A review of the prevalence and impact of multiple symptoms in oncology patients.

Findings from several studies suggest that oncology patients undergoing active treatment experience multiple symptoms, and that these symptoms can have a negative effect on patient outcomes. However, no systematic review has summarized the findings from studies that assessed multiple symptoms in these patients. Therefore, the purposes of this review were to: 1) compare and contrast the characteristics of the three most commonly used instruments to measure multiple symptoms; 2) summarize the prevalence rates for multiple symptoms in studies of oncology patients receiving active treatment; 3) describe the relationships among selected demographic, disease, and treatment characteristics and multiple symptoms; and 4) describe the relationships between the occurrence of multiple symptoms and patient outcomes (i.e., functional status, quality of life). Only 18 studies were found that met the inclusion criteria for this review. The majority of the studies were cross-sectional with sample sizes that ranged from 26 to 527. Approximately 40% of patients experienced more than one symptom. However, little is known about the relationships between demographic and clinical characteristics and the occurrence of multiple symptoms. Findings from this review suggest that the occurrence of multiple symptoms is associated with decreased functional status and quality of life. However, given the large number of oncology patients who undergo active treatment each year, additional research is warranted on the prevalence and impact of multiple symptoms. Only when this descriptive research is completed with homogenous samples of patients in terms of cancer diagnoses and treatments can intervention studies for multiple symptoms be developed and tested.

[1]  S. Paul,et al.  Symptom clusters and their effect on the functional status of patients with cancer. , 2001, Oncology nursing forum.

[2]  M. Youngblood,et al.  A comparison of two methods of assessing cancer therapy‐related symptoms , 1994, Cancer nursing.

[3]  M. Dodd,et al.  Conceptual issues in symptom clusters research and their implications for quality-of-life assessment in patients with cancer. , 2007, Journal of the National Cancer Institute. Monographs.

[4]  J. Sloan,et al.  Symptom distress in newly diagnosed ambulatory cancer patients and as a predictor of survival in lung cancer. , 1995, Journal of pain and symptom management.

[5]  M. Dodd,et al.  Mood states of oncology outpatients: does pain make a difference? , 1995, Journal of pain and symptom management.

[6]  C. Miaskowski,et al.  Differences in outcomes among patients experiencing different types of cancer-related pain. , 1998, Oncology nursing forum.

[7]  J. de Haes,et al.  Measuring psychological and physical distress in cancer patients: structure and application of the Rotterdam Symptom Checklist. , 1990, British Journal of Cancer.

[8]  C. Cleeland,et al.  Filipino version of the M. D. Anderson Symptom Inventory: validation and multisymptom measurement in cancer patients. , 2006, Journal of pain and symptom management.

[9]  M. Dodd,et al.  Symptom clusters: the new frontier in symptom management research. , 2004, Journal of the National Cancer Institute. Monographs.

[10]  J. Richardson,et al.  Multimeasure Pain Assessment in an Ethnically Diverse Group of Patients with Cancer , 1999, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.

[11]  Wan Ariffin Bin Abdullah,et al.  Med Pediatr Oncol , 1999 .

[12]  S. Holmes,et al.  Preliminary investigations of symptom distress in two cancer patient populations: evaluation of a measurement instrument. , 1991, Journal of advanced nursing.

[13]  M. Feuerman,et al.  Symptom and quality of life survey of medical oncology patients at a Veterans Affairs medical center , 2000, Cancer.

[14]  H. Thaler,et al.  Symptom prevalence, characteristics and distress in a cancer population , 1994, Quality of Life Research.

[15]  C. Seynaeve,et al.  Weekly paclitaxel as first-line chemotherapy for elderly patients with metastatic breast cancer. A multicentre phase II trial. , 2004, European journal of cancer.

[16]  C. Cleeland,et al.  Cancer-related symptom assessment in Russia: validation and utility of the Russian M. D. Anderson Symptom Inventory. , 2005, Journal of pain and symptom management.

[17]  Zimmer Jf Clinical trial procedures clarified. , 1990, Oncology nursing forum.

[18]  B. Given,et al.  Predictors of pain and fatigue in the year following diagnosis among elderly cancer patients. , 2001, Journal of pain and symptom management.

[19]  M. Johnson,et al.  Development of reliable and valid measures of nausea and vomiting , 1984, Cancer nursing.

[20]  P. Jacobsen,et al.  Distinguishing fatigue and depression in patients with cancer. , 2003, Seminars in clinical neuropsychiatry.

[21]  C. Cleeland,et al.  Chinese version of the M. D. Anderson Symptom Inventory , 2004, Cancer.

[22]  T. Wong,et al.  The significance of pain among Chinese patients with cancer in Hong Kong. , 1999, Acta anaesthesiologica Sinica.

[23]  J. Sloan,et al.  Perceptions of symptom distress in lung cancer patients: I. Congruence between patients and primary family caregivers. , 1997, Journal of pain and symptom management.

[24]  C. Escalante,et al.  Treatment for cancer-related fatigue: an update , 2003, Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer.

[25]  Mei-Ling Chen,et al.  Symptom clusters in cancer patients , 2006, Supportive Care in Cancer.

[26]  R. McCorkle,et al.  Symptom distress, current concerns and mood disturbance after diagnosis of life-threatening disease. , 1983, Social science & medicine.

[27]  K. Sellick,et al.  Symptoms, Psychological Distress, Social Support, and Quality of Life of Chinese Patients Newly Diagnosed With Gastrointestinal Cancer , 2004, Cancer nursing.

[28]  H. Donovan,et al.  Patient-provider communication and perceived control for women experiencing multiple symptoms associated with ovarian cancer. , 2005, Gynecologic oncology.

[29]  K. Foley,et al.  Pain in ovarian cancer patients. Prevalence, characteristics, and associated symptoms , 1994 .

[30]  L. Degner,et al.  Symptom experiences: perceptual accuracy between advanced-stage cancer patients and family caregivers in the home care setting. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[31]  V. Mock,et al.  Assessment and management of cancer-related fatigue in adults , 2003, The Lancet.

[32]  C. Cleeland,et al.  Assessing symptom distress in cancer patients , 2000 .

[33]  S. Beck An ethnographic study of factors influencing cancer pain management in South Africa. , 2000, Cancer nursing.

[34]  M. Watson,et al.  The Factor Structure and Factor Stability of the Hospital Anxiety and Depression Scale in Patients with Cancer , 1991, British Journal of Psychiatry.

[35]  M. Cooley,et al.  Symptom prevalence, distress, and change over time in adults receiving treatment for lung cancer , 2003, Psycho-oncology.

[36]  L. Sarna Correlates of symptom distress in women with lung cancer. , 1993, Cancer practice.

[37]  C. Cleeland Cancer-related symptoms. , 2000, Seminars in radiation oncology.

[38]  T. Morgan,et al.  A phase I trial of α-interferon in combination with pentostatin in hematologic malignancies , 1991 .

[39]  L. Degner,et al.  Measuring symptom distress in patients with lung cancer. A pilot study of experienced intensity and importance of symptoms. , 2000, Cancer nursing.

[40]  C. Cleeland,et al.  Japanese version of the MD Anderson Symptom Inventory: a validation study. , 2003, Journal of pain and symptom management.

[41]  H. Scher,et al.  The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. , 1994, European journal of cancer.

[42]  Kathryn A. Lee,et al.  Pain, fatigue, and sleep disturbances in oncology outpatients receiving radiation therapy for bone metastasis: a pilot study. , 1999, Journal of pain and symptom management.

[43]  A. Berger Treating fatigue in cancer patients. , 2003, The oncologist.

[44]  Dimensions of symptom distress in women with advanced lung cancer: a factor analysis. , 1997, Heart & lung : the journal of critical care.

[45]  S. Amadori,et al.  Cancer‐related fatigue , 2003, Cancer.

[46]  R. McCorkle The measurement of symptom distress. , 1987, Seminars in oncology nursing.

[47]  J. Sitzia,et al.  Psychometric evaluation of a questionnaire to document side-effects of chemotherapy. , 1997, Journal of advanced nursing.

[48]  Eduardo Bruera,et al.  The Edmonton Symptom Assessment System (ESAS): A Simple Method for the Assessment of Palliative Care Patients , 1991, Journal of palliative care.

[49]  R. McCorkle,et al.  Development of a symptom distress scale , 1978, Cancer nursing.