By Xen Ralf Guimapang
John Editer Hernandez
Michelle Manriquez
Roison Andro Narvaez, MSN RN CMCS CLDP LGBH
Coleen Pulido
Gee Marie Severino
Citation: Guimapang, X. R., Hernandez, J. E., Manriquez, M., Narvaez, R. A., Pulido, C., & Severino, G. M. (2024). Application of the Internet of Things (IoT) in cancer care and management. Canadian Journal of Nursing Informatics, 19(3). https://cjni.net/journal/?p=13494
Background: Short and long-term effects of cancer and its treatments cause different adverse effects that lead to diminished quality of life for cancer patients. With the help of the Internet of Things (IoT), managing and caring for cancer patients has improved and produced impressive outcomes.
Aim: To evaluate how the IoT can be utilized in managing and providing care for cancer patients.
Design: This study used an integrative literature review design.
Results: 15 studies were included based on the eligibility criteria. The primary data points monitored were wearable technologies, including commercially available devices such as fitness trackers, cancer monitors, and software-enabled IoT for cancer monitoring. Working with IoT with cancer patients showed significant results in monitoring and managing cancer patients. Furthermore, IoT is also beneficial for healthcare providers, to enable remote monitoring, with readily available data transmitted through IoT devices and apps. This review shows that IoT has improved patient Quality of Life through proper monitoring of the patient’s health status.
Conclusion: Using different IoT platforms, healthcare providers can collect patient data, including vital signs, physical activities, and laboratory results, which is used to analyze and monitor patient compliance and support with cancer treatment. IoT powered by different data gathering devices or sensors is efficient in collecting data, and sharing health information with patients, which can be used to manage cancer patient care.
Implications: Healthcare providers, especially oncology nurses and nurse informaticists, may help spread awareness and knowledge of the IoT in caring for and managing cancer patients. Through this, we may improve the quality of life of our patients as they go through the challenges of dealing not just with cancer but any other disease that will benefit from this technology.
In 2020, cancer was the leading cause of death worldwide, contributing to nearly 10 million deaths. Men were more likely to develop cancers of the lung, prostate, colorectal, stomach, and liver, whereas women were more likely to develop cancers of the breast, colorectal, lung, cervical, and thyroid (World Health Organization, 2022). In the same year, it was recorded that there were 19,292,789 new cases of all cancers globally, (Global Cancer Observatory, 2020). Death due to cancer has declined significantly compared to three ago but is still currently the world’s second leading cause of death (World Health Organization, 2023). Depending on the stage of the illness and the patient’s clinical condition, cancer treatments can include surgery, immunotherapy, chemotherapy, radiotherapy, and hormone therapy. (Ganggayah et al., 2019). Fatigue, pain, shortness of breath, trouble sleeping, digestive problems such as decreased appetite, constipation, nausea, vomiting, and diarrhea are some adverse reactions to cancer treatment, and both the disease and treatment have short- and long-term side effects or adverse reactions in cancer patients (Carayol et al. 2019).
The Internet of Things (IoT) can be defined as interconnected devices, objects, humans, and/or services to exchange data (Shafiq et al., 2022). One of the advantages of IoT is that it makes the surroundings smarter, with the use of historical data or real data and automatically makes smart decisions (Pradhan & Chawla, 2020). One of the prominent examples of IoT is the smart home, which consists of smart appliances, smart home safety and security systems; examples of these are washers, dryers, refrigerators, sensors, monitors, cameras, and alarm systems (Choi et al., 2020). Such IoT devices can create a smart environment that integrate technology within the set location, enhance safety and be used to monitor health and wellness of the patients remotely: even a patient’s medication adherence can be tracked and support for a patients’ commitment in taking medication is possible (Bartlett, 2019).
The main problem in using the internet is the traffic and unique addresses of countless devices, as there are vast interconnected-heterogeneous devices connected to the internet therefore these devices should have unique identities (Graham, 2011). In relation to cancer patients who use IoTs, some may become irritable since they may not have enough energy to navigate and use the monitoring devices as one of the main problems of patients undergoing treatment is fatigue (Klaas, 2017). However, because of the outbreak of the COVID-19 pandemic, patients focused more on virtual consultation, electronic health (ehealth) or “teleconsultations”, where they no longer needed to be physically present in the doctor’s office or clinic, instead, they received medical advice in the comfort of their homes (Quinn et al., 2020). This greatly helped cancer patients during the pandemic as IoT helped them to connect to their healthcare providers easily. Patients were also able to report to their healthcare providers for follow-up checkups therefore healthcare providers could evaluate their response to medications. IoT also prevented the patients spending too much in travel expenses and at the same time kept social distancing protocols thus reducing the risk of acquiring communicable diseases (Pardolesi, 2022). There are different devices that utilize IoT, some of these include Remote Patient Monitoring (RPM), Mobile Health (mHealth), and Machine Learning (ML).
The implementation of IoT can assist healthcare providers in using vast amounts of information to generate intelligence, ideas, and evidence-based decisions, allowing healthcare providers to improve the quality of patients’ lives. As a result, it is expected that solutions derived from the IoT will improve the quality of healthcare delivery systems. (Onasanya & Elshakankiri, 2019). Although the concept of IoT has been researched in various healthcare-related literature, most of the research has focused on general healthcare-related experiences and on diagnosing and treating cancer, with little research on the application of IoT to cancer care and management. This prompted the researchers to gather a thorough literature review and learn how IoT assists cancer patients in their daily lives. Thus, the aim of this research study is to get an understanding of how the IoT can be used to improve the lives of cancer patients and to what extent IoT and its various mobile applications have impacted their daily lives.
The following are the primary objectives of this research:
This study used an integrative review design with no actual patient testing of IoT use when undergoing cancer treatment and management. All articles were based on available literature related to the Internet of Things (IoT) in cancer management using Whittemore and Knafl’s (2005) five-phase approach to accommodate diverse data sources and available study designs through the following phases: Literature review, problem identification, data analysis, data evaluation, and result or conclusion presentation which offers formulation of understanding as well as the applicability of significant study results to practice (Souza et al., 2010) and provide vital insight to recommend future research directions (Cronin & George, 2020).
The review of the literature was conducted in February 2023. Relevant studies were retrieved from electronic resources, including ScienceDirect, PubMed, SAGE Journals, and Google Scholar. The following keys for retrieving relevant research articles were used: Internet of Things, IoT, Internet, Cancer Management, Cancer Treatments. Some relevant keywords, such as Internet of Things (IoT) AND Cancer; Internet of Things (IoT) AND cancer patients AND Remote Patient Monitoring (RPM); Internet of Things (IoT) AND wearable activity monitors; Internet of Things (IoT) AND smart-phone based monitoring; Internet of Things (IoT) AND machine learning; Internet of Things (IoT) AND old cancer patient; Internet of Things (IoT) AND electronic healthAND mobile-health were also considered as well as only looking at relevant publications that were published in English.
The initial search yielded a plethora of research articles and journals pertaining to the said topic. There were more than 1500 potential peer-reviewed articles when the search was conducted. The researchers narrowed it down to 100 research articles since most were deemed irrelevant to this review. There were 50 studies further excluded as there was no discussion about the application of IoT in Cancer Care and Management. This left only 15 articles specifically selected to be included in this study. The researchers used the Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA) diagram, as shown in Figure 1 to describe the search and selection of studies.
Figure 1
PRISMA diagram of search strategy
Inclusion criteria consisted of the following: Studies that were in the English language or English translated studies, peer-reviewed studies not later than 2017, and studies that are related to Cancer management and the use of the Internet of Things.
Exclusion criteria consisted of the following: Not English or English translated studies, abstracts and protocols, systematic reviews and opinions, as well as studies that were not centered on the Internet of Things in relation to quality of life of cancer patients were eliminated as in Table 1.
Table 1
Inclusion and Exclusion Criteria
An in-depth evaluation of the related literature was performed using Sparbel & Anderson’s (2020) tool with the following information: First Author, Year, Country, Main focus, Design Study, IoT Platform/Method and uses, Study Findings, Study Limitations, and the Level of Evidence (LOE) guide by Melnyk and colleagues (2015) was used to assess the LOE rating system of the selected studies. This rating system was utilized as it ranks the quality of study by design and methodology, using a ranking of levels that starts with 1 up to 7 as one (1) being the lowest and seven (7) as the highest quality evidence.
This guide was used to provide a comprehensive and organized presentation of literature reviewed and the researchers used a Critical Appraisal Skills Programme, [2018] (CASP) to review each article. With support from the Cochrane Qualitative and Implementation Methods Group, the CASP tool is primarily used for qualitative evidence synthesis in the fields of health and social care. It is a universal instrument for evaluating the benefits and drawbacks of any qualitative research methodology (Long et al., 2020). Despite the abundance of critical appraisal resources available for use as a guide, CASP is the most comprehensive and efficient of all of them since it addresses every area required for a critical evaluation of the evidence (Nadelson & Nadelson, 2014).
Peer reviewed research is not well-developed, it usually suffers from similar biases as other scholarly literature (Tennant & Ross-Hellauer, 2020). The selected studies were peer reviewed by the five researchers who also invited two external expert reviewers to validate the matrix table (Table 2). This helped the researchers to eliminate the bias selection and to maintain neutrality of the study. Researchers met frequently to discuss and brainstorm their ideas, disagreements and decisions were resolved by a voting system, three or more votes were considered the majority vote or the consensus of the group.
Overall, studies that were chosen by the researchers were used to seek evidence that IoT provides advantages to the users in the health care system, especially for the quality of life of cancer patients. These studies could be used by future researchers, healthcare professionals and policymakers who are interested in the implication of IoT, as the findings and results could be utilized for the betterment of the healthcare system.
Table 2
Summary of the studies on the Application of Internet of Things (IoT) in Cancer Care and Management
Fifteen (15) studies satisfactorily met the inclusion and exclusion criteria, all published between 2017 – 2023. The first study which was in 2017 is from the United States of America (Sun et al., 2017). Six studies were performed in the year 2018 (Cheong et al., South Korea; Gresham et al., USA; Gupta et al., India; Soto-Perez-De-Celis, et al., Mexico; Marthick et al., Australia; Maxwell-Smith, et al., Australia) while five studies were conducted in the year 2019 (Dreher et al., USA; Onasanya et al., Canada; Rahman et al., Saudi Arabia; Park et al., South Korea; Ji et al., South Korea). Only one study was performed in the year 2021 (Park et al., South Korea), and one of the studies was conducted in 2022 (Sriram et al., India). Lastly, the most recent study was conducted was in 2023 (Ayyoubzadeh et al., Iran).
All the studies used different study methodology, seven of these utilized cohort method (Cheong et al., 2018, South Korea; Sun et al., 2017, USA; Gresham et al., 2018, USA; Park et al., 2021, South Korea; Park et al., 2019, South Korea; Ji et al., 2019, South Korea; Marthick et al., 2018, Australia). Four studies used controlled trial without randomization (Dreher et al., 2019, USA; Gupta et al., 2018, India; Soto-Perez-De-Celis et al., 2018, Mexico; Rahman et al., 2019, Saudi Arabia). Two other studies utilized a randomized controlled trial (Maxwell-Smith, et al., 2018, Australia; Sriram et al., 2022, India), and the last two (Onasanya et al., 2019, Canada; Ayyoubzadeh, et al., 2023, Iran) were qualitative descriptive studies.
All 15 studies were classified for level of evidence (LOE) VI (n=2), LOE IV (n=7), LOE III (n=4), LOE II (n=2). Two of the studies were done as descriptive or qualitative research (n=2), Controlled Trial without Randomization (n=4), Controlled Trial with Randomization (n=2), and cohort (n=7) which were conducted in Australia (n=1), Canada (n=1), India (n=2), Iran (n=1), Korea (n=4), Mexico (n=1), Norway (n=1), Saudi Arabia (n=1), and the USA (n=3) whereas the majority of studies were conducted in Asia. The overall sample size of all examined publications was 1296 respondents from 20 to 569 sample sizes which were composed of administrators, clinicians and cancer patients.
The studies utilized a variety of IoT platforms, including wearable devices, smartphone applications, Cloud based, web portals and intelligent environments. Most of the studies correlated number of steps and physical activity to the quality of life (QOL), occurrences of serious adverse events and survival rates of the patients, thus the majority of the IoT devices were used to track and observe patient physical activity including number of steps and vital signs through the different platforms.
One of the most used platforms was wearable devices which were mostly worn on the wrist: eight of the studies used these wearable devices to monitor and manage cancer patients (Sun et al., 2017; Cheong et al., 2018; Gresham et al., 2018; Dreher et al., 2019; Gupta et al., 2018; Maxwell-Smith, et al., 2018; Sriram et al., 2022; Ayyoubzadeh, et al., 2023). Most of these wearable devices were used to track the number of steps of the patient with the use of a pedometer or accelerometer. However, there is one study by Dreher, et al., (2019) that did not recommend the use of wearable devices such as a Fitbit as they are not an appropriate tool to track physical activity of patients undergoing chemotherapy due to the poor compliance of the participants during the treatment.
The three studies by Cheong et al., (2018), Park, et al., (2021) and Park, et al., (2019) used smartphones installed with an application called Smartphone Aftercare (SAC), as their platform to give health information to the patients via video presentation and personalized rehabilitation exercise. It also included information on chemo-therapy related symptoms, dietary and nutritional instructions and had a real-time communication system with the study coordinator through messaging which decreased unexpected visits by patients to emergency departments, while Soto-Perez-De-Celis et al., (2018) prevented toxicities of chemo-related symptoms by recording the patient’s number of steps with the use of a smartphone’s accelerometer.
Cloud base servers were another type of IoT platform used in three of the studies (Sriram et al., (2022); Onasanya, et al., (2019); Rahman et al., (2019). These server acted as a storage base for the details and patients’ data that could be easily accessed by the healthcare providers and the patients themselves. The three studies that were conducted did not use sensors to track the number of steps of patients but rather they used different sensors to capture real-time data from the patients like electroencephalogram (EEG), Electromyography (EMG), whole body joint trackers, eye trackers and smart home appliance controls.
Lastly, mobile applications installed on smartphones in combination with web portals were used by Ji et al., (2019), while Marthick et al., (2018) combined a web portal and wearable devices to monitor patient physical activity. Participants could get health information, upload inquiries, data, and health status to the web portal that could then be accessed by the healthcare providers.
The Internet of Things (IoT) offers several potential benefits in cancer treatment and management, including:
IoT devices can be used to remotely monitor patients undergoing cancer treatment. For example, wearable sensors can track vital signs such as heart rate and body temperature (Cheong et al. (2018); Sun et al., (2017); Gresham et al., (2018); Dreher et al., (2019); Gupta et al., (2018); Park et al., (2021); (Park et al., 2019) and transmit the data to healthcare providers in real-time. IoT devices like wristband devices can be used to facilitate remote monitoring of patients, and healthcare providers are able to conveniently check the patient regardless of place and time (Ayyoubzadeh et al., 2023).
To assess the level of toxicity of chemotherapy drugs in older adult cancer patients, one study used the Modern smartphone accelerometer-based application that measures the number of steps as a way to detect toxicity in resource-limited settings (Soto-Perez-De-Celis et al., 2018).
Transactional records and multimedia big data, including cancer patient physiological and mental states data, can be shared with an oncologist or palliative care unit for real-time decision support using the IoT and Blockchain-Based Multi-Sensory In-Home Quality of Life (QoL) framework for cancer patients. This real-time data could be used to set an automated and customized treatment plan in response to queues indicated in a patient’s changing QoL data (Rahman et al., 2019).
IoT devices can analyze cancer patients in real-time with accurate and better precision. In one study, called A Smart Solution for Cancer Patient Monitoring Based on Internet of Medical Things Using Machine Learning Approach, patients were observed 24/7 with wearable sensors to gather accurate real-time data and promote better precision rates. It was very useful in monitoring the data of patients accurately (Sriram et al.,2022). IoT devices can generate large amounts of data that can be analyzed in real-time to identify patterns and trends in cancer treatment and management. This can help healthcare providers make more informed decisions and improve treatment outcomes (Ji et al., 2019) and relay the results back to the local health care institution for appropriate medical action (Ogundokun et al.,2022).
The use of wireless sensor networks (WSNs) and smart connected devices, enables a number of spatially distributed autonomous sensors to be linked to the network fabric based on geographical routing from source to destination, could be helpful in the enhanced treatment, diagnosis, and monitoring of cancer patients, according to a system proposed by Onasaya et al. in 2019. This system facilitated data transmission/exchange among healthcare providers and patients and shows promise for treatment.
Marthick et al., (2018) used Misfit shine device and a web portal to monitor patient tracker data in real time. Patients and healthcare providers could access the web portal wherein patients could report their symptoms while healthcare providers could advise and give instructions to the patients.
Overall, the IoT has the potential to revolutionize cancer care and management by improving patient outcomes, reducing healthcare costs, increasing access to healthcare and information, preventing acute care admissions and tracking patient status.
The Internet of Things (IoT) has the potential to play a significant role in healthcare, including in the prediction of the effects of cancer medication. IoT devices can be used to collect real-time patient data, such as heart rate, blood pressure, and other vital signs, which can be analyzed to predict the effectiveness of cancer management. In this review, we presented a considerable amount of literature focused on the role of IoT and its role in cancer care and management. Different IoT concepts related to hardware, software, and AI and how it all works together to bring improvement to the Quality of Life of the patients and improve healthcare delivery for healthcare providers emerged from the reviewed literature.
Several studies concentrated on wearables as they can collect data such as vital signs and other significant information from the patients in real-time to monitor their well-being. According to Sun et al. (2017) and Gresham et al. (2018) commercially available wearable devices effectively collate critical patient data pre- and post-treatment. This gives insights on how the quality of life of cancer patients can be improved. Similarly, Cheong et al. (2018) tackled how smartphones could help consolidate the data from the wearables to be interpreted by healthcare providers. Wearable pedometers when paired with a smartphone can detect the number of steps and equate it to chemo-toxicity and can send notifications if the patient needs medical attention (Soto-Perez-De-Celis, et al., 2018). Multiple researchers used fitness trackers, such as Fitbits, and Vivofits by Garmin within their studies. Athletes have used these commercially available devices to track their performance in their chosen sport. These devices are small enough to be easily worn without disrupting the patients’ everyday life. The flexibility of these devices is the hallmark of IoT.
As well, 3-D printers are more available than ever, making it easier for manufacturers of such devices to customize wearables to the consumer. A study by Ayyoubzadeh et al. (2023) expressed the usefulness of creating a wristband device made by using 3-D printers, which could be worn to help obtain data from cancer patients by offering necessary flexibility based on the patient’s need. Wearables, therefore, improve mobility of the patient, removing the need to be attached to bigger apparatus to collect vital data. This significantly improves the quality of life of those needing constant monitoring during chemotherapy.
According to Gupta et al. (2018) there are positive experiences with physical activity monitors in measuring long-term physical activity in cancer patients receiving systemic therapy. Yang et al. (2018) focused more on chronic lung diseases, which included lung cancers and applied the IoT devices as a form of reminder to patients to stay on track concerning their treatments, as the system automatically reminded them if they were not compliant. It also triggered the system to inform the healthcare providers where appropriate actions and decisions about what would be the best treatment to implement for patients. These devices protected patients from non-compliance and may have saved unnecessary costs related to this. It also described the real-time interactions made possible by the Medical Internet of Things or MIoT platform, ensuring all medical data and its accompanying symptoms were recorded and transmitted digitally. A web-based platform by Marthick et al., (2018) sent personalized messaging to the users to encourage them to continue being active during post therapy, to be more motivated and achieve their goals, by making the patients feel more rewarded when physical goals were attained through pedometers.
While most of the reviewed studies were based on wearables, IoT is a concept interwoven with multiple technologies. It works by exchanging data with other devices and systems over the Internet. Software is being developed to help interpret this data more comprehensively. A study by Nayyar et al. (2018) described BioSenseHealth 1.0 as an IoT-based web service that intelligently monitors patients by giving a real-time interpretation of collected data. Systems like this can bring a dynamic shift in how people think about managing their health and reduce lapses and medical costs. Ogundokun et al. (2018) conducted a study to test the efficiency of their MIoT-based diagnostics in implementing diagnosis and continuity of care of their patients by using Artificial Neural Networks; their findings suggested this should be implemented in the clinical area. With software and hardware working seamlessly to provide sufficient data, Park et al. (2021) conducted a study that demonstrated that their Smart After-Care Systems installed in common Android-based smartphones in conjunction with wearable smart bands effectively managed patients with prostate cancer by helping develop a personalized exercise program. It also suggested that it may increase the effectiveness of unsupervised home-based interventions.
In addition, another non-wearable device is being studied to reduce the risk of developing and advancing the current disease by intelligently monitoring air particles indoors. Marques et al. (2018) described the negative effects of air particulate matters in determining the risk of lung cancer. It presented PMs5003 as an air sensor and iDust, a particulate matter exposure system, which works as both a monitoring and decision-making tool enhanced by IoT architecture. Information from this system offers data to support medical examinations to help healthcare providers analyze the parameters and relate them to the patient’s health status.
Telemedicine or eHealth powered by IoT have also been a great help in providing health information to patients remotely with their healthcare providers, as it increases communication, improves monitoring of a patient’s condition, and empowers patients in self-management (Aapro, 2020), thus it greatly prevented acute care admissions and at the same time provided remote health care information, These findings were also confirmed in the studies by Ayyoubzadeh et al. (2023) and Gresham et al., (2018). Monitoring the patients could help early detection of complications therefore, patients that are not monitored and not followed up after they are discharged in the hospital might suffer from emergency conditions or unplanned readmission to intensive care units.
The advent of Cloud computing and Artificial intelligence proves that the Internet is an essential resource for IoT devices. While not all IoT devices need to be connected to the public network but only need a connection from one device to another, the help of the Internet makes these devices a lot smarter. Specific devices such as kinematic gesture tracking sensors are one of the devices used in a study by Rahman et al., (2019). The multimodal Internet of Things-based framework was especially designed for the quality-of-life enhancement tracking for cancer patients and worked in conjunction with other Internet-enabled medical devices and wearables. To communicate data from gadgets and sensors implanted in homes, they created a safe electronic health record and electronic medical record. AI will eventually be used to collect and learn data from these IoT to help predict cancer diagnosis and help recommend treatments for patients. Artificial intelligence could help interpret patient data through these IoT devices connected to cloud network computing.
While all these IoT systems seemed to work together harmoniously, the researchers encountered several challenges while conducting their studies. Adherence to technology is one of the issues experienced by Sun et al. (2017), Dreher et al. (2019), Gupta et al. (2018), and Park et al. (2021). They indicated that the adaptation to the IoT devices limited data as some of their patients were elderly, making it harder for them to effectively learn how to use the technology, and often, interest in these devices was low (Park et al., 2021). Some of their patients forgot to charge their devices, rendering them unusable and unable to transmit data while some simply refused to use the device at all (Ji et al., 2019). Technical disruptions were also a challenge, and other devices failed to connect to the Internet or other devices. The reliability of these IoT devices is crucial to their usability and success. Park et al. (2019) stated that for the data to be reliable, the devices transmitting them should not have system errors.
Software usability was specified as an issue in the study conducted by Ayyoubzadeh et al. (2023). They stated that for the software to be reliable, the evaluation must be repeated multiple times to correct script errors which could eventually lead them to get the wrong results. Given this, high resources are required, since developing and maintaining the interwoven systems of hardware, software, and cloud infrastructures can prove to be a resource hog (Ogundokun et al., 2022).
Finally, the issues pertaining to the secure transfer of personal data are a common problem for researchers. Ethical implications of the risk of data leaks have been encountered in the past. Onasanya et al. (2019) specified that an important limit of their study was one of the most common consequences of IoT, which is confidentiality and privacy threats. Research that includes IoT with a stronger emphasis on end-to-end encryption of patients’ data is needed. In the future, further research into the interoperability of the IoT integrated into other devices is required and should not be limited to the ones stated above. This may include research on wearables such as clothing with integrated sensors to help IoT not be limited to the devices worn on the wrist. Home appliances with sensors to help improve cancer care at home, generating data that is more oriented to the patient’s environment and what it could contribute to holistic care are being developed. Lastly, the seamless integration of these devices to the currently used cloud platforms may reduce the resources needed to implement future systems related to the Internet of Things.
Managing and caring for cancer patients has begun to change since the discovery of IoT: it has been much easier for both the patient and healthcare providers. As IoT has become readily available, patients can easily access necessary health care services regardless of time and place. IoT is now being utilized effectively by healthcare providers in monitoring their conditions and health status, allowing better care coordination and managing any health-related concerns in real-time. Promoting personalized and proactive treatment plans for cancer patients has become a hallmark of IoT. One of the examples of this is the medication compliance and exercise plan that could be considered as a preventive measure for acute care admission. IoT has revolutionized the way healthcare providers monitor and give care to their patients, and it has provided a promising result to all cancer patients around the globe and should be widely available to all patients and healthcare providers.
The researchers acknowledge that there are limitations to this study, and these are as follows: firstly, the study did not focus on the type and stages of cancer, it is not gender or age-specific, and the studies gathered revolved around the various types of IoT and did not give spotlight to one IoT platform only. Managing cancer patients has been the focus of the reviewed studies but there was no IoT that gave emphasis on detection and treatment of cancer. Lastly, the search was limited to studies related to cancer care and management that were available online, but there are more studies conducted pertaining to treatment and diagnosis of cancer. However, we specifically included studies that were conducted in the last five (5) years, from 2017 to 2023, and this could be considered as one of the strengths of this integrative review. In addition, the studies were performed in different parts of the globe therefore making the reviews diversified and unbiased to culture, race or ethnicity.
This integrative review was limited by these several factors, so more in-depth studies that focus on the devices that the patient would not perceive as obtrusive or distracting with large sample sizes is also recommended with in depth respondent-researcher interaction. Also, both quantitative and qualitative research on IoT is another recommendation, and reproduction of this study using different types of research designs is also encouraged. Lastly, the inclusion of the ethical-moral principle in future study should be done, as this is one of the common limitations of the gathered research. It has been shown how IoT can be a great help in improving quality of life of cancer patients therefore we are suggesting and recommending to some institutions that cares for cancer patients to integrate IoT in their interventions.
In this study, researchers observed that several articles focused on the importance of using the Internet of Things (IoT) in cancer care and management, primarily in how healthcare providers can utilize IoT to manage health concerns of the patients. Further, this review described various IoT devices, such as smartphone applications, wearable devices, internet-based web platform databases, and the use of artificial intelligence, namely, machine and deep learning. It is made known that through the use of different IoT platforms, healthcare providers can collect patient data, including vital signs and physical activities, which can be used to analyze and to monitor patients’ compliance with cancer treatment.
The primary data points monitored were wearable technologies, including commercially available devices such as fitness trackers, cancer monitors, and software-enabled IoT for cancer monitoring. Software developed to interpret the collected data and developed electronic medical records that would share data from installed devices and sensors at home were connected through cloud networks. Using IoT with cancer patients showed significant results in monitoring and managing their care. Wearable devices encouraged patients to increase physical activity associated with better clinical outcomes. Furthermore, IoT was also beneficial for healthcare providers, to facilitate remote monitoring, giving data that was readily available and transmitted through IoT.
IoT for cancer patients has a few difficulties and downsides, including: 1. Low level of compliance with wearable IoT. 2. technical issues during device synchronization 3. technological limitations or just the requirement for the right equipment. The study’s limitations include the lack of gender and age specificity, and the requirement for a control group. The fact that the reviewed studies focused on a variety of IoT platforms rather than just one, and the absence of cancer type and stage highlights some drawbacks in this review. Finally, although there are many studies pertaining to the use of IoT in the diagnosis and treatment of cancer, only a small number of studies concentrated on the care and management of cancer patients.
All marked with asterisk (*) were included studies for review
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Xen Ralf Guimapang, https://orcid.org/0009-0003-9982-2070
John Editer Hernandez https://orcid.org/0009-0002-5907-199X
Michelle Manriquez https://orcid.org/0009-0002-8554-6530
Roison Andro Narvaez https://orcid.org/0000-0001-7555-5420
Coleen Pulido https://orcid.org/0009-0002-9730-9145
Gee Marie Severino https://orcid.org/0009-0000-6555-4395