease.However,during the last years there has been growing evidence for prolonged and chronic infection occurring in patients with immunosuppression.Also patients with malig-nant and rheumatic diseases have been identified to be at risk for chronic hepatitis E.However,their course and prognosis are not well characterized and there have been no reports of hepatitis E virus infection in patients with gynecological cancer.Here,we report three Caucasian females with breast and ovarian cancers presenting with elevation of amino-transferase levels during anticancer treatment.Although only few or no clinical hints suggested hepatitis E virus infection,the diagnosis of hepatitis E virus infection was confirmed by seroconversion,which might occur with some delay,and/or by polymerase chain reaction.While two patients had a self-limited course,the third patient with a high-risk oncological constellation required ribavirin in order to resume chemo-therapy.These cases highlight the need for hepatitis E virus testing in patients with gynecological cancer and elevated aminotransferase levels.Further,these cases show that in selected high-risk patients,ribavirin treatment may be nec-essary based on the decision of a multidisciplinary team.

EVALUATION ON QUALITY OF LIFE FOR GYNECOLOGIC CANCER PATIENTS

Objective: To compare the quality of life (QOL) for gynecologic cancer patients with different cancer sites and to assess the impact of patients’ characteristics, disease parameters, and treatments on the subscale and overall QOL. Methods: A prospective study was conducted including 146 gynecologic cancer patients. QOL data were collected using the general Functional Assessment of Cancer Therapy (FACT- G) QOL questionnaire. Results: Advanced stage patients showed significantly poor physical well-being, emotional well-being, and functional well-being, as compared with early stage patients. QOL was reported higher in older patients (P=0.03), patients above high school education (P=0.004), and patients with help at home (P=0.009). Conclusion: Patients with later stage, multi- modality therapy, poor education, and little social support have the most significant impairments and need more support.