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Published in: Supportive Care in Cancer 9/2019

01-09-2019 | Care | Original Article

Neuropathic symptoms, physical and emotional well-being, and quality of life at the end of life

Authors: Cindy Tofthagen, Constance Visovsky, Sara Dominic, Susan McMillan

Published in: Supportive Care in Cancer | Issue 9/2019

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Abstract

The purpose of this cross-sectional, descriptive study was to assess differences in neuropathic symptoms, physical and emotional well-being, and quality of life in cancer patients at the end of life compared to those without neuropathic symptoms. Neuropathic symptoms were defined as numbness and tingling in the hands and/or feet. A secondary analysis of data from two hospices in Central Florida was performed. Adults (n = 717) with a cancer diagnosis, an identified family caregiver, and who were receiving hospice services, were eligible. The prevalence of numbness/tingling in the hands or feet was 40% in this sample of hospice patients with cancer. Participants with neuropathic symptoms of numbness/tingling had a significantly higher prevalence of pain (76.7% vs. 67.0%; p = .006), difficulty with urination (29.4% vs. 20.3%; p = .007), shortness of breath (64.9% vs. 54.1%; p = .005), dizziness/lightheadedness (46.0% vs. 28.2%; p < .001), sweats (35.5% vs. 20.3%; p < .001), worrying (50.7% vs. 37.3%; p = .001), feeling irritable (38.5% vs. 28.7%; p = .008), feeling sad (48.2% vs. 37.8%; p = .008), and difficulty concentrating (46.2% vs. 32.5%; p < .001). They also reported significantly higher overall symptom intensity and symptom distress scores (p = < .001), higher pain severity (p = .001) and pain distress (p = .002), and decreased quality of life (p = .002) compared to those without numbness/tingling. Neuropathic symptoms are emotionally distressing at the end of life and associated with higher symptom burden and diminished quality of life.
Literature
1.
go back to reference Anderson F, Downing GM, Hill J, Casorso L, Lerch N (1996) Palliative performance scale (PPS): a new tool. J Palliat Care 12:5–11CrossRefPubMed Anderson F, Downing GM, Hill J, Casorso L, Lerch N (1996) Palliative performance scale (PPS): a new tool. J Palliat Care 12:5–11CrossRefPubMed
2.
go back to reference Bao T, Basal C, Seluzicki C, Li SQ, Seidman AD, Mao JJ (2016) Long-term chemotherapy-induced peripheral neuropathy among breast cancer survivors: prevalence, risk factors, and fall risk. Breast Cancer Res Treat 159:327–333CrossRefPubMedPubMedCentral Bao T, Basal C, Seluzicki C, Li SQ, Seidman AD, Mao JJ (2016) Long-term chemotherapy-induced peripheral neuropathy among breast cancer survivors: prevalence, risk factors, and fall risk. Breast Cancer Res Treat 159:327–333CrossRefPubMedPubMedCentral
3.
go back to reference Beijers A, Mols F, Dercksen W, Driessen C, Vreugdenhil G (2014) Chemotherapy-induced peripheral neuropathy and impact on quality of life 6 months after treatment with chemotherapy. J Community Support Oncol 12:401–406CrossRefPubMed Beijers A, Mols F, Dercksen W, Driessen C, Vreugdenhil G (2014) Chemotherapy-induced peripheral neuropathy and impact on quality of life 6 months after treatment with chemotherapy. J Community Support Oncol 12:401–406CrossRefPubMed
4.
go back to reference Beijers AJ, Vreugdenhil G, Oerlemans S, Eurelings M, Minnema MC, Eeltink CM, van de Poll-Franse LV, Mols F (2016) Chemotherapy-induced neuropathy in multiple myeloma: influence on quality of life and development of a questionnaire to compose common toxicity criteria grading for use in daily clinical practice. Support Care Cancer 24:2411–2420CrossRefPubMed Beijers AJ, Vreugdenhil G, Oerlemans S, Eurelings M, Minnema MC, Eeltink CM, van de Poll-Franse LV, Mols F (2016) Chemotherapy-induced neuropathy in multiple myeloma: influence on quality of life and development of a questionnaire to compose common toxicity criteria grading for use in daily clinical practice. Support Care Cancer 24:2411–2420CrossRefPubMed
5.
go back to reference Brundage M, Gropp M, Mefti F, Mann K, Lund B, Gebski V, Wolfram G, Reed N, Pignata S, Ferrero A, Brown C, Eisenhauer E, Pujade-Lauraine E (2012) Health-related quality of life in recurrent platinum-sensitive ovarian cancer--results from the CALYPSO trial. Annals of oncology : official journal of the European Society for Medical Oncology 23:2020–2027CrossRef Brundage M, Gropp M, Mefti F, Mann K, Lund B, Gebski V, Wolfram G, Reed N, Pignata S, Ferrero A, Brown C, Eisenhauer E, Pujade-Lauraine E (2012) Health-related quality of life in recurrent platinum-sensitive ovarian cancer--results from the CALYPSO trial. Annals of oncology : official journal of the European Society for Medical Oncology 23:2020–2027CrossRef
6.
go back to reference Centers for Medicare & Medicaid Services (2008 ) Minimum data set version 2.0 for nursing home resident assessment and care screening. In: Editor (ed)^(eds) Book Minimum Data Set Version 2.0 for Nursing Home Resident Assessment and Care creening. CMS, City Centers for Medicare & Medicaid Services (2008 ) Minimum data set version 2.0 for nursing home resident assessment and care screening. In: Editor (ed)^(eds) Book Minimum Data Set Version 2.0 for Nursing Home Resident Assessment and Care creening. CMS, City
7.
go back to reference Chan CS, Slaughter SE, Jones CA, Wagg AS (2015) Greater independence in activities of daily living is associated with higher health-related quality of life scores in nursing home residents with dementia. Healthcare (Basel, Switzerland) 3:503–518 Chan CS, Slaughter SE, Jones CA, Wagg AS (2015) Greater independence in activities of daily living is associated with higher health-related quality of life scores in nursing home residents with dementia. Healthcare (Basel, Switzerland) 3:503–518
8.
go back to reference Chowdhury D, Patel N (2006) Approach to a case of autonomic peripheral neuropathy. J Assoc Physicians India 54:727–732PubMed Chowdhury D, Patel N (2006) Approach to a case of autonomic peripheral neuropathy. J Assoc Physicians India 54:727–732PubMed
9.
go back to reference Driessen CM, de Kleine-Bolt KM, Vingerhoets AJ, Mols F, Vreugdenhil G (2012) Assessing the impact of chemotherapy-induced peripheral neurotoxicity on the quality of life of cancer patients: the introduction of a new measure. Support Care Cancer 20:877–881CrossRefPubMed Driessen CM, de Kleine-Bolt KM, Vingerhoets AJ, Mols F, Vreugdenhil G (2012) Assessing the impact of chemotherapy-induced peripheral neurotoxicity on the quality of life of cancer patients: the introduction of a new measure. Support Care Cancer 20:877–881CrossRefPubMed
10.
go back to reference Ezendam NP, Pijlman B, Bhugwandass C, Pruijt JF, Mols F, Vos MC, Pijnenborg JM, van de Poll-Franse LV (2014) Chemotherapy-induced peripheral neuropathy and its impact on health-related quality of life among ovarian cancer survivors: results from the population-based PROFILES registry. Gynecol Oncol 135:510–517CrossRefPubMed Ezendam NP, Pijlman B, Bhugwandass C, Pruijt JF, Mols F, Vos MC, Pijnenborg JM, van de Poll-Franse LV (2014) Chemotherapy-induced peripheral neuropathy and its impact on health-related quality of life among ovarian cancer survivors: results from the population-based PROFILES registry. Gynecol Oncol 135:510–517CrossRefPubMed
11.
go back to reference Ghose A, Tariq Z, Taj A, Chaudhary R (2011) Acute dyspnea from treatment of AL amyloidisis with bortezomib. Am J Ther 18:e123–e125CrossRefPubMed Ghose A, Tariq Z, Taj A, Chaudhary R (2011) Acute dyspnea from treatment of AL amyloidisis with bortezomib. Am J Ther 18:e123–e125CrossRefPubMed
12.
go back to reference Hershman DL, Lacchetti C, Dworkin RH, Lavoie Smith EM, Bleeker J, Cavaletti G, Chauhan C, Gavin P, Lavino A, Lustberg MB, Paice J, Schneider B, Smith ML, Smith T, Terstriep S, Wagner-Johnston N, Bak K, Loprinzi CL, American Society of Clinical O (2014) Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 32:1941–1967CrossRefPubMed Hershman DL, Lacchetti C, Dworkin RH, Lavoie Smith EM, Bleeker J, Cavaletti G, Chauhan C, Gavin P, Lavino A, Lustberg MB, Paice J, Schneider B, Smith ML, Smith T, Terstriep S, Wagner-Johnston N, Bak K, Loprinzi CL, American Society of Clinical O (2014) Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 32:1941–1967CrossRefPubMed
13.
go back to reference Hong JS, Tian J, Wu LH (2014) The influence of chemotherapy-induced neurotoxicity on psychological distress and sleep disturbance in cancer patients. Curr Oncol 21:174–180CrossRefPubMedPubMedCentral Hong JS, Tian J, Wu LH (2014) The influence of chemotherapy-induced neurotoxicity on psychological distress and sleep disturbance in cancer patients. Curr Oncol 21:174–180CrossRefPubMedPubMedCentral
14.
go back to reference Hwang KH, Cho OH, Yoo YS (2016) Symptom clusters of ovarian cancer patients undergoing chemotherapy, and their emotional status and quality of life. Eur J Oncol Nurs 21:215–222CrossRefPubMed Hwang KH, Cho OH, Yoo YS (2016) Symptom clusters of ovarian cancer patients undergoing chemotherapy, and their emotional status and quality of life. Eur J Oncol Nurs 21:215–222CrossRefPubMed
15.
go back to reference Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW (1963) Studies of illness in the aged. The index of Adl: a standardized measure of biological and psychosocial function. JAMA 185:914–919CrossRefPubMed Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW (1963) Studies of illness in the aged. The index of Adl: a standardized measure of biological and psychosocial function. JAMA 185:914–919CrossRefPubMed
16.
go back to reference Kim KY, Lee SH, Kim JH, Oh PJ (2015) Disturbance in ADL from chemotherapy-induced peripheral neuropathy and quality of life in cancer patients: the mediating effect of psychological distress. J Korean Acad Nurs 45:661–670CrossRefPubMed Kim KY, Lee SH, Kim JH, Oh PJ (2015) Disturbance in ADL from chemotherapy-induced peripheral neuropathy and quality of life in cancer patients: the mediating effect of psychological distress. J Korean Acad Nurs 45:661–670CrossRefPubMed
17.
go back to reference Knoerl R, Chornoby Z, Smith EML (2018) Estimating the frequency, severity, and clustering of SPADE symptoms in chronic painful chemotherapy-induced peripheral neuropathy. Pain Manag Nurs 19:354–365CrossRefPubMed Knoerl R, Chornoby Z, Smith EML (2018) Estimating the frequency, severity, and clustering of SPADE symptoms in chronic painful chemotherapy-induced peripheral neuropathy. Pain Manag Nurs 19:354–365CrossRefPubMed
18.
go back to reference Lavoie Smith EM, Barton DL, Qin R, Steen PD, Aaronson NK, Loprinzi CL (2013) Assessing patient-reported peripheral neuropathy: the reliability and validity of the European Organization for Research and Treatment of Cancer QLQ-CIPN20 Questionnaire. Qual Life Res 22:2787–2799CrossRefPubMedPubMedCentral Lavoie Smith EM, Barton DL, Qin R, Steen PD, Aaronson NK, Loprinzi CL (2013) Assessing patient-reported peripheral neuropathy: the reliability and validity of the European Organization for Research and Treatment of Cancer QLQ-CIPN20 Questionnaire. Qual Life Res 22:2787–2799CrossRefPubMedPubMedCentral
19.
go back to reference McMillan SC, Mahon M (1994) Measuring quality of life in hospice patients using a newly developed Hospice Quality of Life Index. Qual Life Res 3:437–447CrossRefPubMed McMillan SC, Mahon M (1994) Measuring quality of life in hospice patients using a newly developed Hospice Quality of Life Index. Qual Life Res 3:437–447CrossRefPubMed
20.
go back to reference McMillan SC, Small BJ (2002) Symptom distress and quality of life in patients with cancer newly admitted to hospice home care. Oncol Nurs Forum 29:1421–1428CrossRefPubMed McMillan SC, Small BJ (2002) Symptom distress and quality of life in patients with cancer newly admitted to hospice home care. Oncol Nurs Forum 29:1421–1428CrossRefPubMed
21.
go back to reference McMillan SC, Weitzner M (1998) Quality of life in cancer patients: use of a revised Hospice Index. Cancer Pract 6:282–288CrossRefPubMed McMillan SC, Weitzner M (1998) Quality of life in cancer patients: use of a revised Hospice Index. Cancer Pract 6:282–288CrossRefPubMed
23.
go back to reference Mohammed J, Meeus M, Derom E, Da Silva H, Calders P (2015) Evidence for autonomic function and its influencing factors in subjects with COPD: a systematic review. Respir Care 60:1841–1851CrossRefPubMed Mohammed J, Meeus M, Derom E, Da Silva H, Calders P (2015) Evidence for autonomic function and its influencing factors in subjects with COPD: a systematic review. Respir Care 60:1841–1851CrossRefPubMed
24.
go back to reference Mols F, Beijers T, Lemmens V, van den Hurk CJ, Vreugdenhil G, van de Poll-Franse LV (2013) Chemotherapy-induced neuropathy and its association with quality of life among 2- to 11-year colorectal cancer survivors: results from the population-based PROFILES registry. J Clin Oncol 31:2699–2707CrossRefPubMed Mols F, Beijers T, Lemmens V, van den Hurk CJ, Vreugdenhil G, van de Poll-Franse LV (2013) Chemotherapy-induced neuropathy and its association with quality of life among 2- to 11-year colorectal cancer survivors: results from the population-based PROFILES registry. J Clin Oncol 31:2699–2707CrossRefPubMed
25.
go back to reference Mols F, Beijers AJ, Vreugdenhil G, Verhulst A, Schep G, Husson O (2015) Chemotherapy-induced peripheral neuropathy, physical activity and health-related quality of life among colorectal cancer survivors from the PROFILES registry. J Cancer surviv 9:512–522CrossRefPubMed Mols F, Beijers AJ, Vreugdenhil G, Verhulst A, Schep G, Husson O (2015) Chemotherapy-induced peripheral neuropathy, physical activity and health-related quality of life among colorectal cancer survivors from the PROFILES registry. J Cancer surviv 9:512–522CrossRefPubMed
26.
go back to reference Nho JH, Reul Kim S, Nam JH (2017) Symptom clustering and quality of life in patients with ovarian cancer undergoing chemotherapy. Eur J Oncol Nurs 30:8–14CrossRefPubMed Nho JH, Reul Kim S, Nam JH (2017) Symptom clustering and quality of life in patients with ovarian cancer undergoing chemotherapy. Eur J Oncol Nurs 30:8–14CrossRefPubMed
27.
go back to reference 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:1326–1336CrossRefPubMed 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:1326–1336CrossRefPubMed
28.
go back to reference Rha SY, Lee J (2017) Symptom clusters during palliative chemotherapy and their influence on functioning and quality of life. Support Care Cancer 25:1519–1527CrossRefPubMed Rha SY, Lee J (2017) Symptom clusters during palliative chemotherapy and their influence on functioning and quality of life. Support Care Cancer 25:1519–1527CrossRefPubMed
29.
go back to reference Shimozuma K, Ohashi Y, Takeuchi A, Aranishi T, Morita S, Kuroi K, Ohsumi S, Makino H, Katsumata N, Kuranami M, Suemasu K, Watanabe T, Hausheer FH (2012) Taxane-induced peripheral neuropathy and health-related quality of life in postoperative breast cancer patients undergoing adjuvant chemotherapy: N-SAS BC 02, a randomized clinical trial. Support Care Cancer 20:3355–3364CrossRefPubMed Shimozuma K, Ohashi Y, Takeuchi A, Aranishi T, Morita S, Kuroi K, Ohsumi S, Makino H, Katsumata N, Kuranami M, Suemasu K, Watanabe T, Hausheer FH (2012) Taxane-induced peripheral neuropathy and health-related quality of life in postoperative breast cancer patients undergoing adjuvant chemotherapy: N-SAS BC 02, a randomized clinical trial. Support Care Cancer 20:3355–3364CrossRefPubMed
30.
go back to reference Smith EM, Pang H, Cirrincione C, Fleishman S, Paskett ED, Ahles T, Bressler LR, Fadul CE, Knox C, Le-Lindqwister N, Gilman PB, Shapiro CL (2013) Effect of duloxetine on pain, function, and quality of life among patients with chemotherapy-induced painful peripheral neuropathy: a randomized clinical trial. Jama 309:1359–1367CrossRefPubMedPubMedCentral Smith EM, Pang H, Cirrincione C, Fleishman S, Paskett ED, Ahles T, Bressler LR, Fadul CE, Knox C, Le-Lindqwister N, Gilman PB, Shapiro CL (2013) Effect of duloxetine on pain, function, and quality of life among patients with chemotherapy-induced painful peripheral neuropathy: a randomized clinical trial. Jama 309:1359–1367CrossRefPubMedPubMedCentral
31.
go back to reference Smith EM, Campbell G, Tofthagen C, Kottschade L, Collins ML, Warton C, Ghosh B, Ronis DL, Mallory GA, Visovsky C (2014) Nursing knowledge, practice patterns, and learning preferences regarding chemotherapy-induced peripheral neuropathy. Oncol Nurs Forum 41:669–679CrossRefPubMed Smith EM, Campbell G, Tofthagen C, Kottschade L, Collins ML, Warton C, Ghosh B, Ronis DL, Mallory GA, Visovsky C (2014) Nursing knowledge, practice patterns, and learning preferences regarding chemotherapy-induced peripheral neuropathy. Oncol Nurs Forum 41:669–679CrossRefPubMed
32.
go back to reference Stubblefield MD, McNeely ML, Alfano CM, Mayer DK (2012) A prospective surveillance model for physical rehabilitation of women with breast cancer: chemotherapy-induced peripheral neuropathy. Cancer 118:2250–2260CrossRefPubMed Stubblefield MD, McNeely ML, Alfano CM, Mayer DK (2012) A prospective surveillance model for physical rehabilitation of women with breast cancer: chemotherapy-induced peripheral neuropathy. Cancer 118:2250–2260CrossRefPubMed
33.
go back to reference Tofthagen C (2010) Patient perceptions associated with chemotherapy-induced peripheral neuropathy. Clin J Oncol Nurs 14:E22–E28CrossRefPubMed Tofthagen C (2010) Patient perceptions associated with chemotherapy-induced peripheral neuropathy. Clin J Oncol Nurs 14:E22–E28CrossRefPubMed
34.
go back to reference Tofthagen C, McMillan SC (2010) Pain, neuropathic symptoms, and physical and mental well-being in persons with cancer. Cancer Nurs 33:437–444CrossRef Tofthagen C, McMillan SC (2010) Pain, neuropathic symptoms, and physical and mental well-being in persons with cancer. Cancer Nurs 33:437–444CrossRef
35.
go back to reference Tofthagen C, Donovan KA, Morgan MA, Shibata D, Yeh Y (2013) Oxaliplatin-induced peripheral neuropathy’s effects on health-related quality of life of colorectal cancer survivors. Support Care Cancer 21:3307–3313CrossRefPubMedPubMedCentral Tofthagen C, Donovan KA, Morgan MA, Shibata D, Yeh Y (2013) Oxaliplatin-induced peripheral neuropathy’s effects on health-related quality of life of colorectal cancer survivors. Support Care Cancer 21:3307–3313CrossRefPubMedPubMedCentral
36.
go back to reference Tranmer JE, Heyland D, Dudgeon D, Groll D, Squires-Graham M, Coulson K (2003) Measuring the symptom experience of seriously ill cancer and noncancer hospitalized patients near the end of life with the memorial symptom assessment scale. J Pain Symptom Manag 25:420–429CrossRef Tranmer JE, Heyland D, Dudgeon D, Groll D, Squires-Graham M, Coulson K (2003) Measuring the symptom experience of seriously ill cancer and noncancer hospitalized patients near the end of life with the memorial symptom assessment scale. J Pain Symptom Manag 25:420–429CrossRef
37.
go back to reference Ventzel L, Jensen AB, Jensen AR, Jensen TS, Finnerup NB (2016) Chemotherapy-induced pain and neuropathy: a prospective study in patients treated with adjuvant oxaliplatin or docetaxel. Pain 157:560–568CrossRefPubMed Ventzel L, Jensen AB, Jensen AR, Jensen TS, Finnerup NB (2016) Chemotherapy-induced pain and neuropathy: a prospective study in patients treated with adjuvant oxaliplatin or docetaxel. Pain 157:560–568CrossRefPubMed
38.
go back to reference Visovsky C, Collins M, Abbott L, Aschenbrenner J, Hart C (2007) Putting evidence into practice: evidence-based interventions for chemotherapy-induced peripheral neuropathy. Clin J Oncol Nurs 11:901–913CrossRefPubMed Visovsky C, Collins M, Abbott L, Aschenbrenner J, Hart C (2007) Putting evidence into practice: evidence-based interventions for chemotherapy-induced peripheral neuropathy. Clin J Oncol Nurs 11:901–913CrossRefPubMed
39.
go back to reference Winters-Stone KM, Horak F, Jacobs PG, Trubowitz P, Dieckmann NF, Stoyles S, Faithfull S (2017) Falls, functioning, and disability among women with persistent symptoms of chemotherapy-induced peripheral neuropathy. J Clin Oncol 35:2604–2612CrossRefPubMedPubMedCentral Winters-Stone KM, Horak F, Jacobs PG, Trubowitz P, Dieckmann NF, Stoyles S, Faithfull S (2017) Falls, functioning, and disability among women with persistent symptoms of chemotherapy-induced peripheral neuropathy. J Clin Oncol 35:2604–2612CrossRefPubMedPubMedCentral
Metadata
Title
Neuropathic symptoms, physical and emotional well-being, and quality of life at the end of life
Authors
Cindy Tofthagen
Constance Visovsky
Sara Dominic
Susan McMillan
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Keyword
Care
Published in
Supportive Care in Cancer / Issue 9/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4627-x

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