Symptom Prevalence in Patients with Incurable Cancer: A Systematic Review

Teunissen, Saskia; Wesker, Wendy; Kruitwagen, Cas; Haes, Hanneke C. J. M. de; Voest, Emile E.; Graeff, Alexander de

doi:10.1016/j.jpainsymman.2006.10.015

Cited by 839 publications

(677 citation statements)

References 50 publications

(31 reference statements)

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“…The total symptom prevalence patterns (including those symptoms prevalent on inpatient admission and those that developed or recurred during the inpatient stay) were similar to that of other audits conducted in supportive and palliative care [20]. A systematic review of symptom prevalence in the last weeks of life found that 5 symptoms, (fatigue, pain, lack of energy, weakness and anorexia) occurred in more than 50% of all people [21]. The findings are also consistent with the data on the reasons that referral to specialized supportive and palliative care services occurs [14].…”

Section: What Data Are Supported By the Current Study?supporting

confidence: 66%

Planning phase III multi-site clinical trials in palliative care: the role of consecutive cohort audits to identify potential participant populations

Currow

Shelby‐James

Agar

et al. 2009

Support Care Cancer

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Goals of Work:Multiple sites enable more successful completion of adequately powered phase III studies in palliative care. Audits of the frequency and distribution of the symptoms of interest can better inform research planning by determining realistic recruitment goals for each site. The proposed studies are to improve the evidence-base for registration and subsidy applications for frequently encountered symptoms where current pharmacological interventions are being used 'off-licence'.Methods: Six services participated in a standardized, retrospective, consecutive cohort audit of five symptoms of their inpatient populations to inform the design of double blind randomised controlled phase III studies to which each site would recruit simultaneously. The audit covered all deaths in a three month period for people who were referred to a specialist palliative care service who had at least one inpatient admission between referral and death regardless of when the person was referred to the service. The audits were based around inclusion and exclusion criteria for the proposed studies.Main Results: Of the 468 people whose medical records were reviewed, potential study participant rates varied by symptom having accounted for general and specific inclusion and exclusion criteria: pain 17.7%; delirium 5.8%; anorexia 5.1%; bowel obstruction 2.8% and cholestatic itch 0%. For those people with a symptom of interest, it was noted at the beginning of the inpatient admission more than half the time. Of all inpatients, fewer then one third would be eligible to participate in at least one study. Conclusions:These data provide a baseline estimate of potential people to approach about clinical trials in supportive care but do not account for clinician 'gate-keeping', lack of interest in participating nor withdrawal from the study once initiated. The data are retrospective and therefore limited by clinical documentation. The audit directly informed an increase in the number of participating sites. Page 2 of 11Archived at Flinders University: dspace.flinders.edu.au INTRODUCTIONLarge scale trials in supportive, palliative and hospice care are feasible, especially if protocols can be designed appropriately for use in several sites simultaneously [6]. One reason for the failure of many studies in palliative care is an over-estimation of likely recruitment even for frequently encountered symptoms. A more comprehensive understanding of patterns of symptom occurrence for each participating site (given local variations in referral patterns) and general factors that may affect potential phase III study participation in a supportive and palliative care population need to be included in feasibility assessment. The design needs to take careful account of such findings if studies are going to be successful, and key performance indicators for each site can be tailored to local symptom patterns to monitor trial progress.

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Section: What Data Are Supported By the Current Study?supporting

confidence: 66%

Planning phase III multi-site clinical trials in palliative care: the role of consecutive cohort audits to identify potential participant populations

Currow

Shelby‐James

Agar

et al. 2009

Support Care Cancer

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“…Symptoms such as nervousness, depressed mood, worrying, anxiety and irritability contribute to PD [17] and are quite common in patients with advanced cancer. Nervousness for example, is experienced by almost 50% of incurable cancer patients, according to a systematic review in 25,074 patients [18]. Other symptoms, such as depressed mood, worrying, anxiety and irritability are reported by 39, 36, 30 and 30% of patients, respectively.…”

Section: Introductionmentioning

confidence: 99%

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

et al. 2017

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Background: Psychological distress (PD) has a major impact on quality of life. We studied the incidence of PD before and after radiotherapy for painful bone metastases. Furthermore, we aimed to identify factors predictive for PD. Methods: Between 1996 and 1998, the Dutch Bone Metastasis Study included 1157 patients with painful bone metastases. Patients were randomized between two fractionation schedules. The study showed a pain response of 74% in both groups. Patients filled out weekly questionnaires for 13 weeks, then monthly for two years. The questionnaires included a subscale for PD on the Rotterdam Symptom Checklist. We used generalized estimating equations and multivariable logistic regression analyses. Results: At baseline, 290 patients (27%) had a high level of PD. For the entire group, the level of PD remained constant over time. The majority of patients with a low level of PD at baseline remained at a low level during follow-up. In patients with a high level of PD at baseline, the mean level of PD decreased after treatment and stabilized around the cutoff level. Female patients, higher age, worse performance, lower pain score and worse self-reported QoL were associated with an increased chance of PD, although the model showed moderate discriminative power. Conclusions: A substantial proportion of patients had a high level of PD before and after radiotherapy for painful bone metastases. Most patients who reported high levels of PD when referred for palliative radiotherapy remained at high levels thereafter. Therefore, screening of PD prior to treatment seems appropriate, in order to select patients requiring intervention.

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“…Most patients diagnosed with cancer will receive treatment, and patients undergoing treatment experience a multitude of symptoms, including fatigue, pain, difficulty breathing, nausea, appetite loss, and unintentional weight change (2)(3)(4)(5). These symptoms can negatively impact one's ability to complete treatment as well as one's quality of life during and after treatment (6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Cancer Treatment on the Diets and Food Preferences of Patients Receiving Outpatient Treatment

Coa

Epstein

Ettinger

et al. 2015

Nutrition and Cancer

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Patients undergoing cancer treatment experience a multitude of symptoms that can influence their ability to complete treatment as well as their quality of life during and after treatment. This cross-sectional study sought to describe the dietary changes experienced by cancer patients and to identify associations between these changes and common treatment symptoms. A convenience sample of 1199 cancer patients aged 18 yr and older undergoing active treatment were recruited from 7 cancer centers to complete a selfadministered paper-and-pencil survey. Descriptive analyses were conducted to estimate prevalence of dietary changes and chi-squared tests were used to examine associations between dietary changes and health outcomes. Approximately 40% of patients reported a decreased appetite since beginning treatment, and 67.2% of patients reported at least 1 chemosensory alteration. Increased taste sensitivities were more common than decreased taste sensitivities, with increased sensitivity to metallic being the most common taste sensitivity (18.6%). Patients also had increased sensitivities to certain smells including cleaning solutions (23.4%), perfume (22.4%), and food cooking (11.4%). Patients reported a wide range of

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Symptom Prevalence in Patients with Incurable Cancer: A Systematic Review

Cited by 839 publications

References 50 publications

Planning phase III multi-site clinical trials in palliative care: the role of consecutive cohort audits to identify potential participant populations

Planning phase III multi-site clinical trials in palliative care: the role of consecutive cohort audits to identify potential participant populations

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

The Impact of Cancer Treatment on the Diets and Food Preferences of Patients Receiving Outpatient Treatment

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