Hand-held fan airflow stimulation relieves dyspnea in lung cancer patients

Puspawati, Ni Luh Putu Dewi; Sitorus, Ratna; Herawati, Tuti

doi:10.4103/apjon.apjon_14_17

Cited by 26 publications

(31 citation statements)

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“…Radiotherapy and chemotherapy can easily induce drug resistance of tumor cells and cause tumor recurrence and metastasis, leading to death of patients (22). Studies show that the development of NSCLC is a complex process involving multiple genes, multiple factors and multiple steps, such as gene mutation, abnormal expression, immunosuppression and tumor stem cells (23,24). Of note, miRNA molecules are involved in the regulation of various malignant phenotypes of NSCLC, and have become potential tumor therapy targets (25).…”

Section: Discussionmentioning

confidence: 99%

MicroRNA‑21 promotes the proliferation, migration and invasion of non‑small cell lung cancer A549 cells by regulating autophagy activity via AMPK/ULK1 signaling pathway

Zeng

et al. 2018

Exp Ther Med

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Abstract. The present study investigated the expression of microRNA (miR)-21 in non-small cell lung cancer (NSCLC) tissues, its biological functions and mechanism of autophagy regulation. A total of 46 patients with NSCLC were enrolled in the present study. To measure the expression of miR-21, reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was employed. NSCLC A549 cells were transfected with miR-negative control (NC), miR-21 mimics or inhibitor. The CCK-8 assay was used to investigate the proliferation of A549 cells. To study migration and invasion abilities of A549 cells, The Transwell assay was performed. In addition, to determine the expression levels of ULK1, LC3B, AMPKα, p-AMPKα and p62 proteins, western blotting was conducted and laser confocal microscopy was performed to observe the formation of autophagosomes in A549 cells. To explore whether miR-21 regulates the biological functions of A549 cells via autophagy, an autophagy inhibitor, 3-MA, or agonist, rapamycin, were used in a rescue assay. Results indicated that miR-21 expression in NSCLC tissues was enhanced, and closely correlated with the occurrence and development of NSCLC. In vitro experiments showed that miR-21 mimics promoted the proliferation, migration and invasion of A549 cells, while miR-21 inhibitor inhibited these biological functions. Western blotting indicated that miR-21 upregulated autophagy marker LC3BⅡ protein, but downregulated p62 protein. Laser confocal microscopy showed that miR-21 activated autophagy of A549. Rescue experiments indicated that autophagy reversed the effect of miR-21 on the proliferation, migration and invasion of A549 cells. Western blotting data suggested that autophagy-related AMPK/ULK1 signaling pathway was activated by miR-21, and interference or overexpression of ULK1 reversed the biological functions of miR-21. The present study demonstrated that miR-21 expression in NSCLC tissues was upregulated and positively correlated with lymphatic metastasis and clinical staging. In addition, miR-21 regulated autophagy activity of NSCLC A549 cells via AMPK/ULK1 signaling pathway, and promoted the proliferation, migration and invasion of NSCLC A549 cells.

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Section: Discussionmentioning

confidence: 99%

MicroRNA‑21 promotes the proliferation, migration and invasion of non‑small cell lung cancer A549 cells by regulating autophagy activity via AMPK/ULK1 signaling pathway

Zeng

et al. 2018

Exp Ther Med

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“…In the control arm, airflow was directed unto the legs with the patient's skin exposed for 5 minutes using the same model of the fan as that used in the intervention arm. We adopted the fan-to-legs method as the control treatment based on previous studies [32][33][34] Treatment crossover was performed after a washout time of 1 hour. 35,36 Methodology and data collection details are summarized in ►Fig.…”

Section: Interventions and Proceduresmentioning

confidence: 99%

The FAFA Trial: A Phase 2 Randomized Clinical Trial on the Effect of a Fan Blowing Air on the Face to Relieve Dyspnea in Filipino Patients with Terminal Cancer

Ting

Estreller

Strebel

2020

Asian Journal of Oncology

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Introduction Fan therapy has been suggested by some studies as one of the nonpharmacological supportive interventions to alleviate breathlessness for dyspneic patients with terminal cancer. Unfortunately, data among Asians are limited and there are currently no published data showing that this intervention works among Filipinos—thus this study. Study Design This study was an open-label, randomized, placebo-controlled, crossover Phase 2 trial. The experimental group had a fan blowing air directly to the patient’s face for 5 minutes, and the control group had a fan blowing air to the patient’s legs. Treatment crossover was done after a washout period of 1 hour. The primary outcome, which is dyspnea, was measured subjectively using the Modified Borg Scale (MBS). Differences in the patient’s respiratory rate (RR) and oxygen saturation were also measured. Results A total of 48 patients were enrolled in this trial. The mean age of the patients enrolled was 51 years, and the most common primary tumor was lung cancer (21%). In the control group, results showed that the mean difference before and after intervention in the MBS was 0.15, and the mean difference in RR was 0.25. On the other hand, the intervention group showed a statistically significant decrease in the patient’s dyspnea as evidenced by a mean MBS decrease of 2.79 (p < 0.0001), and a mean RR decrease of 1.88 (p < 0.0001). Conclusion The results of this study reveal that fan on face (FAFA) therapy in terminally ill Filipino cancer patients in addition to the prescribed standard of care can significantly alleviate their level of dyspnea. Thus, FAFA therapy should be considered as an adjunct to standard of care for these patients.

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“…All four randomized controlled trials employed a total of 139 terminally ill adult cancer patients. Two studies 10,11 had a crossover design after a wash-out period of 1 hour. Lung cancer was the most common malignancy, and a great majority were provided with supplemental oxygen.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Puspawati et al 2017 10 Wong et al 2017 21 Kako et al 2018 12 Ting It is worth investigating if longer periods of fan-on-face therapy will afford longer periods of relief. Publication bias could have been a major limitation since the selection of studies only included those which are published or can be translated into the English language.…”

Section: Parametersmentioning

confidence: 99%

Fan-on-Face Therapy in Relieving Dyspnea of Adult Terminally Ill Cancer Patients: A Meta-Analysis

Mendoza

Ting

Vergara

et al. 2020

ASJO

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Abstract Introduction Dyspnea is often encountered in terminally ill cancer patients and is attributed to multiple factors. The use of fan-on-face therapy is a nonpharmacologic adjunct treatment for adult cancer patients suffering from dyspnea at the end-of-life. This study was done to determine if the use of fan-on-face therapy in addition to the standard of care treatment indeed confers clinical benefit to terminally ill adult cancer patients with dyspnea. Materials and Methods A meta-analysis of randomized controlled trials on the use of fan-on-face therapy in relieving dyspnea among terminally ill adult cancer patients was performed. A computerized search was done in MEDLINE, NICE, CENTRAL, Science Direct, and Google Scholar for relevant articles. Other publications were searched, and authors were contacted for additional information. The primary outcome measure was the mean change in dyspnea score, determined by the Modified Borg Scale, Numeric Rating Scale, or Visual Analog Scale. The secondary outcome was the post-intervention mean change in respiratory rate (RR). Results Four eligible randomized controlled trials of low to moderate risk of bias employed a total of 139 cancer patients. Fan-on-face therapy was effective in decreasing mean dyspnea scores (standard mean difference = −1.81, 95% confidence interval [CI]: −3.12, −0.50, p < 0.00001, I 2 93%) and improving mean change in RR (mean difference = −0.91, 95% CI: −1.68, −0.15; p = 0.001, I 2 = 81%) versus control. Conclusion Fan-on-face therapy, as an adjunct to standard of care, is effective in alleviating dyspnea among adult cancer patients during the end of life.

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Hand-held fan airflow stimulation relieves dyspnea in lung cancer patients

Cited by 26 publications

References 28 publications

MicroRNA‑21 promotes the proliferation, migration and invasion of non‑small cell lung cancer A549 cells by regulating autophagy activity via AMPK/ULK1 signaling pathway

MicroRNA‑21 promotes the proliferation, migration and invasion of non‑small cell lung cancer A549 cells by regulating autophagy activity via AMPK/ULK1 signaling pathway

The FAFA Trial: A Phase 2 Randomized Clinical Trial on the Effect of a Fan Blowing Air on the Face to Relieve Dyspnea in Filipino Patients with Terminal Cancer

Fan-on-Face Therapy in Relieving Dyspnea of Adult Terminally Ill Cancer Patients: A Meta-Analysis

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