A26 Fear of cancer NOS (ICD-10:Z71.1)

Introduction

Fear of cancer NOS (Not Otherwise Specified) refers to a general fear or anxiety related to the possibility of developing cancer. This fear can be debilitating and may significantly impact a person’s quality of life^[1].The aim of this guide is to provide healthcare professionals with a comprehensive approach to diagnosing and managing fear of cancer NOS.

Codes

• ICPC-2 Code: A26 Fear of cancer NOS
• ICD-10 Code: Z71.1 Person with feared complaint in whom no diagnosis is made^[2]

Symptoms

• Persistent worry or preoccupation with the possibility of having cancer^[3]
• Excessive fear or anxiety related to cancer, despite reassurance from healthcare professionals^[4]
• Avoidance of medical appointments or procedures due to fear of receiving a cancer diagnosis^[5]
• Physical symptoms such as increased heart rate, sweating, trembling, or shortness of breath when thinking about or discussing cancer^[6]

Causes

• Personal or family history of cancer^[7]
• Exposure to cancer-related information or media^[8]
• Traumatic experiences related to cancer, such as witnessing a loved one’s battle with the disease^[9]
• Anxiety or other mental health disorders^[10]

Diagnostic Steps

Medical History

• Gather information about the patient’s personal and family history of cancer
• Assess any traumatic experiences or significant life events related to cancer
• Evaluate the patient’s overall mental health and any existing anxiety disorders

Physical Examination

• Perform a thorough physical examination to rule out any physical symptoms that may be contributing to the fear of cancer
• Pay attention to signs of anxiety or distress during the examination

Laboratory Tests

• No specific laboratory tests are indicated for the diagnosis of fear of cancer NOS
• However, blood tests may be ordered to rule out any underlying medical conditions that could be causing or exacerbating anxiety symptoms

Diagnostic Imaging

• Diagnostic imaging is not typically necessary for the diagnosis of fear of cancer NOS
• However, if the patient’s fear is focused on a specific area of the body, imaging studies may be considered to provide reassurance

Other Tests

• No other specific diagnostic tests are indicated for the diagnosis of fear of cancer NOS
• However, additional assessments may be necessary based on the patient’s clinical presentation, such as psychological evaluations or consultations with mental health professionals

Follow-up and Patient Education

• Schedule regular follow-up appointments to monitor the patient’s progress and provide ongoing support
• Offer patient education materials or resources to help the patient better understand and cope with their fear of cancer
• Encourage the patient to seek counseling or therapy to address underlying anxiety or mental health concerns

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for fear of cancer NOS:

1. Selective Serotonin Reuptake Inhibitors (SSRIs) (e.g., Fluoxetine, Sertraline, Escitalopram):
   • Cost: Generic versions can range from $10 to $50 per month.
   • Contraindications: Hypersensitivity to SSRIs, concurrent use of monoamine oxidase inhibitors (MAOIs).
   • Side effects: Nausea, headache, insomnia.
   • Severe side effects: Serotonin syndrome, suicidal thoughts.
   • Drug interactions: MAOIs, other serotonergic medications.
   • Warning: May take several weeks to achieve full therapeutic effect.
2. Benzodiazepines (e.g., Alprazolam, Lorazepam, Diazepam):
   • Cost: Generic versions can range from $10 to $30 per month.
   • Contraindications: Acute narrow-angle glaucoma, concurrent use of opioids.
   • Side effects: Sedation, dizziness, confusion.
   • Severe side effects: Respiratory depression, dependence.
   • Drug interactions: Opioids, alcohol.
   • Warning: Risk of dependence and withdrawal symptoms with long-term use.
3. Beta-blockers (e.g., Propranolol, Atenolol, Metoprolol):
   • Cost: Generic versions can range from $10 to $30 per month.
   • Contraindications: Severe bradycardia, heart block, uncontrolled heart failure.
   • Side effects: Fatigue, dizziness, bradycardia.
   • Severe side effects: Bronchospasm, heart block.
   • Drug interactions: Calcium channel blockers, insulin.
   • Warning: Should not be abruptly stopped.
4. Antidepressants (e.g., Venlafaxine, Duloxetine, Bupropion):
   • Cost: Generic versions can range from $10 to $50 per month.
   • Contraindications: Hypersensitivity to antidepressants, concurrent use of MAOIs.
   • Side effects: Nausea, headache, insomnia.
   • Severe side effects: Serotonin syndrome, suicidal thoughts.
   • Drug interactions: MAOIs, other serotonergic medications.
   • Warning: May take several weeks to achieve full therapeutic effect.
5. Antipsychotics (e.g., Quetiapine, Risperidone, Olanzapine):
   • Cost: Generic versions can range from $10 to $50 per month.
   • Contraindications: Hypersensitivity to antipsychotics, concurrent use of certain cardiac medications.
   • Side effects: Sedation, weight gain, extrapyramidal symptoms.
   • Severe side effects: Neuroleptic malignant syndrome, tardive dyskinesia.
   • Drug interactions: Other antipsychotics, certain cardiac medications.
   • Warning: Increased risk of mortality in elderly patients with dementia-related psychosis.

Alternative Drugs:

• Buspirone: An anxiolytic medication that does not cause sedation or dependence. Cost: Generic versions can range from $10 to $30 per month.
• Hydroxyzine: An antihistamine with anxiolytic properties. Cost: Generic versions can range from $10 to $30 per month.
• Pregabalin: An anticonvulsant medication used for anxiety disorders. Cost: Generic versions can range from $10 to $50 per month.
• Gabapentin: An anticonvulsant medication used for anxiety disorders. Cost: Generic versions can range from $10 to $50 per month.
• Mirtazapine: An antidepressant with anxiolytic properties. Cost: Generic versions can range from $10 to $50 per month.

Surgical Procedures:

• Surgical procedures are not indicated for the treatment of fear of cancer NOS.

Alternative Interventions

• Cognitive Behavioral Therapy (CBT): A form of psychotherapy that helps individuals identify and change negative thought patterns and behaviors. Cost: $100-$200 per session.
• Mindfulness-Based Stress Reduction (MBSR): A meditation-based program that teaches individuals to focus on the present moment and reduce anxiety. Cost: $200-$400 for an 8-week program.
• Support Groups: Joining a support group can provide a sense of community and understanding. Cost: Varies, some groups may be free or have a nominal fee.
• Relaxation Techniques: Techniques such as deep breathing, progressive muscle relaxation, and guided imagery can help reduce anxiety. Cost: Free or minimal cost for instructional materials.

Lifestyle Interventions

• Regular Exercise: Engaging in physical activity can help reduce anxiety and improve overall well-being. Cost: Varies depending on the chosen activity (e.g., gym membership, home workout equipment).
• Healthy Diet: Consuming a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall mental and physical health. Cost: Varies depending on individual food choices.
• Stress Management Techniques: Practicing stress management techniques such as meditation, yoga, or journaling can help reduce anxiety. Cost: Free or minimal cost for instructional materials.
• Sleep Hygiene: Establishing a regular sleep routine and creating a sleep-friendly environment can improve sleep quality and reduce anxiety. Cost: Free or minimal cost for adjustments to sleep environment.

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions. It is recommended to consult with healthcare professionals or insurance providers for accurate cost information.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – A26 Fear of cancer NOS (ICD-10:Z71.1)

Localized (0) Sacrum (1) Prostate & Uterus (2) Kidney, Liver & Spleen (3) Heart, Bile & Pancreas (4) Lungs (5) Throat, Lymphatic & Thyroid (6) Neuro system & ENT (7)

Use the Mirari Cold Plasma device to treat Fear of cancer NOS effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Fear of cancer NOS. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

References

1. Iverach, L., Menzies, R. G., & Menzies, R. E. (2014). Death anxiety and its role in psychopathology: Reviewing the status of a transdiagnostic construct. Clinical Psychology Review, 34(7), 580-593.
2. Menzies, R. E., & Menzies, R. G. (2020). Death anxiety in the time of COVID-19: Theoretical explanations and clinical implications. The Cognitive Behaviour Therapist, 13, e19.
3. World Health Organization. (2018). International classification of primary care, second edition (ICPC-2).
4. Menzies, R. E., Zuccala, M., Sharpe, L., & Dar-Nimrod, I. (2021). Toward an understanding of death anxiety: A systematic review of measurement and prevalence. Death Studies, 45(10), 753-768.
5. Neimeyer, R. A., Wittkowski, J., & Moser, R. P. (2004). Psychological research on death attitudes: An overview and evaluation. Death Studies, 28(4), 309-340.
6. Yalom, I. D. (2008). Staring at the sun: Overcoming the terror of death. The Humanistic Psychologist, 36(3-4), 283-297.
7. Peacock, Craig D ; Watkins, D Neil (2008.0). Cancer Stem Cells and the Ontogeny of Lung Cancer. DOI: 10.1200/JCO.2007.15.2702
8. Chen, Yafei ; Li, Xiaoli ; Zhang, Rui ; Xia, Yuhong ; Shao, Zhuo ; Mei, Zubing (2019.0). Effects of statin exposure and lung cancer survival: A meta-analysis of observational studies. DOI: 10.1016/j.phrs.2019.01.016
9. Cui, Guanghui ; Liu, Donglei ; Li, Weihao ; Fu, Xiao ; Liang, Youguang ; Li, Yuhang ; Shi, Wensong ; Chen, Xiaofang ; Zhao, Song (2017.0). A meta-analysis of the association between BRAF mutation and nonsmall cell lung cancer. DOI: 10.1097/MD.0000000000006552
10. Kim, Young Min ; Ku, Min Jeong ; Son, Young-Jin ; Yun, Jung-Mi ; Kim, Seong Hwan ; Lee, Sang Yeol (2013.0). Anti-metastatic effect of cantharidin in A549 human lung cancer cells. DOI: 10.1007/s12272-013-0044-3