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Supportive Care in Cancer

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01-01-2019 | Original Article

Nausea in advanced cancer: relationships between intensity, burden, and the need for help

Authors: Signe Ladegaard Harder, Mogens Groenvold, Jørn Herrstedt, Anna Thit Johnsen

Published in: Supportive Care in Cancer | Issue 1/2019

Abstract

Purpose

This study aimed at expanding the knowledge of nausea in patients with advanced cancer by elucidating (a) the prevalences of patients having nausea, experiencing nausea as a problem, and having a need for help with their nausea, respectively, (b) determining variables associated with nausea, and (c) investigating the relation between nausea and the need for help regarding nausea.

Methods

In 2004–2006, the EORTC QLQ-C30 and the Three-Levels-of-Needs Questionnaire (3LNQ) were mailed to 2364 patients with advanced cancer who had been in contact with one of the 54 hospital departments within the past year. Further information was collected from medical records.

Results

Patient-response rate was 61%. Twenty-two percent reported having had some degree of nausea within the past week, with a mean nausea score of 10.4 and a two-item combined nausea and vomiting score of 7.5 (0–100, 100 = “very much”). Factors associated with nausea on the multivariate level were contact type (inpatient/outpatient) and treatment status (receiving ongoing oncologic treatment yes/no).

“Nausea intensity” and “nausea problem burden” showed acceptable abilities to distinguish between patients having or not having an unmet need for help regarding nausea with areas under the curve (AUCs) of 0.81 and 0.82, respectively.

Conclusions

Around one in four patients with advanced cancer reported nausea within the past week, highest in patients who were inpatients or undergoing active oncologic treatment. Almost all patients reporting nausea on the EORTC QLQ-C30 experienced this to be a problem, and the 3LNQ can therefore be restricted to cases where additional details are needed.

Glare P, Miller J, Nikolova T, Tickoo R (2011) Treating nausea and vomiting in palliative care: a review. Clin Interv Aging 6:243–259. https://doi.org/10.2147/cia.s13109 CrossRefPubMedPubMedCentral

Walsh D, Davis M, Ripamonti C, Bruera E, Davies A, Molassiotis A (2017) 2016 updated MASCC/ESMO consensus recommendations: management of nausea and vomiting in advanced cancer. Support Care Cancer 25(1):333–340. https://doi.org/10.1007/s00520-016-3371-3 CrossRefPubMed

Davis MP, Hallerberg G (2010) A systematic review of the treatment of nausea and/or vomiting in cancer unrelated to chemotherapy or radiation. J Pain Symptom Manag 39(4):756–767. https://doi.org/10.1016/j.jpainsymman.2009.08.010 CrossRef

Balaban CD, Yates BJ (2017) What is nausea? A historical analysis of changing views. Auton Neurosci 202:5–17. https://doi.org/10.1016/j.autneu.2016.07.003 CrossRefPubMed

Wintner LM, Sztankay M, Aaronson N, Bottomley A, Giesinger JM, Groenvold M, Petersen MA, van de Poll-Franse L, Velikova G, Verdonck-de Leeuw I, Holzner B (2016) The use of EORTC measures in daily clinical practice—a synopsis of a newly developed manual. Eur J Cancer 68:73–81. https://doi.org/10.1016/j.ejca.2016.08.024 CrossRefPubMed

Johnsen AT, Tholstrup D, Petersen MA, Pedersen L, Groenvold M (2009) Health related quality of life in a nationally representative sample of haematological patients. Eur J Haematol 83(2):139–148. https://doi.org/10.1111/j.1600-0609.2009.01250.x CrossRefPubMedPubMedCentral

Johnsen AT, Petersen MA, Pedersen L, Groenvold M (2009) Symptoms and problems in a nationally representative sample of advanced cancer patients. Palliat Med 23(6):491–501. https://doi.org/10.1177/0269216309105400 CrossRefPubMed

American Joint Committee on Cancer (2002) AJCC cancer staging manual. In: Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M (ed). Springer, New York

Johnsen AT, Petersen MA, Pedersen L, Houmann LJ, Groenvold M (2013) Do advanced cancer patients in Denmark receive the help they need? A nationally representative survey of the need related to 12 frequent symptoms/problems. Psychooncology 22(8):1724–1730. https://doi.org/10.1002/pon.3204 CrossRefPubMed

10.

Johnsen AT, Petersen MA, Snyder CF, Pedersen L, Groenvold M (2016) How does pain experience relate to the need for pain relief? A secondary exploratory analysis in a large sample of cancer patients. Support Care Cancer 24(10):4187–4195. https://doi.org/10.1007/s00520-016-3246-7 CrossRefPubMed

11.

Madsen UR, Groenvold M, Petersen MA, Johnsen AT (2015) Comparing three different approaches to the measurement of needs concerning fatigue in patients with advanced cancer. Qual Life Res 24(9):2231–2238. https://doi.org/10.1007/s11136-015-0962-2 CrossRefPubMed

12.

AN FPM, Bjordal K, Groenvold M, Curran D, Bottomley A, on behalf of the EORTC Quality of Life Group (2001) The EORTC QLQ-C30 Scoring Manual, 3rd edn. European Organisation for Research and Treatment of Cancer, Brussels

13.

Looney SW, Hagan JL (2015) Analysis of biomarker data. John Wiley & Sons, Incorporated, Somerset

14.

Gupta M, Sahi MS, Bhargava A, Talwar V (2016) A prospective evaluation of symptom prevalence and overall symptom burden among cohort of critically ill cancer patients. Indian J Palliat Care 22(2):118–124. https://doi.org/10.4103/0973-1075.179601 CrossRefPubMedPubMedCentral

15.

Laugsand EA, Sprangers MA, Bjordal K, Skorpen F, Kaasa S, Klepstad P (2010) Health care providers underestimate symptom intensities of cancer patients: a multicenter European study. Health Qual Life Outcomes 8:104. https://doi.org/10.1186/1477-7525-8-104 CrossRefPubMedPubMedCentral

16.

Seow H, Barbera L, Sutradhar R, Howell D, Dudgeon D, Atzema C, Liu Y, Husain A, Sussman J, Earle C (2011) Trajectory of performance status and symptom scores for patients with cancer during the last six months of life. J Clin Oncol 29(9):1151–1158. https://doi.org/10.1200/jco.2010.30.7173 CrossRefPubMed

17.

Kirkova J, Rybicki L, Walsh D, Aktas A (2012) Symptom prevalence in advanced cancer: age, gender, and performance status interactions. Am J Hosp Palliat Care 29(2):139–145. https://doi.org/10.1177/1049909111410965 CrossRefPubMed

18.

Portenoy RK, Thaler HT, Kornblith AB, Lepore JM, Friedlander-Klar H, Kiyasu E, Sobel K, Coyle N, Kemeny N, Norton L et al (1994) The memorial symptom assessment scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30a(9):1326–1336CrossRefPubMed

19.

Sigurdardottir KR, Haugen DF (2008) Prevalence of distressing symptoms in hospitalised patients on medical wards: a cross-sectional study. BMC Palliat Care 7:16. https://doi.org/10.1186/1472-684x-7-16 CrossRefPubMedPubMedCentral

20.

Fainsinger R, Miller MJ, Bruera E, Hanson J, Maceachern T (1991) Symptom control during the last week of life on a palliative care unit. J Palliat Care 7(1):5–11PubMed

21.

Conill C, Verger E, Henriquez I, Saiz N, Espier M, Lugo F, Garrigos A (1997) Symptom prevalence in the last week of life. J Pain Symptom Manag 14(6):328–331CrossRef

22.

Delgado-Guay MO, Rodriguez-Nunez A, Shin SH, Chisholm G, Williams J, Frisbee-Hume S, Bruera E (2016) Characteristics and outcomes of patients with advanced cancer evaluated by a palliative care team at an emergency center. A retrospective study. Support Care Cancer 24(5):2287–2295. https://doi.org/10.1007/s00520-015-3034-9 CrossRefPubMed

23.

Jimenez A, Madero R, Alonso A, Martinez-Marin V, Vilches Y, Martinez B, Feliu M, Diaz L, Espinosa E, Feliu J (2011) Symptom clusters in advanced cancer. J Pain Symptom Manag 42(1):24–31. https://doi.org/10.1016/j.jpainsymman.2010.10.266 CrossRef

24.

Vainio A, Auvinen A (1996) Prevalence of symptoms among patients with advanced cancer: an international collaborative study. Symptom Prevalence Group. J Pain Symptom Manage 12(1):3–10CrossRefPubMed

25.

Bedard G, Zeng L, Zhang L, Lauzon N, Holden L, Tsao M, Danjoux C, Barnes E, Sahgal A, Poon M, Chow E (2014) Minimal important differences in the EORTC QLQ-C30 in patients with advanced cancer. Asia Pac J Clin Oncol 10(2):109–117. https://doi.org/10.1111/ajco.12070 CrossRef

26.

Arraras JI, de la Vega FA, Asin G, Rico M, Zarandona U, Eito C, Cambra K, Barrondo M, Errasti M, Verdun J, Rivadeneira J, Dominguez MA (2014) The EORTC QLQ-C15-PAL questionnaire: validation study for Spanish bone metastases patients. Qual Life Res 23(3):849–855. https://doi.org/10.1007/s11136-013-0511-9 CrossRefPubMed

27.

Raman S, Ding K, Chow E, Meyer RM, van der Linden YM, Roos D, Hartsell WF, Hoskin P, Wu JSY, Nabid A, Haas R, Wiggenraad R, Babington S, Demas WF, Wilson CF, Wong RKS, Zhu L, Brundage M (2017) Minimal clinically important differences in the EORTC QLQ-C30 and brief pain inventory in patients undergoing re-irradiation for painful bone metastases. Qual Life Res 27:1089–1098. https://doi.org/10.1007/s11136-017-1745-8 CrossRefPubMed

28.

Cotogni P, De Carli L, Passera R, Amerio ML, Agnello E, Fadda M, Ossola M, Monge T, De Francesco A, Bozzetti F (2017) Longitudinal study of quality of life in advanced cancer patients on home parenteral nutrition. Cancer Med 6(7):1799–1806. https://doi.org/10.1002/cam4.1111 CrossRefPubMedPubMedCentral

29.

Groenvold M, Petersen MA, Damkier A, Neergaard MA, Nielsen JB, Pedersen L, Sjogren P, Stromgren AS, Vejlgaard TB, Gluud C, Lindschou J, Fayers P, Higginson IJ, Johnsen AT (2017) Randomised clinical trial of early specialist palliative care plus standard care versus standard care alone in patients with advanced cancer: the Danish palliative care trial. Palliat Med 269216317705100:814–824. https://doi.org/10.1177/0269216317705100 CrossRef

30.

Laird BJ, Fallon M, Hjermstad MJ, Tuck S, Kaasa S, Klepstad P, McMillan DC (2016) Quality of life in patients with advanced cancer: differential association with performance status and systemic inflammatory response. J Clin Oncol 34(23):2769–2775. https://doi.org/10.1200/jco.2015.65.7742 CrossRefPubMedPubMedCentral

31.

Walsh D, Donnelly S, Rybicki L (2000) The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Support Care Cancer 8(3):175–179CrossRefPubMed

32.

Morrison EJ, Novotny PJ, Sloan JA, Yang P, Patten CA, Ruddy KJ, Clark MM (2017) Emotional problems, quality of life, and symptom burden in patients with lung cancer. Clin Lung Cancer 18:497–503. https://doi.org/10.1016/j.cllc.2017.02.008 CrossRefPubMed

33.

Sugimura H, Yang P (2006) Long-term survivorship in lung cancer: a review. Chest 129(4):1088–1097. https://doi.org/10.1378/chest.129.4.1088 CrossRefPubMed

Title: Nausea in advanced cancer: relationships between intensity, burden, and the need for help
Authors: Signe Ladegaard Harder
Mogens Groenvold
Jørn Herrstedt
Anna Thit Johnsen
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 1/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4326-7

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