Association between symptom burdens with delayed medical presentation and treatment in Indonesian cancer patients

Abstract

Background: Cancer and its therapy produce various symptoms that may have an impact on the patients' lives and cause significant burdens. Late presentations to medical care and delays in treatments are factors that may lead from a cancer progression to a more advanced stage and hence a poorer prognosis. It is important for healthcare providers to understand the patients' symptom burdens in order to improve the physical and psychological well-being of the patients. The aim of this study is to identify the association between patient delay (PD) and treatment delay (TD) with symptom burdens in Indonesia cancer patients. Methods: This is a cross sectional study that took place in Siloam General Hospital, Tangerang, a suburban area in Indonesia from July 2016 to January 2017. The samples included in this study were solid cancer patients. Symptom burden was assessed using Memorial Symptom Assessment Scale-Short Form (MSAS-SF) questionnaire. Patients were classified as PD if the time from first symptom to medical presentation is more than 3 months and classified as TD if the time from first diagnosis by a medical professional to medical treatment is more than 1 month. Analysis was done using Students' T-test or Mann-Whitney. Results: A total of 56 patients were included in our study, out of which 50 (89.3%) were female. The mean age of the patients was 48.6 610.9 years. Breast cancer was the most common type of cancer (76.7%), followed by adenocarcinoma of the colon (8.9%). PD and TD were present in 24 (42.9%) and 21 (37.5%) patients respectively. PD had significant association with global distress index subscale (p ¼ 0.017) and total score of symptom burden (p ¼ 0.026). TD had significant association with global distress index (p: 0.024) subscale, physical symptom subscale (p: 0.024) and total score of symptom burden (p ¼ 0.022). Conclusions: Patient delay and treatment delay were associated with higher levels of symptom burden in Indonesian cancer patients.