Psilocybin
Psilocybin is a naturally occurring psychedelic compound found in various species of mushrooms. Psilocybin is rapidly metabolized to psilocin, which is a potent agonist at serotonin receptor activation, directly correlated with human hallucinogenic activity. It has been examined in the treatment of anxiety in patients with advanced stage cancer.
Prucalopride
Prucalopride is a selective, high-affinity 5-HT4 agonist that targets impaired motility in the gastrointestinal tract. This drug has been examined for the treatment of constipation.
Provider Communication Skill Training
Provider communication skill training is an approach in which the healthcare professional who provides services to the patient is trained to improve communication skills. Improved communication with the patient is proposed to have a positive effect on the patient’s symptoms and outcomes. Improved provider communication skills may improve assessment of the patient and the provider’s ability to facilitate effective communication by the patient, thereby enhancing symptom management.
Propolis (Bee Glue)
Propolis, or bee glue, is a resin-like material made by bees to coat the inside of the hive. Propolis is derived from the buds of poplar and cone-bearing toma trees and is believed to have antioxidant and anti-inflammatory properties. Propolis has been studied in patients with cancer for treatment of mucositis.
Prophylactic Platelet Transfusions
Prophylactic platelet transfusion involves transfusion prior to thrombocytopenia levels generally requiring therapeutic platelet transfusion. Use of trigger levels for platelet transfusion, different dosage, and varied intervals between transfusions have been studied in patients with cancer for prevention of bleeding.
Prophylactic Octreotide
Octreotide is a medication that has physiologic effects that inhibit glucagon, insulin, splanchnic blood flow, and vasoactive peptides in the gastrointestinal tract. It has been used for treatment of watery diarrhea from tumors that secrete vasoactive intestinal peptides. Octreotide has been studied for management of chemotherapy- and radiation therapy-induced diarrhea. Octreotide is given by IV or subcutaneous injection.
Prophylactic Laxatives for Patients on Opioids
Prophylactic laxatives are the provision of laxatives prior to any symptoms of constipation to prevent or avoid constipation. This approach has been suggested for patients with cancer on opioids for pain management.
Prophylactic Colony Stimulating Factors: GCSF - GMCSF (Systemic)
Granulocyte (G-CSF) and granulocyte-macrophage stimulating factors (GM-CSF) are substances that bind to hematopoietic stem cells, activating them to profliferate and differentiate into granulocytes and macrophages – the specific cell type of interest. Colony-stimulating factors administered systemically have been evaluated and recommended for patients with cancer for the prevention of infection and febrile neutropenia. CSFs may be used for primary or secondary prophylaxis.
Prophylactic Chlorhexidine
Chlorhexidine is an antiseptic that has a broad spectrum effect against both gram-positive and -negative bacteria. Chlorhexidine gluconate oral rinse that contains glycerol, coloring, flavoring, and other compounds has been studied in patients with cancer for the prevention and treatment of mucositis. It is important to note that prophylactic use, before development of mucositis, has a different PEP category than the use of chlorhexidine in patients who already have mucositis symptoms.
Progressive Muscle Relaxation and Guided Imagery
Progressive muscle relaxation (PMR) is a technique of alternately tensing and relaxing muscles groups in sequence throughout the body. When going through muscle groups, individuals can start with the head and neck and progress to the feet, or vice versa. Similarly individuals may do one side of the body at a time, or both sides at the same time. Listening to a prerecorded script may be used to guide individuals through the process.