The persistence of symptom burden: symptom experience and quality of life of cancer patients across one year

Abstract

PURPOSE The purpose of this longitudinal study was to track the symptom experience in a sample of cancer patients, determine the persistence of cancer symptoms and symptom burden, and examine the relationship between symptoms and QOL over time. METHODS 542 patients provided longitudinal data, completing surveys over a 12 month period. Patients had breast, colorectal, gynecologic, lung or prostate cancer with stage 1, 2 or 3 disease. Surveys included the Memorial Symptom Assessment Scale and the Functional Assessment of Cancer Therapy-General Scale and were administered every three months. Demographic and clinical information and comorbidities were collected from the tumor registry. RESULTS The number and type of symptoms experienced by patients varied by cancer type, but about 90% of patient reported one or more symptoms – with prostate cancer patients reporting fewer symptoms and colorectal patients more symptoms. Prostate patients also had the lowest symptom burden at every timepoint. Overall symptom burden decreased over time, as did the Physical subscale for the MSAS. Quality of life was stable over time, except for Physical Well-being, which improved. Quality of life was negatively correlated with symptom burden at every timepoint. CONCLUSIONS The differences in symptom experience by cancer type suggest that assessment and management of symptoms must be individually tailored or at least adjusted by cancer type. While symptom burden decreased over time, residual symptom burden was still noteworthy. As quality of life was persistently negatively correlated with symptom burden, the results suggest the need for comprehensive symptom assessment and management.

Symptoms, Quality of Life, and Daily Activities in People With Newly Diagnosed Solid Tumors Presenting to a Medical Oncologist

“…For QOL specifically, some have examined newly diagnosed older populations with cancer 33,34 or else symptoms in various phases of cancer illness. 3,10,35,36 Our experience supports prior medical informatics reports of Web-based, 37 computer-assisted, 17,28,38,39 tablet 40 or hand-held 11,16,41,42 assessments in various cancer and palliative medicine populations and at other stages of the illness. None of them involved newly diagnosed patients.…”

Symptom Experience and Self-rated Physical Functioning in Patients With Ovarian Cancer Receiving Chemotherapy

“…In one of few longitudinal studies using the MSAS in a heterogeneous sample of patients with gynecological cancer, total MSAS scores at enrollment was similar to our findings (0.71 vs 0.69). 2 However, although the total MSAS score temporarily worsened during treatment in our patients, the trend was opposite in the study by Deshields et al, 2 where the women tended to have better scores during treatment before it returned TABLE 3. The MSAS* subscales related to self-rated performance status at enrollment Subscales to enrollment values.…”

“…2 However, most studies assessing symptoms are cross-sectional and include various cancer types, and in studies of a single cancer type, there is an overrepresentation of studies in breast, colorectal, and lung cancer, 22,23 which make comparisons challenging. Of the few self-reported symptom studies that have been conducted in patients with ovarian cancer, our results are comparable with 2 studies using MSAS, where mean numbers of reported symptoms were 11.2 9 and 10.0, 24 compared with 10.7 in our study.…”

“…During and after chemotherapy, patients with ovarian cancer often experience several disease and treatment-related symptoms, which may increase in severity with advanced disease. 2,3 Although chemotherapy has been shown to improve symptoms in most platinum-sensitive patients, approximately half of platinum-resistant patients do not benefit. 4 It is shown that approximately 30% of patients previously treated with chemotherapy and/or surgery report disturbed sleep, fatigue, or numbness/tingling of moderate severity, whereas approximately 20% report back pain, feeling bloated, or constipation of at least moderate severity.…”

Effectiveness of a tailored return to work program for cancer survivors with job loss: results of a randomized controlled trial

“…Among the many challenges in cancer survivorship are longterm or permanent physical and mental health problems, which often occur as a result of diagnosis and treatment [1,2]. For example, cancer survivors (CSs) may experience fatigue, pain and cognitive problems, long after treatment has been completed [3].…”