Electronic Antinausea Device (ELANI)
An electronic antinausea instrument is an apparatus that provides low-frequency electric stimulation percutaneously through a pulse generator that looks similar to a wristwatch. The pulse generated is transferred to the brain cortex via the median nerve in the wrist. The electric pulse is supposed to adjust a number of activities, including the central stimulation of nausea and vomiting in the brain. This type of device was studied in patients with cancer for its effect on chemotherapy-induced nausea and vomiting.
EEG Biofeedback
EEG biofeedback, or neurofeedback, involves real-time display of brain electrical activity provided to the individual as visual or auditory information. Use of this feedback approach was studied in patients with cancer for its effect on cognitive impairment, sleep-wake disturbances, and fatigue.
Early Palliative Care
Palliative care services encompassing holistic multidisciplinary patient care and aggressive symptom management are often associated with care at the end of life. Early palliative care refers to instituting specialized palliative care services at the time of cancer diagnosis or soon after diagnosis. Early palliative care is not reflective of end-of-life care needs but is aimed at providing comprehensive care and specialized expertise in symptom management.
Early Opioid Use
Early opioid use refers to managing chronic pain by using opioids to treat levels of pain lower than the levels the World Health Organization’s (WHO's) three-step pain relief ladder specifies for treating with opioids. The WHO suggests beginning treatment at step 1, using nonopioids with or without adjuvant medication, and moving to step 2, using weak opioids, if pain persists.
EACA (Epsilon-Aminocaproic acid)
Epsilon-aminocaproic acid is a potent antifibrinolytic agent used to control bleeding by inhibiting the plasmin-plasminogen system. It can be administered orally or intravenously and is excreted in the urine. Major side effects include cardiac arrhythmias, hypotension, rhabdomyolysis, and creation of thrombi. It may be beneficial in the prevention of bleeding, but additional studies are necessary.
Duloxetine
Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant. Antidepressants in general have been examined for treatment of depression in patients with cancer. Duloxetine specifically has been examined for its effect on pain and peripheral neuropathy.
Drain Antisepsis
The irrigation of surgical drains with an antiseptic solution was investigated for its effect on postoperative drain cultures and surgical site infections in patients undergoing surgery for cancer.
Doxepin Mouthwash
Doxepin is a tricyclic antidepressant and has anxiolytic properties. Doxepin also has been used to suppress itching and has antihistamine effects. Doxepin mouth rinse has been evaluated in patients with cancer for management of painful mucositis.
Dose Interruption or Modification
Dose interruption or modification involves delay in planned treatment or reduction in treatment dosages. This is generally done in response to treatment-related toxicities.
Donepezil
Donepezil is a centrally active cholinesterase inhibitor that has been used to treat dementia in patients with Alzheimer disease. It may improve the ability to think and remember in these patients, and has also been studied in patients with cancer for fatigue and cognitive impairment.