Chemotherapy-Induced Nausea and Vomiting Treatment

Problem Statement

Cancer has become the most dreaded condition and the most common cause of death over the past few years (National Cancer Institute, 2016). Gastric cancer, as one of the specimens of the disease, has been affecting the U.S. population significantly, even though the rates of disease development have dropped recently. Nowadays, gastric cancer affects 7.3 people per 100,000 cases (National Cancer Institute, 2014). Even though chemotherapy (FOLFOX) has been used quite successfully to address gastric cancer, chemotherapy-induced nausea and vomiting (CINV), which is the side effect thereof, poses a significant threat to the success of the patient’s recovery (National Cancer Institute, 2014). Therefore, there is a need to design the framework for addressing the issue of CINV in cancer patients undergoing FOLFOX treatment. Particularly, the use of pharmacological treatment (i.e., antiemetics with high binding affinities, such as Palonosetron and Olanzapine (Janelsins et al., 2013)) should be compared to the alternative options (i.e., Chinese herbal medications such as Shenqi fuzheng (Sheikhi, Ebadi, Talaeizadeh, & Rahmani, 2015; Jiang et al., 2015)).

Research Purpose

The goal of the study is to compare the effects of the traditional treatment of CINV in gastric cancer patients (i.e., the application of pharmacological methods) and the usage of the alternative approaches (particularly, herbal medicine) so that possible means of reducing CINV as a severe side effect could be found. The research will focus on identifying the advantage and disadvantages of each approach based on the clinical trial carried out in a hospital setting. Thus, the foundation for improving the current approach toward preventing CINV in cancer patients undergoing chemotherapy will be built.

Research Question (PICOT)

Patient/Population/Problem

Hispanic patients diagnosed with gastric cancer, currently undergoing chemotherapy (FOLFOX), and suffering from CINV symptoms are the target population of the research.

Intervention/Exposure

An observation of the effects produced by two different types of CINV management strategies (i.e., the pharmacological and alternative ones) will be carried out in the course of the research. The patients will be provided with both traditional (antiemetics-based, e.g., involving the use of Palonosetron) alternative (herbal) medicine as the means of reducing the CINV symptoms and addressing the subject matter (Vidall, Sharma, & Amlani, 2016).

Comparison

The efficacy of Palonosetron will be compared to the one of herbal medicine provided to the target population. Presumably, the use of herbal treatment as the means of reducing nausea and vomiting will allow developing an individual approach toward the needs of each patient and, thus, manage the problem more successfully (Navari, 2013).

Outcome

It is expected that the strategies for reducing the levels of CINV will be developed after the research is over. Particularly, the selection of an appropriate method of preventing the development of CINV symptoms will be carried out.

Timeframe

The study will take presumably around three months to implement the treatment strategies, observe their effects, gather the necessary information, and analyze it accordingly. Therefore, the results will be presented within three months from the start of the study.

PICOT Question

(P) In Hispanic gastric cancer patients, (I) will the use of Chinese herbal medicine such as Shenqi fuzheng (C) prove to be more efficient than antiemetic treatment, i.e., the use of Olanzapine, in (O) preventing and addressing CINV (T) within three months?

The use of Chinese herbal medicine will serve as the intervention strategy, whereas the patients provided with Olanzapine as antiemetic treatment will represent the comparison group. Both prevention and management of CINV will be considered in the study. Despite a comparatively tight deadline, it is expected that there will be enough patients to carry out the research. In the USC Norris Cancer Center, which will serve as the study setting, FOLFOX (5-FU, Leucovorin, and Oxaliplatin) is administered to 12 patients with metastatic gastric cancer. Chemotherapy infusion is given every two weeks, and most of the patients recover within 6-12 months. The youngest patient, a 26-year-old woman, is on cycle 43 now. It is expected that the research results will help address the CINV issue successfully.

References

Janelsins, M. C., Tejani, M., Kamen, C., Peoples, A., Mustian, K. M., & Morrow, G. R. (2013). Current pharmacotherapy for chemotherapy-induced nausea and vomiting in cancer patients. Expert Opinion on Pharmacotherapy, 14(6), 757-766. Web.

Jiang, L., Wang, J. C., Ma, B., Gao, W., Chen, P., Sun, R. & Yang, K. H, (2015). Shenqi fuzheng injection for advanced gastric cancer: A systematic review of randomized controlled trials. Chinese Journal of Integrative Medicine, 21(1), 71-79. Web.

National Cancer Institute. (2014). Web.

National Cancer Institute. (2016). Web.

Navari, R. M. (2013). Management of chemotherapy-induced nausea and vomiting. Drugs, 73(3), 249-262. Web.

Sheikhi, M. A., Ebadi, A., Talaeizadeh, A., & Rahmani, H. (2015). Alternative methods to treat nausea and vomiting from cancer chemotherapy. Chemotherapy Research and Practice, 2015(818759), 1-6. Web.

Vidall, C., Sharma, S., & Amlani, B. (2016). Patient–practitioner perception gap in treatment-induced nausea and vomiting. British Journal of Nursing, 25(16), 4-11. Web.

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