Symptom prevalence, characteristics and distress in a cancer population

Abstract

Despite the importance of symptom control in the cancer population, few studies have systematically assessed the prevalence and characteristics of symptoms or the interactions between various symptom characteristics and other factors related to quality of life (QOL). As part of a validation study of a new symptom assessment instrument, inpatients and outpatients with prostate, colon, breast or ovarian cancer were evaluated using the Memorial Symptom Assessment Scale and other measures of psychological condition, performance status, symptom distress and overall quality of life. The mean age of the 243 evaluable patients was 55.5 years (range 23-86 years); over 60% were women and almost two-thirds had metastatic disease. The Karnofsky Performance Status (KPS) score was < or = 80 in 49.8% and 123 were inpatients at the time of assessment. Across tumour types, 40-80% experienced lack of energy, pain, feeling drowsy, dry mouth, insomnia, or symptoms indicative of psychological distress. Although symptom characteristics were variable, the proportion of patients who described a symptom as relatively intense or frequent always exceeded the proportion who reported it as highly distressing. The mean (+/- SD range) number of symptoms per patient was 11.5 +/- 6.0 (0-25); inpatients had more symptoms than outpatients (13.5 +/- 5.4 vs. 9.7 +/- 6.0, p < 0.002) and those with KPS < or = 80 had more symptoms than those with KPS > 80 (14.8 +/- 5.5 vs. 9.2 +/- 4.9, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Discordance between physicians' estimations and breast cancer patients' self-assessment of side-effects of chemotherapy: an issue for quality of care

“…Figure 1 compares the frequency of declaration of each symptom, during the 180 cycles of chemotherapy of these 30 patients, to those noted by clinicians in their medical records. Concordance between patient's self-assessment and clinical reports is moderately correct (Kappa coefficient between 0.45 and Figure 1 Comparison of chemotherapy side-effects evaluated by patients with those reported by physicians in medical records (n = 30,180 cycles of chemotherapy), *, Patient; physician; (,Cohen's Kappa coefficient; *P < 0.05; **P<10-2; ***P < 10-3; NS, not significant 0.75; Landis and Koch, 1977) (Love et al, 1989;Portenoy et al, 1994a) that the number of disturbing physical symptoms experienced by cancer patients is strongly associated with their overall quality of life during chemotherapy treatment. Our study, carried out in a group of female patients with standard risk breast cancer, also found similar frequencies of symptoms, such as nausea and vomiting, associated with NCF chemotherapy as in other groups of patients (metastatic breast cancers) receiving the same regimen (Bennett et al, 1988).…”

Exploring the differential experience of breast cancer treatment-related symptoms: a cluster analytic approach

“…The MSAS is a validated patient-rated instrument comprised of 32 highly prevalent physical and psychological symptoms [25,26]. If a symptom was present during the past week, patients rate symptom frequency, severity, and distress for 24 physical symptom items; the remaining 8 psychological symptom items are rated only for severity and distress.…”

“…If a symptom was present during the past week, patients rate symptom frequency, severity, and distress for 24 physical symptom items; the remaining 8 psychological symptom items are rated only for severity and distress. Instrument reliability and validity in cancer patients has been demonstrated [3,25,26]. The current study used an adapted version of the MSAS consisting of 26 items rated for prevalence (present or absent).…”

Symptom Prevalence and Related Distress in Cancer Patients Undergoing Chemotherapy

“…Cytotoxic chemotherapy remains a mainstay in management of variety of malignancies, be it in the adjuvant or palliative setting. Although chemotherapy improves cancer survivorship, the side effects of these agents frequently render significant physical and psychological sequelae (Portenoy et al, 1994a).…”