Management of Unexplained Symptoms in Survivors of Cancer (original) (raw)
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Symptom Documentation in Cancer Survivors as a Basis for Therapy Modifications
Acta Oncologica, 2002
In order to suggest therapy modi cations with the aim of diminishing the risk of therapy-induced long-term distressful symptom s in cancer survivors, data are needed relating details of therapy to the long-term symptom situation. In this article, the concept s and mean s used to assess the latter while developin g the R adiumhemmet scale for sympto m assessmen t are described. The focus is on the subjective long-term situation, and symptoms as a perceived abnormality are de ned. F or concep tual clarity, one symptom at a time is considered , excluding scales in which items are summarized . M oreover , measures of disease occurrence in the population are translated (epidemiologically) into measures of symptom occurrence in an individual. Nature distinguishes one long-term symptom from another . Occurrence of a symptom in an individual is measured by an incidence (e.g. number of defecations per week) or prevalence rate (e.g. urinations with involuntar y cessation divided by the total number of urinations). Any scale expressing symptom intensity is arbitrary, be it 'verbal' (no:little:moderate:much pain) or visual (analogue or with integers). A time period describes sympto m duration. The relevance of a sympto m to emotions and social activities, sometimes cited as the associated symptom-indu ced distress, is a separate issue from symptom occurrence, intensity, and duration.
Symptom Burden Among Cancer Survivors: Impact of Age and Comorbidity
The Journal of the American Board of Family Medicine, 2007
Background: Previous research among specific cancer populations has shown high but variable symptom burden; however, very little is known about its extent and pattern among the entire population of US cancer survivors, which is more clinically relevant to primary care physicians.
Symptom burden in cancer survivors 1 year after diagnosis
Cancer, 2011
Background-Few studies have examined risk for severe symptoms during early cancer survivorship. Using baseline data from the American Cancer Society's Study of Cancer Survivors-I, we examined cancer survivors with high symptom burden, identified risk factors associated with high symptom burden, and evaluated the impact of high symptom burden on health-related quality of life (HRQoL) 1 year post-diagnosis.
Br. J. Cancer, 2002
We investigated if a cancer patient's unrelieved symptoms during the last 3 months of life increase the risk of long-term psychological morbidity of the surviving partner. All women (n=506) living in Sweden under 80 years of age, who lost their husband/partner owing to cancer of the prostate in 1996 or of the urinary bladder in 1995 or 1996 were asked to answer an anonymous postal questionnaire, 2 -4 years after their loss. The widows' psychological morbidity was associated with the patient's unrelieved mental symptoms. When the patient was perceived to have been very anxious during last three months of life (compared to no observed symptoms) the relative risks for the widows' psychological morbidity were: 2.5 (1.4 -4.3) for depression and 3.4 (1.4 -8.2) for anxiety. When comparing reports of the patient's pain (much vs no), the relative risks were 0.8 (0.5 -1.2) for widowhood depression, and 0.8 (0.4 -1.7) for widowhood anxiety. The patients were found to have had adequate access to physical pain control but poor access to psychological symptom control. Efficiency in diagnosing and treating psychological complications of terminally ill cancer patients may not only improve their quality of life but possibly also prevent long-term psychological morbidity of their surviving partners.
Symptom Documentation in Cancer Survivors as a Basis for Therapy Modié cations
2000
In order to suggest therapy modié cations with the aim of diminishing the risk of therapy-induced long-term distressful symptoms in cancer survivors, data are needed relating details of therapy to the long-term symptom situation. In this article, the concepts and means used to assess the latter while developing the Radiumhemmet scale for symptom assessment are described. The focus is on
Supportive Care in Cancer, 2013
Purpose Patients with cancer experience acute and chronic symptoms caused by their underlying disease or by the treatment. While numerous studies have examined the impact of various treatments on symptoms experienced by cancer patients, there are inconsistencies regarding the symptoms measured and reported in treatment trials. This article presents a systematic review of the research literature of the prevalence and severity of symptoms in patients undergoing cancer treatment. Methods A systematic search for studies of persons receiving active cancer treatment was performed with the search terms of "multiple symptoms" and "cancer" for studies involving patients over the age of 18 years and published in English during the years 2001 to 2011. Search outputs were reviewed independently by seven authors, resulting in the synthesis of 21 studies meeting criteria for generation of an Evidence Table reporting symptom prevalence and severity ratings. Results Data were extracted from 21 multinational studies to develop a pooled sample of 4,067 cancer patients in whom the prevalence and severity of individual symptoms was reported. In total, the pooled sample across the 21 studies was comprised of 62 % female, with a mean age of 58 years (range 18 to 97 years). A majority (62 %) of these studies assessed symptoms in homogeneous samples with respect to tumor site (predominantly breast and lung cancer), while 38 % of the included studies utilized samples with mixed diagnoses and treatment regimens. Eighteen instruments and structured interviews were including those measuring single symptoms, multisymptom inventories, and single symptom items drawn from HRQOL or health status measures. The MD Anderson Symptom Inventory was the most commonly used instrument in the studies analyzed (n=9 studies; 43 %), while the Functional Assessment of Cancer Therapy, Hospital Anxiety and Depression Subscale, Medical Outcomes Survey Short Form-36, and Symptom Distress Scale were each employed in two studies. Forty-seven symptoms were identified across the 21 studies which were then categorized into 17 logical groupings. Symptom prevalence and severity were calculated across the entire cohort and also based upon sample sizes in which the symptoms were measured providing the ability to rank symptoms. Conclusions Symptoms are prevalent and severe among patients with cancer. Therefore, any clinical study seeking to evaluate the impact of treatment on patients should consider including measurement of symptoms. This study demonstrates that a discrete set of symptoms is common across cancer types. This set may serve as the basis for defining a "core" set of