Symptom trajectories during chemotherapy in outpatients with lung cancer colorectal cancer, or lymphoma

Brant, Jeannine M.; Beck, Susan L.; Dudley, William N.; Cobb, Patrick; Pepper, Ginette A.; Miaskowski, Christine

doi:10.1016/j.ejon.2010.12.002

Cited by 44 publications

(64 citation statements)

References 27 publications

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“…Our study verified that patients had higher pain scores during the treatment period, and this pain decreased to near the baseline level at the end of therapy. This finding is consistent with studies of pain trajectories during chemotherapy in outpatients with colorectal cancer, in which pain deteriorated during the initial period of treatment and further decreased after each treatment cycle (Brant et al, 2011;Green et al, 2010). Cancer pain is associated with cancer or its treatment and significantly decreases health and quality of life.…”

Section: Discussionsupporting

confidence: 80%

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Patient and Clinical Variables Account for Changes in Health-related Quality of Life and Symptom Burden as Treatment Outcomes in Colorectal Cancer: A Longitudinal Study

Hung¹,

Chien²,

Tsay³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Objective: The aim of the current study was to evaluate changes in treatment outcomes in terms of healthrelated quality of life (HRQoL) and symptom burden at zero, one, three, and six months after an initial diagnosis of colorectal cancer. The demographic and clinical characteristics that account for outcome changes in patients were investigated using a repeated measures framework. Methods and Materials: A cohort study was performed of 134 colorectal cancer patients followed from diagnosis to 6 months post-treatment in Central Taiwan. HRQoL and symptoms were assessed at diagnosis and one, three, and six months thereafter. The Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire, VAS pain, and the Memorial Symptom Assessment Scale (MSAS) were used for data collection. A generalized estimating equation (GEE) was applied for statistical analysis. Results: The majority of the patients were male (55%) and married (91.5%). The mean age was 60.4 years (SD = 11.71). Most were diagnosed stage III and IV colorectal cancer (54.5%). All underwent surgery; some also received chemotherapy (CT) or concurrent chemoradiation therapy (CCRT). The results of the GEE showed that overall, the HRQoL, pain, and symptoms of the patients significantly improved over the treatment period. Patients with stage IV disease who had received surgery and CCRT showed the worst HRQoL. Females, patients with comorbidity, and stage IV patients had higher pain scores over time. Female and stage IV patients had more severe physical symptoms, whereas stage II and IV patients had worse psychological symptoms over time. Conclusion: The patients' HRQoL, pain, and symptoms significantly improved over the 6-month treatment period. Certain patient and clinical variables accounted for changes in treatment outcomes regarding HRQoL and symptom burden in colorectal cancer patients.

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Section: Discussionsupporting

confidence: 80%

“…This finding is consistent with a limited number of studies on physical symptoms (Reyes-Gibby et al, 2007;Brant et al, 2011). One possible explanation for the increase in severity of symptoms is the severe side effects that result from cancer treatments, including surgery, chemotherapy or CCRT.…”

Section: Discussionsupporting

confidence: 78%

Patient and Clinical Variables Account for Changes in Health-related Quality of Life and Symptom Burden as Treatment Outcomes in Colorectal Cancer: A Longitudinal Study

Hung¹,

Chien²,

Tsay³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…In prior studies of patients with mixed cancer diagnoses and treatments, 42,47,49 patients with lung cancer reported the highest levels of fatigue severity. An explanation for these differences in evening fatigue scores between GI cancer and the other cancer diagnoses is not readily apparent.…”

Section: Discussionmentioning

confidence: 86%

Trajectories of Evening Fatigue in Oncology Outpatients Receiving Chemotherapy

Wright

Melkus

Hammer

et al. 2015

Journal of Pain and Symptom Management

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Context Fatigue is a distressing, persistent sense of physical tiredness that is not proportional to a person’s recent activity. Fatigue impacts patients’ treatment decisions and can limit their self-care activities. While significant interindividual variability in fatigue severity has been noted, little is known about predictors of interindividual variability in initial levels and trajectories of evening fatigue severity in oncology patients receiving chemotherapy (CTX). Objectives To determine whether demographic, clinical, and symptom characteristics were associated with initial levels as well as the trajectories of evening fatigue. Methods A sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer (N=586) completed demographic and symptom questionnaires a total of six times over two cycles of CTX. Fatigue severity was evaluated using the Lee Fatigue Scale. Hierarchical linear modeling (HLM) was used to answer the study objectives. Results A large amount of interindividual variability was found in the evening fatigue trajectories. A piecewise model fit the data best. Patients who were White, diagnosed with breast, gynecological, or lung cancer, and who had more years of education, child care responsibilities, lower functional status, and higher levels of sleep disturbance and depression reported higher levels of evening fatigue at enrollment. Conclusion This study identified both non-modifiable (e.g., ethnicity) and modifiable (e.g., child care responsibilities, depressive symptoms, sleep disturbance) risk factors for more severe evening fatigue. Using this information, clinicians can identify patients at higher risk for more severe evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors.

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“…5,11-15 For example, patients who were younger, 5,11 female, 5 unmarried, 11 and with more education 13 reported higher fatigue severity. In other studies, patients who were employed, 16 had a higher stage of disease at diagnosis, 12 and those who reported more comorbidities 12,17 had higher fatigue severity scores during CTX. Across these studies, 5,11-17 inconsistencies were found in the predictors, which may be related to the timing of the fatigue assessments; the failure to examine demographic, clinical and symptom characteristics in the same patients longitudinally; and/or the failure to evaluate diurnal variations in fatigue severity.…”

Section: Introductionmentioning

confidence: 73%

Predictors and Trajectories of Morning Fatigue Are Distinct From Evening Fatigue

Wright

Melkus

Hammer

et al. 2015

Journal of Pain and Symptom Management

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Context Fatigue is the most common symptom in oncology patients during chemotherapy (CTX). Little is known about the predictors of interindividual variability in initial levels and trajectories of morning fatigue severity in these patients. Objectives An evaluation was done to determine which demographic, clinical, and symptom characteristics were associated with initial levels as well as the trajectories of morning fatigue and to compare findings with our companion paper on evening fatigue. Methods A sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer (N=586) completed demographic and symptom questionnaires a total of six times over two cycles of CTX. Fatigue severity was evaluated using the Lee Fatigue Scale. Hierarchical linear modeling (HLM) was used to answer the study objectives. Results A large amount of interindividual variability was found in the morning fatigue trajectories. A piecewise model fit the data best. Patients with higher body mass index (BMI), who did not exercise regularly, with a lower functional status, and who had higher levels of state anxiety, sleep disturbance and depressive symptoms, reported higher levels of morning fatigue at enrollment. Variations in the trajectories of morning fatigue were predicted by the patients’ ethnicity and younger age. Conclusion The modifiable risk factors that were associated with only morning fatigue were BMI, exercise, and state anxiety. Modifiable risk factors that were associated with both morning and evening fatigue included functional status, depressive symptoms, and sleep disturbance. Using this information, clinicians can identify patients at higher risk for more severe morning fatigue and evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors.

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Symptom trajectories during chemotherapy in outpatients with lung cancer colorectal cancer, or lymphoma

Cited by 44 publications

References 27 publications

Patient and Clinical Variables Account for Changes in Health-related Quality of Life and Symptom Burden as Treatment Outcomes in Colorectal Cancer: A Longitudinal Study

Patient and Clinical Variables Account for Changes in Health-related Quality of Life and Symptom Burden as Treatment Outcomes in Colorectal Cancer: A Longitudinal Study

Trajectories of Evening Fatigue in Oncology Outpatients Receiving Chemotherapy

Predictors and Trajectories of Morning Fatigue Are Distinct From Evening Fatigue

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