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Published in: Supportive Care in Cancer 4/2017

01-04-2017 | Original Article

Comparing the symptom experience of cancer patients and non-cancer patients

Authors: Teresa L. Deshields, Valentina Penalba, Jingxa Liu, James Avery

Published in: Supportive Care in Cancer | Issue 4/2017

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Abstract

Purpose

Symptom burden is an established concept in oncology encompassing the presence and severity of symptoms experienced by cancer patients. Few studies have examined differences in symptom burden between cancer patients and non-cancer patients. This study seeks to examine the differences in symptom burden between cancer patients (CP) and non-cancer patients (NCP) in order to better understand symptom burden in both populations.

Methods

Two groups of patients completed the Memorial Symptom Assessment Scale: 301 patients from a general medical clinic and 558 cancer patients from a cancer tumor registry. Participants provided demographic information—age, race/ethnicity, and sex and completed the Memorial Symptom Assessment Scale. Medical comorbidity was also measured.

Results

Most symptoms were more common in CP, except for pain, which was more prevalent in the NCP (45% of CP vs. 54% of NCP, p < .05). There was no difference in prevalence for the following symptoms: dry mouth, mouth sores, feeling nervous, worry, cough, and dizziness. The CP had greater mean MSAS Total scores (0.53 vs. 0.43, p < .01), number of symptoms (9.11 vs. 6.13, p < .01), and psychological subscale scores (0.77 vs. 0.64, p < .05). There was no difference by group in the physical nor the GDI subscale scores.

Conclusion

The results of this study support the perception that cancer patients have greater symptom burden. There were some unexpected results, particularly in terms of pain, which was more common in NCP and other symptoms that were experienced equally in both patient populations.
Literature
1.
go back to reference American Cancer Society (2016) Cancer Facts & Figures 2016. American Cancer Society, Atlanta American Cancer Society (2016) Cancer Facts & Figures 2016. American Cancer Society, Atlanta
2.
go back to reference Institute of Medicine and National Research Council (2006) From cancer patient to cancer survivor: lost in transition. National Academies Press, Washington, DC Institute of Medicine and National Research Council (2006) From cancer patient to cancer survivor: lost in transition. National Academies Press, Washington, DC
3.
go back to reference Cleeland CS (2007) Symptom burden: multiple symptoms and their impact as patient-reported outcomes. J Natl Cancer Inst Monogr 37:16–21CrossRef Cleeland CS (2007) Symptom burden: multiple symptoms and their impact as patient-reported outcomes. J Natl Cancer Inst Monogr 37:16–21CrossRef
4.
go back to reference Wu H-S, Harden JK (2015) Symptom burden and quality of life in survivorship: a review of the literature. Cancer Nurs 38(1):E29–E54CrossRef Wu H-S, Harden JK (2015) Symptom burden and quality of life in survivorship: a review of the literature. Cancer Nurs 38(1):E29–E54CrossRef
5.
go back to reference Deshields TL, Potter P, Olsen S, Liu J, Dye L (2011) Documenting the symptom experience of cancer patients. J Support Oncol 9(6):216–223CrossRef Deshields TL, Potter P, Olsen S, Liu J, Dye L (2011) Documenting the symptom experience of cancer patients. J Support Oncol 9(6):216–223CrossRef
6.
go back to reference Deshields T, Potter P, Olsen S, Liu J (2014) The persistence of symptom burden: symptom experience and quality of life of cancer patients across one year. Support Care Cancer 22(4):1089–1096CrossRef Deshields T, Potter P, Olsen S, Liu J (2014) The persistence of symptom burden: symptom experience and quality of life of cancer patients across one year. Support Care Cancer 22(4):1089–1096CrossRef
7.
go back to reference Marvel MK, Epstein RM, Flowers K, Beckman HB (1999) Soliciting the patient’s agenda: have we improved? JAMA 281(3):283–287CrossRef Marvel MK, Epstein RM, Flowers K, Beckman HB (1999) Soliciting the patient’s agenda: have we improved? JAMA 281(3):283–287CrossRef
8.
go back to reference Tai-Seale M, McGuire T, Zhang W (2007) Time allocation in primary care visits. Health Serv Res 42(5):871–894CrossRef Tai-Seale M, McGuire T, Zhang W (2007) Time allocation in primary care visits. Health Serv Res 42(5):871–894CrossRef
9.
go back to reference Haas LJ, Glazer K, Houchins J, Terry S (2006) Improving the effectiveness of the medical visit: a brief visit-structuring workshop changes patients’ perceptions of primary care visits. Patient Educ Couns 62(3):374–378CrossRef Haas LJ, Glazer K, Houchins J, Terry S (2006) Improving the effectiveness of the medical visit: a brief visit-structuring workshop changes patients’ perceptions of primary care visits. Patient Educ Couns 62(3):374–378CrossRef
10.
go back to reference Kroenke K, Jackson JL, Chamberlin J (1997) Depressive and anxiety disorders in patients presenting with physical complaints: clinical predictors and outcome. Am J Med 103(5):339–347CrossRef Kroenke K, Jackson JL, Chamberlin J (1997) Depressive and anxiety disorders in patients presenting with physical complaints: clinical predictors and outcome. Am J Med 103(5):339–347CrossRef
11.
go back to reference Bausewein C, Booth S, Gysels M et al (2010) Understanding breathlessness: cross-sectional comparison of symptom burden and palliative care needs in chronic obstructive pulmonary disease and cancer. J Palliat Med 13(9):1109–1118CrossRef Bausewein C, Booth S, Gysels M et al (2010) Understanding breathlessness: cross-sectional comparison of symptom burden and palliative care needs in chronic obstructive pulmonary disease and cancer. J Palliat Med 13(9):1109–1118CrossRef
12.
go back to reference Goodridge D, Lawson J, Duggleby W et al (2008) Health care utilization of patients with chronic obstructive pulmonary disease and lung cancer in the last 12 months of life. Respir Med 102(6):885–891CrossRef Goodridge D, Lawson J, Duggleby W et al (2008) Health care utilization of patients with chronic obstructive pulmonary disease and lung cancer in the last 12 months of life. Respir Med 102(6):885–891CrossRef
13.
go back to reference Bekelman DB, Rumsfeld JS, Havranek EP et al (2009) Symptom burden, depression, and spiritual well-being: a comparison of heart failure and advanced cancer patients. J Gen Intern Med 24(5):592–598CrossRef Bekelman DB, Rumsfeld JS, Havranek EP et al (2009) Symptom burden, depression, and spiritual well-being: a comparison of heart failure and advanced cancer patients. J Gen Intern Med 24(5):592–598CrossRef
14.
go back to reference Malik FA, Gysels M, Higginson IJ (2013) Living with breathlessness: a survey of caregivers of breathless patients with lung cancer or heart failure. Palliat Med 27(7):64–56CrossRef Malik FA, Gysels M, Higginson IJ (2013) Living with breathlessness: a survey of caregivers of breathless patients with lung cancer or heart failure. Palliat Med 27(7):64–56CrossRef
15.
go back to reference Sherman DW, Ye XY, Beyer McSherry C et al (2007) Symptom assessment of patients with advanced cancer and AIDS and their family caregivers: the results of a quality-of-life pilot study. Am J Hosp Palliat Care 24(5):350–365CrossRef Sherman DW, Ye XY, Beyer McSherry C et al (2007) Symptom assessment of patients with advanced cancer and AIDS and their family caregivers: the results of a quality-of-life pilot study. Am J Hosp Palliat Care 24(5):350–365CrossRef
16.
go back to reference Basch E, Reeve BB, Mitchell SA et al (2014) Development of the National Cancer Institute’s patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE). J Natl Cancer Inst 106(9):1–11CrossRef Basch E, Reeve BB, Mitchell SA et al (2014) Development of the National Cancer Institute’s patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE). J Natl Cancer Inst 106(9):1–11CrossRef
17.
go back to reference Steindal SA, Bredal IS, Sorbye LW et al (2011) Pain control at the end of life: a comparative study of hospitalized cancer and noncancer patients. Scand J Caring Sci 25(4):771–779CrossRef Steindal SA, Bredal IS, Sorbye LW et al (2011) Pain control at the end of life: a comparative study of hospitalized cancer and noncancer patients. Scand J Caring Sci 25(4):771–779CrossRef
18.
go back to reference Charlson ME, Pompei P, Ales KL et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRef Charlson ME, Pompei P, Ales KL et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRef
19.
go back to reference Piccirillo JF, Creech CM, Zequeira R (1999) Anderson S, Johnston AS. Inclusion of comorbidity into oncology data registries. J Registry Manag 26(2):66–70 Piccirillo JF, Creech CM, Zequeira R (1999) Anderson S, Johnston AS. Inclusion of comorbidity into oncology data registries. J Registry Manag 26(2):66–70
20.
go back to reference Portenoy RK, Thaler HT, Kornblith AB et al (1994) The memorial symptom assessment scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30A(9):1326–1236CrossRef Portenoy RK, Thaler HT, Kornblith AB et al (1994) The memorial symptom assessment scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30A(9):1326–1236CrossRef
21.
go back to reference Tranmer JE, Heyland D, Dudgeon D et al (2003) Measuring the symptom experience of seriously ill cancer and non-cancer hospitalized patients near the end of life with the memorial symptom assessment scale. J Pain Symptom Manag 25(5):420–429CrossRef Tranmer JE, Heyland D, Dudgeon D et al (2003) Measuring the symptom experience of seriously ill cancer and non-cancer hospitalized patients near the end of life with the memorial symptom assessment scale. J Pain Symptom Manag 25(5):420–429CrossRef
22.
go back to reference Esther Kim JE, Dodd MJ, Aouizerat BE et al (2009) Review of the prevalence and impact of multiple symptoms in oncology patients. J Pain Symptom Manag 37(4):715–736CrossRef Esther Kim JE, Dodd MJ, Aouizerat BE et al (2009) Review of the prevalence and impact of multiple symptoms in oncology patients. J Pain Symptom Manag 37(4):715–736CrossRef
23.
go back to reference Chang VT, Hwang SS, Feuerman M et al (2000) Symptom and quality of life survey of medical oncology patients at a veteran’s affairs medical center: a role for symptom assessment. Cancer 88(5):1175–1183CrossRef Chang VT, Hwang SS, Feuerman M et al (2000) Symptom and quality of life survey of medical oncology patients at a veteran’s affairs medical center: a role for symptom assessment. Cancer 88(5):1175–1183CrossRef
24.
go back to reference Van den Beuken-van Everdingen MHJ, De Rijke JM, Kessels AG et al (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 18(9):1437–1449CrossRef Van den Beuken-van Everdingen MHJ, De Rijke JM, Kessels AG et al (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 18(9):1437–1449CrossRef
25.
go back to reference Kroenke K. A (2014) Practical and evidence-based approach to common symptoms. Ann Intern Med 161:579–586CrossRef Kroenke K. A (2014) Practical and evidence-based approach to common symptoms. Ann Intern Med 161:579–586CrossRef
26.
go back to reference Schumacher S, Rief W, Brähler E et al (2014) Disagreement in doctor’s and patient’s rating about medically unexplained symptoms and health care use. Int J Behav Med 20(1):30–37CrossRef Schumacher S, Rief W, Brähler E et al (2014) Disagreement in doctor’s and patient’s rating about medically unexplained symptoms and health care use. Int J Behav Med 20(1):30–37CrossRef
27.
go back to reference Fries JF, Koop CE, Beadle CE et al (1993) Reducing health care costs by reducing the need and demand for medical services. N Engl J Med 329:321–325CrossRef Fries JF, Koop CE, Beadle CE et al (1993) Reducing health care costs by reducing the need and demand for medical services. N Engl J Med 329:321–325CrossRef
28.
go back to reference Jensen SB, Pedersen AM, Vissink A et al (2010) A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer 18(8):1039–1060CrossRef Jensen SB, Pedersen AM, Vissink A et al (2010) A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer 18(8):1039–1060CrossRef
29.
go back to reference Chambers MS, Garden AS, Kies MS, Martin JW (2004) Radiation-induced xerostomia in patients with head and neck cancer: pathogenesis, impact on quality of life, and management. Head & Neck 26(9):796–807CrossRef Chambers MS, Garden AS, Kies MS, Martin JW (2004) Radiation-induced xerostomia in patients with head and neck cancer: pathogenesis, impact on quality of life, and management. Head & Neck 26(9):796–807CrossRef
30.
go back to reference Barkokebas A1, Silva IH, de Andrade SC et al (2014) Impact of oral mucositis on oral-health-related quality of life of patients diagnosed with cancer. J Oral Pathol Med 44(9):746–751CrossRef Barkokebas A1, Silva IH, de Andrade SC et al (2014) Impact of oral mucositis on oral-health-related quality of life of patients diagnosed with cancer. J Oral Pathol Med 44(9):746–751CrossRef
31.
go back to reference Smith RG, Burtner AP (1994) Oral side-effects of the most frequently prescribed drugs. Spec Care Dentist 14(3):96–102CrossRef Smith RG, Burtner AP (1994) Oral side-effects of the most frequently prescribed drugs. Spec Care Dentist 14(3):96–102CrossRef
32.
go back to reference Reyes-Gibby C, Anderson K, Morrow P et al (2012) Depressive symptoms and health-related quality of life in breast cancer survivors. J Women's Health 21(3):311–318CrossRef Reyes-Gibby C, Anderson K, Morrow P et al (2012) Depressive symptoms and health-related quality of life in breast cancer survivors. J Women's Health 21(3):311–318CrossRef
33.
go back to reference Graça Pereira M1, Figueiredo AP, Fincham FD (2012) Anxiety, depression, traumatic stress and quality of life in colorectal cancer after different treatments: a study with Portuguese patients and their partners. Eur J Oncol Nurs 16(3):227–232CrossRef Graça Pereira M1, Figueiredo AP, Fincham FD (2012) Anxiety, depression, traumatic stress and quality of life in colorectal cancer after different treatments: a study with Portuguese patients and their partners. Eur J Oncol Nurs 16(3):227–232CrossRef
34.
go back to reference Collins C (2009) Integrating behavioral and mental health services into the primary care setting. N C Med J 70:248–252PubMed Collins C (2009) Integrating behavioral and mental health services into the primary care setting. N C Med J 70:248–252PubMed
35.
go back to reference Perkins A (1994) Saving money by reducing stress. Harvard Bus Rev 72:12 Perkins A (1994) Saving money by reducing stress. Harvard Bus Rev 72:12
36.
go back to reference Cummings N, VandenBos G (1981) The twenty years Kaiser-Permanente experience with psychotherapy and medical utilization: implications for national health policy and national health insurance. Health Policy Q 1(2):159–175PubMed Cummings N, VandenBos G (1981) The twenty years Kaiser-Permanente experience with psychotherapy and medical utilization: implications for national health policy and national health insurance. Health Policy Q 1(2):159–175PubMed
39.
go back to reference Nesic VS, Petrovic AM, Sipetic SB et al (2012) Comparison of the adult comorbidity evaluation 27 and the Charlson comorbidity indices in patients with laryngeal squamous cell carcinoma. J Laryngol Otol 126:516–524CrossRef Nesic VS, Petrovic AM, Sipetic SB et al (2012) Comparison of the adult comorbidity evaluation 27 and the Charlson comorbidity indices in patients with laryngeal squamous cell carcinoma. J Laryngol Otol 126:516–524CrossRef
40.
go back to reference Kallogjeri D, Gaynor SM, Piccirillo ML et al (2014) Comparison of comorbidity collection methods. J Am Coll Surg 219(2):245–255CrossRef Kallogjeri D, Gaynor SM, Piccirillo ML et al (2014) Comparison of comorbidity collection methods. J Am Coll Surg 219(2):245–255CrossRef
Metadata
Title
Comparing the symptom experience of cancer patients and non-cancer patients
Authors
Teresa L. Deshields
Valentina Penalba
Jingxa Liu
James Avery
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 4/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3498-2

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