Cancer symptom clusters—a dynamic construct

Excerpt

Cancer symptoms are influenced by disease progression, treatment, time, patient personality, and demographic factors: age, gender, performance status [1, 2]. Symptom experience may be genetically predetermined [3]. Understanding cancer symptoms as dynamic constructs helps us understand the multifaceted character of the disease process and hopefully improve patient care by improving symptom assessment and management. Cancer patients have multiple symptoms, which often appear in groups or clusters [2, 4]. Symptom research has identified a separate symptom entity, i.e., “a symptom cluster” [4‐6]. Symptom clusters consist of co-occurrence of two or more symptoms or symptom correlation based upon a particular symptom domain (prevalence, severity, distress) [5, 7]. The relationship among the symptoms within the cluster is assumed to be stronger than that across different clusters [5, 7]. Symptom clusters may influence disease course, treatment, function, quality of life (QoL), or prognosis, which differs from the sum of individual symptoms [7]. Methodological issues in cluster research include lack of consensus on cluster definition, instruments, study design, and statistical analyses used to identify clusters [7‐9]. Further studies in cancer like the one by Chow and colleagues (in this issue) contribute to cluster research and our knowledge of its clinical meaning [4, 5, 10‐12]. …