Patient-reported symptoms in metastatic gastric cancer patients in the last 6 months of life

Bubis, Lev D.; Delibasic, Victoria; Davis, Laura; Jeong, Yunni; Chan, Kelvin K.; Kosyachkova, Ekaterina; Mahar, Alyson; Karanicolas, Paul J.; Coburn, Natalie

doi:10.1007/s00520-020-05501-1

Cited by 17 publications

(29 citation statements)

References 42 publications

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“…Our results suggest that patients with metastatic NSCLC exhibited worse symptom burden when compared with other advanced, incurable malignancies such as metastatic breast, gastric, and esophageal cancers [28–30]. The degree of early symptom burden from our results suggests that almost all patients with stage IV NSCLC would benefit from supportive interventions such as psychosocial or palliative care referral soon after diagnosis.…”

Section: Discussionmentioning

confidence: 72%

Province-Wide Analysis of Patient-Reported Outcomes for Stage IV Non-Small Cell Lung Cancer

et al. 2021

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Background. In Ontario, Canada, patient reported outcomes (PRO) evaluation through Edmonton Symptom Assessment System (ESAS) has been integrated into clinical workflow since 2007. As stage IV non-small cell lung cancer (NSCLC) is associated with substantial disease and treatment-related morbidity, this province-wide study investigated moderateto-severe symptom burden in this population. Methods. ESAS collected from stage IV NSCLC patients diagnosed between 2007-2018 linked to Ontario provincial healthcare system database were studied. ESAS acquired within 12 months following diagnosis were analyzed and the proportion reporting moderate-to-severe scores (ESAS ≥4) in each domain was calculated. Predictors of moderateto-severe scores were identified using multivariable Poisson regression models with robust error variance. Results. Of 22,799 patients, 13,289 (58.3%) completed ESAS (84,373 assessments) in the year following diagnosis. Patients with older age, high comorbidity, and not receiving active cancer therapy had lower ESAS completion. Majority (94.4%) reported at least 1 moderate-to-severe symptoms. Most prevalent were tiredness (84.1%), low wellbeing (80.7%), low appetite (71.7%), and shortness of breath (67.8%). Most symptoms peaked at diagnosis, while declining, remained high in the following year.On multivariable analyses, comorbidity, low income, non-immigrants, and urban residency were associated with moderate-to-severe symptoms. Moderate-to-severe scores in all ESAS domains aside from anxiety were associated with radiotherapy within 2 weeks prior, while drowsiness, low appetite and wellbeing, nausea, and tiredness were associated with systemic therapy within 2 weeks prior. Conclusion. This province-wide PRO analysis showed moderate-to-severe symptoms were prevalent and persistent among metastatic NSCLC patients, underscoring the need to address supportive measures in this population especially around treatments. The Oncologist ;9999:• • Implications for Practice: This is the largest patient reported outcome (PRO) results among lung cancer patients worldwide. Our results demonstrated the worse moderate-to-severe symptoms among stage IV non-small cell lung cancer patients compared to other patients with metastatic, other malignancies such as breast, gastric, or esophageal cancers assessed with similar methodology. These patients symptom severity also peaked early, and persistently high during 1 year follow-up. Symptoms burden was also associated with recent radiation and systemic treatments. This emphasized the importance of early and sustained PRO collection to detect actionable symptom progression, especially around treatments. Moreover, PRO

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Section: Discussionmentioning

confidence: 72%

Province-Wide Analysis of Patient-Reported Outcomes for Stage IV Non-Small Cell Lung Cancer

et al. 2021

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“…Aligned to existing research whereby signi cant and sustained levels of psychological morbidity are experienced in patients with curative oesophago-gastric cancer (8, 60), this review suggests that impaired psychosocial functioning is also common in those with advanced disease. Moreover, proximity to death was identi ed as a factor associated with worsened psychosocial functioning (50) aligning to evidence that palliative care needs increase and quality of life deteriorates as cancer progresses (14). Given that promoting quality of life (QOL) at end of life is a major component of palliative and end-of-life care (PEOLC), this is an important nding for clinical consideration.…”

Section: Discussionmentioning

confidence: 92%

“…The studies were carried out in Denmark (15,16,42,43), Italy (44), South Korea (45,46), Scotland ( 47) Japan (48), Canada (49,50) and one study included pooled global data (51). Of the included studies, 4 of the papers included advanced gastric cancer patients (45,46,48,50), 6 included advanced oesophageal cancer patients (15,16,(42)(43)(44)47), 1 included gastric and oesophageal cancer patients (49) and 1 included both gastric and gastroesophageal junction cancer patients (51). No studies from the perspective of informal carers or HCPs were found regarding the challenges facing patients or informal carers.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Of the six included studies, three studies identi ed a number of physical factors associated with psychosocial functioning in individuals with advanced oesophago-gastric cancer. These included dysphagia (44), performance status (51) and proximity to death (50). For dysphagia, Brunelli et al (44) reported that higher grades of dysphagia led to higher levels of QoL impairment in advanced oesophageal cancer patients.…”

Section: Physical Factors Associated With Psychosocial Functioningmentioning

confidence: 99%

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Psychosocial functioning in individuals with advanced oesophago-gastric cancer: a mixed methods systematic review

Ghiglieri

Dempster

Wright

et al. 2022

Preprint

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Background Oesophago-gastric cancer is an aggressive disease with a high rate of recurrence and mortality across the disease trajectory. Reduced psychosocial functioning has been evidenced amongst those with advanced disease, however little is known about the contributing factors. Determining these factors is an important clinical consideration to inform assessment and intervention. This review aimed to synthesize the available evidence on the psychosocial functioning of individuals with advanced oesophago-gastric cancer and their carers. Methods A JBI mixed-methods systematic review. Four bibliographic databases, MEDLINE, Embase, PsycINFO, and CINAHL, were searched. Quantitative and qualitative studies were screened for inclusion and critically appraised for methodological quality. Both types of data were extracted using JBI tools for mixed-methods systematic reviews. A convergent segregated approach to synthesis and integration was used. The findings of the synthesis have been configured according to JBI methodology. Results A total of 12 studies were included in this review, including 6 quantitative studies and 6 qualitative studies. The quantitative results provide preliminary indication of several physical, biological, psychological and macro-level contextual factors associated with psychosocial functioning in this clinical population. The qualitative findings shed light on a range of physical, psychosocial, and existential challenges faced by advanced oesophago-gastric cancer patients. These multiple and often persistent challenges appear to cause considerable distress; however, patients describe the importance of maintaining a sense of normality and control over their illness and its effects. Patients value continuity and structure, however many report shortcomings when accessing care. No findings reporting the experiences from the perspective of carers were found, therefore all findings represent the perspective of the patient. Conclusions Further high-quality research is needed to understand how best to support and manage the palliative care needs of individuals living with advanced oesophago-gastric cancer. Implications for practice are discussed, suggesting that psychosocial interventions, complex symptom management and continuity of care could improve the psychosocial functioning of individuals in this setting. Pre-registration The systematic review was pre-registered at the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020181273) and the protocol can be viewed on the OSF (http://osf.io/exuzf)

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“…According to our own previous research, we hold the opinion that one main cause of cancer discrimination is the discrimination against cancer symptoms in healthy people [33,34]. The easy-to-be-noticed cancer symptoms are the primary differences between cancer patients and the healthy people [35,36]. Healthy people may label cancer patients as "dangerous", "marginal" and "different" because of their fear, rejection and avoidance of cancer symptoms.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of the cancer symptoms discrimination scale: a cross-sectional survey of students in Yunnan, China

et al. 2020

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Background This study aimed to devise a Cancer symptoms Discrimination Scale (CSDS) suitable for China based on a cross-sectional survey. Methods The CSDS was developed using the classical measurement theory. A total of 3610 students from Yunnan province, China, participated in the cross-sectional survey. The test version of the scale was modified by the item analysis method, and after the official version of CSDS was developed, its reliability and validity were verified. A univariate analysis of variance and a multiple linear regression model were used to analyze the influencing factors of cancer symptoms discrimination among the university/college students. Results There were 21 items in total for the CSDS, including 3 subscales --- common clinical manifestations (11 items), physical appearance defects (6 items), and drainage tube(s) wearing (4 items). This CSDS had good validity (GFI = 0.930, AGFI = 0.905, RMR = 0.013, I-CVIs> 0.80, and the Pearson correlation coefficient was satisfactory.) and reliability (Cronbach’s alpha = 0.862, spearman-brown coefficient = 0.875). The multiple linear regression showed that certain factors may affect the students’ discrimination level against cancer symptoms (P < 0.05), including gender, major, current education degree, guardian’s highest record of formal schooling, self-rated health status, history of care for cancer patients, family relationship, ways of cancer knowledge acquisition, good/poor understanding of cancer-related information, degree of cancer fear, and their perception of cancer infectiousness. Conclusion This CSDS, with good reliability and validity, can be used for the evaluation of the discrimination risk and levels against cancer symptoms among healthy students.

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Patient-reported symptoms in metastatic gastric cancer patients in the last 6 months of life

Cited by 17 publications

References 42 publications

Province-Wide Analysis of Patient-Reported Outcomes for Stage IV Non-Small Cell Lung Cancer

Province-Wide Analysis of Patient-Reported Outcomes for Stage IV Non-Small Cell Lung Cancer

Psychosocial functioning in individuals with advanced oesophago-gastric cancer: a mixed methods systematic review

Development and validation of the cancer symptoms discrimination scale: a cross-sectional survey of students in Yunnan, China

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