Network Analysis of the Multidimensional Symptom Experience of Oncology

Papachristou, Nikolaos; Barnaghi, Payam; Cooper, Bruce A.; Kober, Kord M.; Maguire, Roma; Paul, Steven M.; Hammer, Marilyn J.; Wright, Fay; Armes, Jo; Furlong, Eileen; McCann, Lisa; Conley, Yvette P.; Patiraki, Elisabeth; Katsaragakis, Stylianos; Levine, Jon D.; Miaskowski, Christine

doi:10.1038/s41598-018-36973-1

Cited by 86 publications

(125 citation statements)

References 68 publications

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“…Equally noteworthy is the relatively high occurrence rates for many of the COVID-19-related symptoms among the total sample. For example, symptoms like headache, muscle aches, severe fatigue or tiredness, and difficulty with word finding that are on the list of COVID-19-related symptoms are common symptoms associated with cancer and its treatment [21,22]. This significant overlap of COVID-19 and cancer-related symptoms poses challenges for clinicians who are assessing and triaging oncology patients for COVID-19 testing.…”

Section: Discussionmentioning

confidence: 99%

Oncology patients’ perceptions of and experiences with COVID-19

Miaskowski

Paul

Snowberg

et al. 2020

Support Care Cancer

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Purpose No information is available on cancer patients' knowledge of and experiences with COVID-19. We undertook an evaluation of differences in COVID-19 symptom occurrence rates, COVID-19 testing rates, clinical care activities, knowledge of COVID-19, and use of mitigation procedures between patients who were and were not receiving active cancer treatment. Methods Patients enrolled were > 18 years of age; had a diagnosis of cancer; and were able to complete the emailed study survey online. Results Of the 174 patients who participated, 27.6% (n = 48) were receiving active treatment, 13.6% were unemployed because of COVID-19, 12.2% had been tested for COVID-19, and 0.6% had been hospitalized for COVID-19. Patients who were not on active treatment reported a higher mean number of COVID-19 symptoms (3.1 (± 4.2) versus 1.9 (± 2.6)), and patients who reported a higher number of COVID-19 symptoms were more likely to be tested. Over 55% of the patients were confident that their primary care provider could diagnose COVID-19, and the majority of the patients had high levels of adherence with the use of precautionary measures (e.g., social distancing, use of face coverings). Conclusion The high level of COVID-19 symptoms and the significant overlap of COVID-19 and cancer-related symptoms pose challenges for clinicians who are assessing and triaging oncology patients for COVID-19 testing. For patients on active treatment, clinicians face challenges with how to assess and manage symptoms that, prior to COVID-19, would be ascribed to acute toxicities associated with cancer treatments or persistent symptoms in cancer survivors.

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Section: Discussionmentioning

confidence: 99%

Oncology patients’ perceptions of and experiences with COVID-19

Miaskowski

Paul

Snowberg

et al. 2020

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“…32 In addition, network analysis may be used to determine the role of the ''core'' symptoms in a changing cluster. 51…”

Section: Limitations and Recommendationsmentioning

confidence: 99%

Stability and Impact of Symptom Clusters in Patients With End-Stage Renal Disease Undergoing Dialysis

Ng¹,

So²,

Wong³

et al. 2020

Journal of Pain and Symptom Management

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“…In our recent study (Singh, Kober, et al, 2018), 48% of the patients reported CIN prior to their second or third cycle of CTX. Findings from 2 studies suggest that CIN could be the sentinel symptom for the occurrence and severity of a wide array of CTX-induced symptoms (Donovan et al, 2016; Papachristou et al, 2019). Little is known about the molecular mechanisms that are associated with occurrence and/or severity of CIN.…”

mentioning

confidence: 99%

Perturbations in Endocytotic and Apoptotic Pathways Are Associated With Chemotherapy-Induced Nausea

Singh

Cao

Miaskowski

et al. 2020

Biological Research For Nursing

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Background: While vomiting is well controlled with current antiemetic regimens, unrelieved chemotherapy-induced nausea (CIN) is a significant clinical problem. Perturbations in endocytotic and apoptotic pathways in the gut can influence the functioning of the microbiome-gut-brain-axis and the occurrence of gastrointestinal (GI) symptoms. However, limited information is available on the mechanisms that underlie unrelieved CIN. Objectives: The purpose of this study was to evaluate for perturbed biological pathways associated with endocytosis and apoptosis in oncology patients who did (n = 353) and did not (n = 275) report CIN prior to their second or third cycle of chemotherapy (CTX). Methods: Oncology patients (n = 735) completed study questionnaires in the week prior to their second or third cycle of CTX. CIN occurrence was evaluated using the Memorial Symptom Assessment Scale. Pathway impact analyses (PIA) were performed in 2 independent samples using RNA-sequencing (sample 1, n = 334) and microarray (sample 2, n = 294) methodologies. Fisher’s combined probability method was used to identify signaling pathways related to endocytotic and apoptotic mechanisms that were significantly perturbed between the 2 nausea groups across both samples. Results: CIN was reported by 63.6% of the patients in sample 1 and 48.9% of the patients in sample 2. Across the 2 samples, PIA identified 4 perturbed pathways that are involved in endocytosis (i.e., endocytosis, regulation of actin cytoskeleton) and apoptosis (i.e., apoptosis, PI3K/Akt signaling). Conclusions: Our findings suggest that CTX-induced inflammation of the GI mucosa, that results in the initiation of endocytotic and apoptotic processes in the gut, is associated with the occurrence of CIN.

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Network Analysis of the Multidimensional Symptom Experience of Oncology

Cited by 86 publications

References 68 publications

Oncology patients’ perceptions of and experiences with COVID-19

Oncology patients’ perceptions of and experiences with COVID-19

Stability and Impact of Symptom Clusters in Patients With End-Stage Renal Disease Undergoing Dialysis

Perturbations in Endocytotic and Apoptotic Pathways Are Associated With Chemotherapy-Induced Nausea

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