IKCS 2022: Daily Aspects of Side-Effect Management Logistics in Kidney Cancer Treatment

(UroToday) The 2022 IKCS North American annual meeting featured a session on side-effect management and quality of life perspectives in kidney cancer treatment, including a presentation by Kiran Virdee discussing daily aspects of side-effect management logistics. Ms. Virdee notes that given the many different treatment modalities available for treating kidney cancer, the side effect profile and patient education of these side effects is important. As follows are several side effects stratified by treatment received:

  • TKIs: hypertension, diarrhea, dermatitis, mucositis, fatigue, and nausea
  • Immunotherapy: colitis, dermatitis, pruritus, pneumonitis, endocrinopathies, and myocarditis
  • Radiation therapy: fatigue, pancytopenia, dermatitis, edema, and nausea
  • Surgery: pain, wound care, and fatigue

Furthermore, the daily aspect of side-effect management relies on individual management of each specific side effect, for example:

  • Hypertension: accurate blood pressure monitoring, recording a daily log of readings, and understanding blood pressure parameters
  • Diarrhea: understanding baseline bowel movement habits, incorporating diet modification, obtaining stool samples, and taking anti-diarrheal medication
  • Dermatitis: having daily skin checks, using emollient-based creams, using topical steroids, and having a dermatology referral
  • Mucositis: review of mouth care, using steroid rinses, and understanding diet modification
  • Fatigue: prioritize activities, continue doing light activity, eat a well-balanced diet, limit naps, and do relaxing activities
  • Decreased appetite: utilize small frequent meals, schedule meals and snacks, utilize fluids with calories, and having a nutrition referral

daily aspects of side effect management infographic

Ms. Virdee notes that there are many challenges affecting the quality of life. First, there is a fear of discontinuing treatment, thus patients may be reluctant to report symptoms, and there may be patient non-compliance. Second, there are practical concerns, such as patient transportation, ability to continue working (particularly for those that are the primary household provider), and the concern for financial toxicity. Finally, there are support services concerns, especially for those that lack access to homecare services and navigate delays in referrals.

Kiran Virdee concluded her presentation by discussing daily aspects of side-effect management logistics with the following take home messages:

  • Quality of life is subjective
  • While it is important to provide patient education on side effect management, it is also imperative to factor in an individual patient’s challenges

Presented by: Kiran Virdee, RN, CCRN-K, Memorial Sloan Kettering Cancer Center, New York City, NY

Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 2022 International Kidney Cancer Symposium (IKCS) North America, November 4-5, Austin, Texas, USA

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