publication date: Apr. 25, 2014
ASCO Releases Three Guidelines For Cancer Survivorship Care
The American Society of Clinical Oncology published three clinical practice guidelines for the prevention and management of neuropathy, fatigue, depression, and anxiety.
They are the first in a series of evidence-based guidelines on survivorship care. ASCO has also updated information for survivors on its Cancer.Net website based on the recommendations. The guidelines were published April 14 in the Journal of Clinical Oncology.
Managing Peripheral Neuropathy
ASCO’s Prevention and Management of Chemotherapy-induced Peripheral Neuropathy in Survivors of Adult Cancers guideline offers recommendations for prevention and treatment of the debilitating side effect of certain chemotherapy regimens, particularly those containing platinum drugs, vinca alkaloids, bortezomib, and/or taxanes. For a minority of patients, severe symptoms can last for years.
The guideline identifies a handful of drugs that may be helpful in diminishing the symptoms of CIPN, but it does not recommend any agents for prevention of CIPN. Specifically, the recommendation says, the following agents should not be taken for prevention of CIPN: acetyl-L-carnitine, amifostine, amitriptyline, CaMg, dietyldithio-carbamate, glutathione, nimodipine, Org 2766, all-trans retinoic acid, rhuLIF, and vitamin E.
While there is no strong evidence of benefit from for use of tricyclic antidepressants, gabapentin, and a topical gel containing baclofen, amitriptyline, and ketamine, it may be reasonable to try those agents in select patients, according to the guideline. Clinicians may also offer duloxetine.
Screening and Management of Fatigue
ASCO’s fatigue guideline adaptation provides recommendations on screening, assessment, and treatment approaches for adult cancer survivors. It is recommended that all survivors be evaluated for symptoms of fatigue upon completion of primary … Continue reading 40-17 ASCO Guidelines
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