Research Highlights From the 2019 Supportive Care in Oncology Symposium, with William Dale, MD, PhD, and Joe Rotella, MD, MBA, HMDC, FAAHPM

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Greg Guthrie: Hi everyone, I'm Greg Guthrie, and I'm a member of the Cancer.Net content team. And I'll be your host for today's Cancer.Net podcast. As a reminder, Cancer.Net is the patient information website of ASCO, The American Society of Clinical Oncology. Today, we're going to be talking about some research highlights from the upcoming Supportive Care in Oncology Symposium. And my guests are Dr. William Dale and Dr. Joe Rotella. Dr. Dale is the Arthur M. Coppola Family Chair in Supportive Medicine at the City of Hope National Medical Center in Duarte, California. He is also the Cancer.Net Associate Editor for Geriatric Oncology. Thanks for joining us, William.

Dr. William Dale: Thanks for having me. I'm happy to be here.

Greg Guthrie: And Dr. Rotella is the Chief Medical Officer of the American Academy of Hospice and Palliative Medicine. Thank you for joining us as well, Joe.

Dr. Joe Rotella: It's nice to be here with you today.

Greg Guthrie: All right. Now, I also want to comment that William and Joe both served on the news planning team for this symposium, which means they helped select the studies that we'll be discussing on this podcast. So let's start off by discussing what is meant when we say “supportive care.” William, what do you think when I say supportive care?

Dr. William Dale: So supportive care medicine, and we have a Department of Supportive Care Medicine here at City of Hope, focuses on providing quality of life considerations for patients in a multidisciplinary way to emphasize functional status, to emphasize overall health for patients. Within supportive care, almost any part of the multidisciplinary team could be included outside of the cancer-directed therapy itself. As an example, palliative care exists as a division within our department of supportive care along with psychology, psychiatry, interventional pain, social work and some others. So when someone says supportive care, I think of everything outside of the cancer-directed therapy that we might do on a multidisciplinary team.

Greg Guthrie: That's a great foundation to have before we jump into these studies. And the first one I'd like us to talk about is called “A pilot study of oncology massage to treat chemotherapy-induced peripheral neuropathy, also called CIPN.” So Joe, what is chemotherapy-induced peripheral neuropathy?

Dr. Joe Rotella: Well, peripheral neuropathy is a nerve damage which is often associated with neuropathic pain which can be of 2 sorts: sort of a constant burning or a deep kind of pain, or it can be more of a sharp and shooting type of pain. But it's associated with the toxicity of some common chemotherapy drugs, particularly those related to platinum and the Taxol family of drugs. And so it's a pretty common side effect of pretty common chemotherapy that's given to people with advanced cancers and not an easy symptom to treat. The typical pain medications that we would use for any sort of pain, for example opioids, don't always work that well for neuropathic pain. And, of course, there are safety issues and other concerns around using opioids. The other medicines that are often used might fall in the class of the medicines like Gabapentin, or anticonvulsants. And they also can have quite a few side effects and are just not terribly effective.

So this study looked at a nonpharmacological approach to managing the pain of chemotherapy-induced peripheral neuropathy. Very interesting, they looked at a standardized Swedish massage technique applied to the lower extremity, and then they had a number of other less intensive massage therapies that were used as a control. And they gave this 3 times a week over 6 weeks, and they were actually able to show a significant reduction in the symptoms related to the chemotherapy-induced peripheral neuropathy, and that it actually was sustained for up to 6 weeks after the massage treatment had been completed.

So this was fascinating that we could apply what appears to be a low-risk treatment that seems to be free of significant side effects that falls in that category of complementary alternative medicine that is so appealing to patients, and...