Management of chemotherapy-related arm symptoms in patients with breast cancer
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Management of chemotherapy-related arm symptoms in patients with breast cancer

Rebecca Marshall-McKenna Research assistant, University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow
Cathy Hutchison Cancer nurse consultant and a member of the Cancer Nursing Practice editorial advisory board, Beatson West of Scotland Cancer Centre, Glasgow
Dawn Lindsay Breast cancer nurse specialist, Beatson West of Scotland Cancer Centre, Glasgow
Carol Stevenson Senior nurse chemotherapy, Beatson West of Scotland Cancer Centre, Glasgow
Lynne Stirling Breast clinical nurse specialist, Beatson West of Scotland Cancer Centre, Glasgow
Anne Armstrong Specialist breast radiographer, Beatson West of Scotland Cancer Centre, Glasgow
Pauline McIlroy Advanced breast clinical nurse specialist, Beatson West of Scotland Cancer Centre, Glasgow

Rebecca Marshall-McKenna and colleagues report on a local audit that found uncertainty about appropriate intervention and self-management advice

Anthracyclines are used widely as part of combination chemotherapy regimens to treat patients with early breast cancer. Epirubicin administered through a peripheral catheter may cause venous irritation resulting in symptoms of phlebitis. Management of phlebitis in oncology remains conflicted.

In response to anecdotal patient reports of arm symptoms, a local audit was conducted to identify the incidence and type of arm symptoms during or after chemotherapy and their management.

An audit questionnaire was designed by research and clinical staff and completed by 110 patients with breast cancer aged between 25 years and 76 years (± 52.7 years).

FEC-80 was the most frequently administered (n=68) chemotherapy regimen. Out of 108 responses, 65 patients reported arm symptoms during chemotherapy, of which the most commonly reported were arm pain 43% (n=28), tightness 32% (n=21) and vein discolouration 22% (n=14). They were most commonly provided with a heat pad, ibuprofen gel or bandaging for symptom relief.

Only 27 patients (25%) recalled being given aftercare advice on self-management of arm symptoms.

While a number of interventions were used to manage symptoms, there was no standardised care. Uncertainty exists about appropriate intervention and advice on self-management of persisting arm symptoms. Future research and guideline development should focus on prevention and early detection, as well as assessing the effectiveness of interventions.

Cancer Nursing Practice. 14, 2,22-28. doi: 10.7748/cnp.14.2.22.e1163

Correspondence

Rebecca.Marshall-McKenna@ggc.scot.nhs.uk

Peer review

This article has been subject to double blind peer review

Conflict of interest

None declared

Received: 18 November 2014

Accepted: 11 February 2015