Kanserli Hastalarda Bulantı-Kusmanın Yönetimi: Tamamlayıcı ve Alternatif Tıp Uygulamalarının Kullanımı

Öz

Kanser, dünya çapında önde gelen ölüm nedenlerinden biridir ve giderek toplumda görülme sıklığı artmaktadır. Kanser tedavisi alan hastalarda tedaviye bağlı olarak çeşitli semptomlar görülmektedir. En sık görülen semptomlardan olan bulantı ve kusma gastrointestinal semptomların başında gelmektedir. Bu semptomlar etkili yönetilmediğinde hastaların günlük yaşam aktivitelerine katılımını ve yaşam kalitelerini azaltmaktadır. Kanser hastaları bulantı ve kusmayı azaltmak veya kontrol altına alabilmek için farmakolojik tedavinin yanında tamamlayıcı ve alternatif tıp uygulamalarını da kullanmaktadırlar. Bulantı ve kusmanın yönetiminde sık kullanılan tamamlayıcı ve alternatif tıp uygulamaları arasında; aromaterapi, hipnoz, akupunktur, akupresür, müzik terapi, refleksoloji, masaj, progresif gevşeme egzersizleri yer almaktadır. Bu derlemede kanser hastalarında meydana gelen bulantı-kusmanın yönetiminde kullanılan tamamlayıcı ve alternatif tıp uygulamalarının kullanımına yer verilmiştir. Onkoloji hemşirelerinin bu uygulamalar hakkında bilgi sahibi olmaları etkili semptom yönetimini sürdürmeleri için önemlidir. Hemşireler tarafından hastanın değerlendirmesi yapılarak uygun eğitim ve danışmanlık desteği verilmelidir.

Anahtar Kelimeler

• Kanserli hasta
• bulantı
• kusma
• TAT
• hemşire

Management of Nausea and Vomiting in Cancer Patients: Use of Complementary and Alternative Medicine Applications

Öz

Cancer is one of the leading causes of death worldwide and its incidence is increasing in society. Various symptoms are seen in patients receiving cancer treatment depending on the treatment. Nausea and vomiting, which are the most common symptoms, are among the gastrointestinal symptoms. When these symptoms are not managed effectively, they reduce the patients' participation in daily life activities and their quality of life. Cancer patients use complementary and alternative medicine practices as well as pharmacological treatment to reduce or control nausea and vomiting. Complementary and alternative medicine applications frequently used in the management of nausea and vomiting include; aromatherapy, hypnosis, acupuncture, acupressure, music therapy, reflexology, massage, and progressive relaxation exercises are included. In this review, the use of complementary and alternative medicine applications used in the management of nausea and vomiting in cancer patients is included. It is important for oncology nurses to have knowledge about these practices in order to maintain effective symptom management. Nurses should evaluate the patient and provide appropriate training and consultancy support.

Anahtar Kelimeler

• Cancer patient
• nausea
• vomiting
• CAM
• nurse

Kaynakça

1. Al Qadire M, Khalaileh M. Prevalence of symptoms and quality of life among Jordanian cancer patients. Clin Nurs Res 2019;25:174– 191. https://doi.org/10.1177/1054773814564212.
2. Andersen MR, Sweet E, Hager S, Gaul M, Dowd F, Standish LJ. Use of Integrative oncology, involvement in decision-making, and breast cancer survivor health-related quality of life in the first 5 years post diagnosis. Integr Cancer Ther 2018;17:636-645. https://doi.org/10.1177/1534735418762543.
3. Asha C, Manjini KJ, Dubashi B. Effect of foot massage on patients with chemotherapy ınduced nausea and vomiting: A randomized clinical trial. J Caring Sci 2020;18;9(3):120-124. https://doi.org/10.34172/jcs.2020.018.
4. Arslan M, Ozdemir L. Oral intake of ginger for chemotherapy-induced nausea and vomiting among women with breast cancer. Clin J Oncol Nurs 2015;19(5):E92-97. https://doi.org/10.1188/15.CJON.
5. Avcı HS, Ovayolu N, Ovayolu Ö. Effect of acupressure on nauseavomiting in patients with Acute Myeloblastic Leukemia. Holistic Nursing Practice 2016;30(5):257-262. https://doi.org/10.1097/HNP.0000000000000161. Baykara O. Kanser tedavisinde güncel yaklaşımlar. Balıkesir Sağlık Bilimleri Dergisi 2016;5(3):154-165.
6. Buluş M. Bulantı ve Kusma. Can G, (ed.). Onkoloji Hemşireliği. 2. Baskı. İstanbul: Nobel Tıp Kitabevleri; 2020. s.427-436. Carvalho EC, Martins FTM, Santos CB. A pilot study of a relaxation technique for management of nausea and vomiting in patients receiving cancer chemotherapy. Cancer Nurs 2007;30(2):163– 167. https://doi.org/10.1097/01.NCC.0000265007.87311.d0.
7. Charalambous A, Giannakopoulou M, Bozas E, Marcou Y, Kitsios P, Paikousis L. Guided ımagery and progressive muscle relaxation as a cluster of symptoms management ıntervention in patients receiving chemotherapy: A randomized control trial. PLoS ONE 2016;11(6):e0156911. https://doi.org/10.1371/journal.pone.0156911. Cope DG. Clinical Updates in Nausea and Vomiting. Semin Oncol Nurs 2022;38(1):151249. https://doi.org/10.1016/j.soncn.2022.151249.
8. Cramer H, Lauche R, Paul A, Langhorst J, Kuemmel S, Dobos GJ. Hypnosis in breast cancer care: a systematic review of randomized controlled trials. Integrative Cancer Therapies 2015;14(1):5-15. https://doi.org/10.1177/1534735414550035.

9. Dadkhah B, Mozaffari N, Amani F, Pourghasemian M, Anisi E. Effect of music therapy with periorbital massage on chemotherapyinduced nausea and vomiting in gastrointestinal cancer: A randomized controlled trail. J Caring Sci 2019;8(3):165-71. https://doi.org/10.15171/jcs.2019.024.
10. Dranitsaris A, Molassiotis A, Clemons M, Roeland E, Schwartzberg L, Dielenseger P, et al. The development of a prediction tool to identify cancer patients at high risk for chemotherapy-induced nausea and vomiting. Ann Oncol 2017;28(6):1260–1267. https://doi.org/10.1093/annonc/mdx100.
11. Dogan MD, Savuci Y, Sayılan AA. The effect of complementary and integrative medicine on symptom management and quality of life in oncology patients. Adv Integr Med 2020; doi: 10.1016/j.aimed.2020.05.004.
12. Escobar Y, Cajaraville G, Virizuela JA, Alvarez R, Munoz A, Olariaga O, et al. Incidence of chemotherapy-induced nausea and vomiting with moderately emetogenic chemotherapy: ADVICE (Actual Data of Vomiting Incidence by Chemotherapy Evaluation) study. Support Care Cancer 2015;23(9):2833– 2840. https://doi.org/10.1007/s00520-015-2809-3.
13. Ergin E, Midilli TS, Akdağ E, Kirgöz C. Evaluation of outpatient cancer patients’ use of nonpharmacological methods in the management of chemotherapy-induced nausea and vomiting. Cukurova Med J 2021;46(2):574-582. https://doi.org/10.17826/cumj.852985.
14. Ertürk NE, Taşçı S. The effects of peppermint oil on nausea, vomiting and retching in cancer patients undergoing chemotherapy: An open label quasi–randomized controlled pilot study. Complement Ther Med 2021;56:102587. https://doi.org/10.1016/j.ctim.2020.102587.
15. Gan GG, Leong YC, Bee PC, Chin E, Teh AK. Complementary and alternative medicine use in patients with hematological cancers in Malaysia. Support Care Cancer 2015;23:2399-2406. https://doi.org/10.1007/s00520-015-2614-z. Genç A. Kemoterapi alan hastalarda bulantı-kusmanın önlenmesinde Akupressure'ın etkinliği. Yüksek Lisans Tezi, İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul, 2011.
16. Gozzo TO, Souza SG, Moyses AMB, Panobianco MS, Almeida AM. Incidence and management of chemotherapy-induced nausea and vomiting in women with breast cancer. Rev Gaucha Enferm 2014;35(3):117–123. https://doi.org/10.1590/1983- 1447.2014.03.42068.
17. Gupta K, Walton R, Kataria SP. Chemotherapy-induced nausea and vomiting: pathogenesis Recommendations. Cancer Treatment and Research Communications 2021;26:100278. https://doi.org/10.1016/j.ctarc.2020.100278.
18. Horneber M, Bueschel G, Dennert G, Less D, Ritter E, Zwahlen M. How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis. Integrative Cancer Therapies 2012;11(3):187-203. https://doi.org/10.1177/1534735411423920.
19. Hsieh RK, Chan A, Kim HK, Yu S, Kim JG, Lee MA, et al. Baseline patient characteristics, incidence of CINV, and physician perception of cinv incidence following moderately and highly emetogenic chemotherapy in Asia Pacific Countries. Support Care Cancer 2015;23(1):263–272. https://doi.org/10.1007/s00520-014-2373-2.
20. Ilyas AB, Bahaj RK, Shaikh AA, Khawandanah BS, Foheidi MA, Omer TY. Breast cancer patients’ perceptions of their experience with chemotherapy-induced nausea and vomiting and its impact on quality of life in Jeddah. Saudi Arabia. Cureus 2020;12(12):e12038. https://doi.org/10.7759/cureus.12038. Jafarimanesh H, Akbari M, Hoseinian R, Zarei M, Harorani M. The effect of peppermint (mentha piperita) extract on the severity of nausea, vomiting and anorexia in patients with breast cancer undergoing chemotherapy: A randomized controlled trial. Integrative Cancer Therapies 2020;19:1–10. https://doi.org/10.1177/1534735420967084. Karagozoglu S, Tekyasar F, Yilmaz FA. Effects of music therapy and guided visual imagery onchemotherapy-induced anxiety and nausea–vomiting. J Clin Nurs 2012;22:39–50. https://doi.org/10.1111/jocn.1203039.
21. Keene MR, Heslop IM, Sabesan SS, Glass BD. Complementary and alternative medicine use in cancer: A systematic review. Complement Ther Clin Pract 2019;35:33–47. https://doi.org/10.1016/j.ctcp.2019.01.004.
22. Korkmaz M, Tavsanli NG, Ozcelik H. Use of complementary and alternative medicine and quality of life of cancer patients: Turkish samples. Holist. Nurs Pract 2016;30(2):88–95. https://doi.org/10.1097/HNP.0000000000000121.
23. Kreye G, Wasl M, Dietz A, Klaffel D, Groselji-Strele A, Eberhard K, et al. Aromatherapy in palliative care: A single-institute retrospective analysis evaluating the effect of lemon oil pads against nausea and vomiting in advanced cancer patients. Cancers 2022;14:2131. https://doi.org/10.3390/cancers14092131.
24. Kurt S. Onkoloji hastalarının semptom yönetiminde refleksolojinin kullanımı. Sakarya Üniversitesi Holistik Sağlık Dergisi 2018;1(1):28-38. Li QW, Yu MW, Wang XM, Yang GW, Wang H, Zhang CX, et al. Efficacy of acupuncture in the prevention and treatment of chemotherapy-induced nausea and vomiting in patients with advanced cancer: a multi-center, single-blind, randomized, sham-controlled clinical research. Chin Med 2020;15(57). https://doi.org/10.1186/s13020-020-00333-x.
25. Min-Young K, Pok-Ja O. Meta-analysis of the effectiveness on footreflexomassage for cancer patients, Journal Korean Oncology Nursing, 2011;11(2):127-135. https://doi.org/10.5388/jkon.2011.11.2.127.
26. Molassiotis A, Aapro M, Dicato M, Gascon P, Novoa SA, Isambert N, et al. Evaluation of risk factors predicting chemotherapy-related nausea and vomiting: results from a European prospective observational study. J Pain Symptom Manage 2014;47:839– 848. https://doi.org/10.1016/j.jpainsymman.2013.06.012.
27. Mosa ASM, Hossain M, Lovoie BJ, Yoo I. Patient-related risk factors for chemotherapy- induced nausea and vomiting: A systemic review. Front Pharmacol 2020;11:329. https://doi.org/10.3389/fphar.2020.00329.
28. Murat-Ringot A, Souquet PJ, Subtil F, Boutitie F, Preau M, Piriou. The effect of foot reflexology on chemotherapy-ınduced nausea and vomiting in patients with digestive or lung cancer: randomized controlled trial. JMIR Cancer 2021;7(4): e25648. https://doi.org/10.2196/25648.
29. Özdelikara A, Arslan B. Kemoterapiye bağlı bulantı-kusma yönetiminde tamamlayıcı ve alternatif tıp yöntemlerinin kullanımı. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 2017;6(4):218-223.
30. Özdelikara A, Tan M. The effect of reflexology on chemotherapyinduced nausea, vomiting, and fatigue in breast cancer patients. Asia Pac J Oncol Nurs 2017;4:241-249. Panahi Y, Saadat A, Sahebkar A, Hashemian F, Taghikhani M, Abolhasani E. Effect of ginger on acute and delayed chemotherapy‐induced nausea and vomiting: A pilot, randomized, open‐label clinical trial. Integrative Cancer Therapies 2012;11(3):204–211. https://doi.org/10.1177/1534735411433201.
31. Pekmezci H, Genç Köse B, Akbal Y, Aşık Özdemir V, Kefeli Çöl B. Kemoterapi alan kanser hastalarında görülen semptomlar ve tamamlayıcı terapi uygulamaları kullanımları. Sağlık Akademisyenleri Dergisi 2022;9(3):211-219.
32. Peksoy S, Demirhan İ, Kaplan S, Şahin S, Arıöz Düzgün A. Tamamlayıcı ve alternatif tedavinin jinekolojik kanserlerde kullanımı. Türkiye Sağlık Bilimleri ve Araştırmaları Dergisi 2018;1(1):36-47. Yıldız Çilengiroğlu&Kurt 78 Perkins P, Parkinson A, Parker R, Blaken A, Akyea RK. Does acupressure help reduce nausea and vomiting in palliative care patients? A double blind randomised controlled trial. BMJ Support Palliat Care 2022;12(1):58-63. https://doi.org/10.1136/bmjspcare-2020-002434. Pirri C, Katris P, Trotter J, Bayliss E, Bennett R, Drummond P. Risk factors at pretreatment predicting treatment-induced nausea and vomiting in Australian cancer patients: a prospective, longitudinal, observational study. Support Care Cancer 2011;19:1549–1563. https://doi.org/10.1007/s00520-010- 0982-y.
33. Richardson J, Smith JE, McCall G, Richardson A, Pilkington K, Kirsch I. Hypnosis for nausea and vomiting in cancer chemotherapy: A systematic review of the research evidence. Eur J Cancer Care 2007;16:402–412. https://doi.org/10.1111/j.1365- 2354.2006.00736.x.
34. Soliman HM, Eltantawy A, El-Kurdy R. The effect of progressive muscle relaxation training on chemotherapy-induced nausea, vomiting and anxiety in Egyptian breast cancer women: A randomized controlled trial. J Nurs Educ Pract 2022;12(4). https://doi.org/10.5430/jnep.v12n4p1. Stomski NJ, Petterson A, Kristjanson L, Lobb EA, Phillips M, Williams A et al. The effect of self-selected complementary therapies on cancer patients’quality of life and symptom distress: A prospective cohort study in an integrative oncology setting. Complement Ther Med 2018;37:1–5. https://doi.org/10.1016/j.ctim.2018.01.006.
35. Tan JY, Molassiotis A, Suen LKP, Liu J, Wang T, Huang HR. Effects of auricular acupressure on chemotherapy‑induced nausea and vomiting in breast cancer patients: a preliminary randomized controlled trial. BMC Complement Med 2022;22(1):87. https://doi.org/10.1186/s12906-022-03543-y.
36. Tarakçıoğlu Çelik GH. Onkoloji hemşireliğinde semptom yönetimi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 2016;5(4):93- 100.
37. Tian X, Tang RY, Xu LL, Xie W, Chen H, Pi YP, et al. Progressive muscle relaxation is effective in preventing and alleviating of chemotherapy-induced nausea and vomiting among cancer patients: a systematic review of six randomized controlled trials. Support Care Cancer 2020;28:4051–4058. https://doi.org/10.1007/s00520-020-05481-2. Teggart K, Bryant DL, Neil SES, Ganann R. Implementation strategies to address barriers to evidence- informed symptom management among outpatient oncology nurses: a scoping review protocol. BMJ Open 2022;12(4):e057661. https://doi.org/10.1136/bmjopen-2021-057661.
38. Tufan S, İnangil D. Kemoterapiye bağlı gelişen bulantı ve kusmanın yönetiminde akupres uygulamasının etkinliği: Sistematik derleme. Sağlık Bilimleri Üniversitesi Hemşirelik Dergisi 2019;1(3):173-182.
39. Wang YL, Li JX, Guo XQ, Fu RY, Guan XJ. Effect of acupuncture in different time on nausea and vomiting induced by chemotherapy of lung cancer. Zhongguo Zhen Jiu 2019;39(12):1269-1273. https://doi.org/10.13703/j.0255- 2930.2019.12.004. Yüce GE, Muz G. Kanser hastalarında tedaviye bağlı bulantı ve kusmanın yönetimi. Nevşehir Bilim ve Teknoloji Dergisi 2020;9(2):116-124.
40. Yildiz I, Ozguroglu M, Toptas T, Turna H, Sen F, Yildiz M. Patterns of complementary and alternative medicine use among Turkish cancer patients. J Palliat Med 2013;16:383–390. https://doi.org/10.1089/jpm.2012.0226.
41. Zorba P, Özdemir L. The preliminary effects of massage and ınhalation aromatherapy on chemotherapy-ınduced acute nausea and vomiting: A quasi-randomized controlled pilot trial. Cancer Nurs 2018;41(5):359-366. https://doi.org/10.1097/NCC.0000000000000496.
42. World Healt Organization WHO. [Internet], The Global Cancer Observatory 2020. [cited 2023 May 05]. Available from: https://gco.iarc.fr/today/data/factsheets/cancers/39-Allcancers-fact-sheet.pdf Türkiye Cumhuriyeti Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü 2021. [Internet], Türkiye Kanser İstatistikleri, [Erişim tarihi: 05.05.2023]. Web adresi: http://kanser.gov.tr/dairefaaliyetleri/kanser-istatistikleri.html.pdf