High Symptom Burden Among Patients With Newly Diagnosed Incurable Cancer in a Developing Country

Alsirafy, Samy A.; El-Aal, Hesham H. Abd; Farag, Dina E.; Radwan, Riham H.; El-Sherief, Wessam A.; Fawzy, Radwa

doi:10.1016/j.jpainsymman.2016.02.003

Cited by 16 publications

(18 citation statements)

References 10 publications

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“…The current study is one of the few studies that addressed the needs of PC patients in Egypt. Our results confirm the high symptom burden experienced by Egyptian patients with advanced cancer 26 . In a previous study from Egypt, patients with newly diagnosed incurable cancer had high symptom burden where the average number of symptoms per patients was 17 and 67% of patients had >5 moderate/severe symptoms 26 .…”

Section: Discussionsupporting

confidence: 85%

“…Our results confirm the high symptom burden experienced by Egyptian patients with advanced cancer 26 . In a previous study from Egypt, patients with newly diagnosed incurable cancer had high symptom burden where the average number of symptoms per patients was 17 and 67% of patients had >5 moderate/severe symptoms 26 . The relation between the symptom burden and the functional status of patients with advanced cancer has been reported by other researchers; however, the results are not consistent among studies.…”

Section: Discussionsupporting

confidence: 85%

“…In this context, little is known about the needs of Egyptian terminal cancer patients 15,26,27 . The current study is one of the few studies that addressed the needs of PC patients in Egypt.…”

Section: Discussionmentioning

confidence: 99%

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The Relationship between Distressing Symptoms and Performance Status among Cancer Patients Receiving Palliative Care

Hussenein

Hashem

Hadary

et al. 2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background:Patients with advanced cancer experience distressing symptoms and progressive decline in their performance status (PS) as death approaches. Aim: To identify the relationship between symptom burden and PS of Egyptian cancer patients receiving palliative care. Methods: This was a prospective observational study that included 100 patients with advanced cancer. Symptom burden was assessed using the Arabic version of the revised Edmonton Symptom Assessment System (ESAS-r). Performance status was assessed using the Palliative Performance Scale (PPS). Results:The mean total ESAS-r score was 60.1 (±10.7). The most common symptom to be reported as severe was pain (93%) followed by tiredness (74%), poor wellbeing (67%), lack of appetite (62%), anxiety (60%) and drowsiness (56%). The majority of patients (76%) had a PPS score ≤30 with an overall mean PPS score of 36.2 (±13.3). There was a statistically significant negative correlation between the total ESAS score and the PPS score (r = -0.687, p = < 0.001). Conclusion:The results suggest that Egyptian patients with advanced cancer experience high symptom burden and significant decline in PS. The higher the symptom burden, the poorer the PS of patients with advanced cancer.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

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The Relationship between Distressing Symptoms and Performance Status among Cancer Patients Receiving Palliative Care

Hussenein

Hashem

Hadary

et al. 2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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“…Patients with advanced cancer usually suffer from multiple physical and psychological symptoms 2 . In a study from Egypt, >70% of newly diagnosed incurable cancer patients reported more than 10 symptoms and the average number of symptoms per patient was 16.8 in the same study 3 . Cancer patients near end of life report more severe symptoms than other cancer patients 4 .…”

Section: The World Health Organization Defines Palliative Care As "Anmentioning

confidence: 82%

The Relation between the Severity of Pain and Common Symptoms in Patients with Metastatic Cancer

El-Sayed

Elsawy

El-Azony

et al. 2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background: There is a relation between the severity of pain and common symptoms in patients with metastatic cancer. Aim: This study was done to explore this relation among Egyptian patients with advanced cancer. Methods: The study included 120 adult metastatic cancer patients with pain from two cancer centers in Cairo and Sharkia, Egypt. Pain and other common symptoms were assessed using the Arabic version of the Edmonton Symptom Assessment System (ESAS). The Eastern Cooperative Oncology Group (ECOG) performance scale was used to assess performance status. Results:The prevalence of ESAS symptoms was high among patients with cancer pain (tiredness, 94%; drowsiness, 63%; nausea, 60%; lack of appetite, 77%; shortness of breath, 53%; depression, 88%; anxiety, 83%; poor wellbeing, 96%). The ECOG performance scale was 1 in 21 (17.5%) patients, 2 in 57 (47.5%), 3 in 38 (31.7%) and 4 in 4 (3.3%). The average ESAS score was 33.9 ± 13.8, 48.9 ± 14.7, 58 ± 15.4 and 70 ± 5.5 among patients with ECOG score 1, 2, 3 and 4; respectively (p < 0.001). There was no significant difference in the average score of any of the ESAS items according to the site of metastases. There was a significant positive correlation between the pain score and the scores of tiredness (p<0.001), nausea (p=0.037), lack of appetite (p<0.001), shortness of breath (p=0.001), depression (p<0.001), anxiety (p<0.001) and poor wellbeing (p<0.001). Conclusion: Egyptian patients with cancer pain experience high symptom burden. The severity of pain strongly correlates with the presence and severity of other ESAS symptoms. Systematic assessment of other symptoms is indispensable in patients with cancer pain for proper control of symptoms and improving quality of life.

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“…1-3 Although PC access in Africa has increased in recent years, 1,4,5 these services still reach less than 5% of those in need. 6-9 This may account for the substantial symptom burden still observed in patients with cancer in Africa, 6,10,11 where cancer remains the second-leading cause of death. 12…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Quality of Dying and Death Questionnaire in Kenya

Mah

Powell²,

Malfitano

et al. 2019

JGO

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PURPOSE A culturally appropriate, patient-centered measure of the quality of dying and death is needed to advance palliative care in Africa. We therefore evaluated the Quality of Dying and Death Questionnaire (QODD) in a Kenyan hospice sample and compared item ratings with those from a Canadian advanced-cancer sample. METHODS Caregivers of deceased patients from three Kenyan hospices completed the QODD. Their QODD item ratings were compared with those from 602 caregivers of deceased patients with advanced cancer in Ontario, Canada, and were correlated with overall quality of dying and death ratings. RESULTS Compared with the Ontario sample, outcomes in the Kenyan sample (N = 127; mean age, 48.21 years; standard deviation, 13.57 years) were worse on 14 QODD concerns and on overall quality of dying and death ( P values ≤ .001) but better on five concerns, including interpersonal and religious/spiritual concerns ( P values ≤ .005). Overall quality of dying was associated with better patient experiences with Symptoms and Personal Care, interpersonal, and religious/spiritual concerns ( P values < .01). Preparation for Death, Treatment Preferences, and Moment of Death items showed the most omitted ratings. CONCLUSION The quality of dying and death in Kenya is worse than in a setting with greater PC access, except in interpersonal and religious/spiritual domains. Cultural differences in perceptions of a good death and the acceptability of death-related discussions may affect ratings on the QODD. This measure requires revision and validation for use in African settings, but evidence from such patient-centered assessment tools can advance palliative care in this region.

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High Symptom Burden Among Patients With Newly Diagnosed Incurable Cancer in a Developing Country

Cited by 16 publications

References 10 publications

The Relationship between Distressing Symptoms and Performance Status among Cancer Patients Receiving Palliative Care

The Relationship between Distressing Symptoms and Performance Status among Cancer Patients Receiving Palliative Care

The Relation between the Severity of Pain and Common Symptoms in Patients with Metastatic Cancer

Evaluation of the Quality of Dying and Death Questionnaire in Kenya

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