Nurses' Role in Cancer Survivors' Quality of Life
The American Journal of Nursing (AJN) recently released a consensus report on how nurses can improve care and quality of life for long-term cancer survivors. This report is based on "The State of the Science on Nursing Approaches to Managing Late and Long-Term Sequelae of Cancer and Cancer Treatment" invitational symposium, which took place in July 2005, in Philadelphia, PA.
Cancer treatments focus primarily on physical survival of the disease, not the physical and emotional side effects that accompany them. Cancer affects quality of life not only during the courses of treatment, but also in the long term for survivors. Their healthcare delivery is centered on the history of cancer; providers sometimes unintentionally overlook other noncancer-related conditions.
Physically, survivors tend to experience chronic pain and some experience infertility. The majority of cancer survivors also suffer from depression as well as anxiety and other mental disorders.
With the many recent advances in cancer research, methods of early detection, and effective treatments, more cancer patients are surviving. Nurses and nurse practitioners are most often the providers who manage the long-term side effects experienced by survivors. They have so many different roles within the healthcare system that they can truly make a difference in the lives of cancer survivors. The symposium reached consensus on several strategies and recommendations from the nursing perspective.
The consensus report was published in the March 2006 issue of AJN. The report is also available online at http://www.NursingCenter.com/AJNcancersurvivors in its entirety.
Rotavirus Vaccine Added to Infant Schedule
The Advisory Committee on Immunization Practices (ACIP) has issued a new childhood vaccination schedule that now includes RotaTeq (Merck), a newly approved rotavirus vaccine. Rotavirus is a significant problem for children. It infects nearly every child in the United States by 5 years of age, and is responsible for 55,000 to 70,000 hospitalizations and 60 deaths each year.
The ACIP previously recommended the addition of a rotavirus vaccine in 1999, with the RotaShield vaccine. However, RotaShield was quickly recalled due to its association with increased risk of intussusception, a rare bowel impediment. RotaTeq, however, did not have any associations with intussusception in large clinical trials. Even so, the CDC will conduct a postmarketing study on RotaTeq to quickly identify any cases of intussusception, as well as any other adverse reactions.
RotaTeq is expected to reduce rotavirus cases by more than 70% of all cases and nearly 100% of the most severe cases. RotaTeq will be administered in three liquid oral doses between 12 and 36 weeks of age.
Prostate Cancer May Have a Viral Cause
Breakthrough research has detected a common virus in cancerous prostates removed from men with a specific genetic anomaly. No actual link between this virus and prostate cancer has been discovered. However, infectious disease has already been shown to cause cervical and some liver cancers. Researchers are confident that after further investigations, prostate cancer can be added to the list.
This virus was detected by the "gene chip", the same device that identified and confirmed the SARS virus in 2003. The virus was found in 8 out of 20 patients who all possessed two copies of a common mutated gene. This gene matched DNA in an existing mouse virus. This particular gene is essential to the body's defense system. Men with mutated versions of the gene make fewer of the enzymes that help ward off and kill incoming viruses.
More studies need to be conducted to determine whether or not genetics play a role in the virus' association with the cancer. Additionally, researchers need to measure how prevalent the virus is in humans and whether or not it only has associations with prostate cancer. A large-scale study of prostate cancer patients is currently being planned, as is a diagnostic tool to detect the virus in the blood.
Weak Immune System May Cause Crohn's Disease
Crohn's disease is an irritable bowel disease that causes ulcers within the digestive tract due to chronic inflammation. This eventually leads to severe gastrointestinal problems, such as pain, rectal bleeding, and continuous diarrhea. Previously, Crohn's disease was believed to be caused by an overactive immune system. However, a new British study conversely suggests that a weak immune system is responsible.
The reasoning behind this theory is that a weak immune system cannot protect the bowel wall from infections that result from breakage. Instead of responding to the inflammation by producing more white blood cells and bacteria-removing proteins, these acute responses either fail to, or are slow to start with Crohn's. The bacteria further aggravate the bowel wall, which can cause chronic secondary infections.
This theory is supported by a series of small experiments on Crohn's as well as healthy patients. Researchers measured white blood cell production in response to intestinal and skin injury in both groups. Members of the Crohn's group had uncharacteristically lower levels of white blood cells and proteins involved in inflammation than the healthy group.
In related research, 10 Crohn's patients were administered sildenafil (Viagra) after being injected with killed gut bacteria. The sildenafil caused an increase in blood flow to the infected area. Increasing the blood flow increases inflammatory response, which is why sildenafil might be a successful treatment.
Both findings offer hope to Crohn's disease patients. However, more studies need to be conducted before the true origin of Crohn's can be determined; and or sildenafil should replace or accompany existing treatment.
Green Tea May Decrease Mental Decline in the Aging
Japanese researchers have recently released findings from an observational study of Japanese people, aged 70 years and older, which imply that drinking green tea regularly may preserve brain function in the aging. They also suggest that Japan's low rate of dementia may be explained by the regular drinking of green tea.
Surveys were given to 1,003 adults 70 years of age and older that asked detailed questions about diet and overall physical health, as well as lifestyle. In addition, they were given a standardized examination of cognitive functions, including attention and memory, as well as language use. The results showed that the individuals who consumed 2 or more cups of green tea on a daily basis showed approximately 50% less cognitive impairment than those who consumed 3 or less cups per week. Those who drank an average of 1 cup daily rated somewhere in the middle. The researchers further fueled their findings with the additional accounts of overall diet, smoking, and exercise habits.
This study was not a controlled experiment, so there is no actual proof of a correlation between green tea and cognitive function; however, the findings were enough to warrant further studies.