Research Ideas and Outcomes :
Research Idea
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Corresponding author: Marco Cirillo (marcocir8@gmail.com)
Academic editor: Editorial Secretary
Received: 08 Jul 2021 | Accepted: 12 Oct 2021 | Published: 28 Oct 2021
© 2021 Marco Cirillo
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Citation:
Cirillo M (2021) Sedation-Led chEmotherapy Evades Pain (S.L.E.E.P.). Research Ideas and Outcomes 7: e71271. https://doi.org/10.3897/rio.7.e71271
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Chemotherapy and other invasive therapies are often limited by side effects, pain and negative experiences that can limit adherence to the therapy itself. Such negative components add to the patient's depressive state due to the disease. This research project proposes the use of deep sedation during chemotherapy sessions or other disabling therapies in the treatment of tumors or other severe diseases. The proposed protocol provides for an ad hoc hospitalization which could be during the night, during the day or limited to a few hours. Administration during sleep eliminates the memory and the negative impact the treatment has on the rest of the patient's daily life. This approach also agrees with the evidence of the circadian rhythm of cellular repair processes, which is greater at sunrise and sunset and linked to a good quantity and quality of sleep. In conclusion, this project aims to reduce the negative impact and increase the adherence to and efficacy of the therapy itself.
disease, memory, cancer, chemotherapy, sedation, pain
Reduce pain, side effects and memory of chemotherapy and/or particularly invasive therapies in oncological or severe pathology by deep sedation, with night/day/hourly clinic/home hospitalization (Fig.
The well-known tale of "Sleeping Beauty" is a good simile for this project. In the impossibility of canceling the death of the princess because it was determined by a higher evil will, the solution found by the godmother fairies is to make her fall asleep waiting for a solution that could come over time. Sleep protects the princess, keeps her alive and prevents her from pain. At the same time, the people who love her don't see her suffer and keep the hope that one day she can just wake up and resume her normal life without even the memory of the curse [cropped from "The sleeping beauty" by John Collier (1921), available via Wikimedia Commons, Public Domain].
Chemotherapy and other invasive therapies are often limited by disabling side effects, pain [
The project proposes the use of deep sedation during chemotherapy sessions or other disabling therapies in the treatment of tumors or other severe diseases, based on studies demonstrating a beneficial effect of moderate sedation during chemotherapy for breast cancer [
The treatment scheme will be established according to the indications of the reference oncologist and to the specific agents.
Main scenario:
Alternative scenarios:
The scenarios could be adapted according to the knowledge of chronotherapy and circadian rhythms of cell regeneration, greater at sunrise and sunset [
The project aims to insert chemotherapy, or other invasive therapies, into the normal life of patients by relegating it to periods of sleep, thus removing most of its negative impact and effects from consciousness. At the same time this regulates the sleep-wake cycle, often altered by the disease itself but very important for the patient's overall biological response. This advantage aims to increase adherence to therapy and therefore its effectiveness.
It must be said that given that the majority of side effects occur beyond the time of drug administration and given the presence of highly active drugs for the prevention and treatment of nausea and vomiting, this project could be applied to a limited and selected series of patients, as regards the control of the side effects themselves. Ideal candidates would be those with severe anticipatory vomiting, agitation, young people etc.
But in this pilot series the usefulness of this approach could also be tested with regard to the inclusion of drug treatment in the patient's normal life.
The impact of "going for chemo", dealing with other patients who are in different stages of the disease, "consciously" experiencing the administration of the drug that comes down from the drip, remaining "thinking" during therapy, etc. it is certainly very hard; it would be different to "go to sleep in hospital" and receive therapy during sleep, waking up without having consciously experienced the therapeutic act.