Cancer Symptom Cluster Management

Abstract

Objectives To discuss the importance of cancer symptom clusters in clinical practice, review evidence for symptom cluster interventions, and make recommendations for symptom cluster identification, patient education, and management in clinical practice. Data Sources Primary research and review articles identified through CINAHL, PubMed, and PsycINFO databases. Conclusions Several studies have investigated interventions for multi-symptom management, or have evaluated the secondary effects of a single-symptom intervention on related symptoms. To date, only five studies have tested an intervention designed to manage a specific cancer symptom cluster. Those studies used non-pharmacologic approaches (psycho-education, cognitive-behavioral strategies, and acupressure) to address the pain, fatigue, and sleep disturbance symptom cluster, or the respiratory distress symptom cluster with some initial evidence of success. Further development and efficacy testing of symptom cluster interventions is needed. Implications for Nursing Practice Clinical practice can be guided by knowledge of individual and multi-symptom management, and clinical judgment regarding possible etiologies of cancer symptom clusters. Clinicians should be aware of co-occurring symptoms in their patients, educate and involve patients in identifying symptom clusters and aggravating / alleviating factors, and coordinate treatment recommendations using strategies that are likely to be beneficial across symptoms.

Relationship among symptom clusters, quality of life, and treatment-specific optimism in patients with cancer

“…These clusters conform to findings of recent international studies, which frequently report SCs of identical or very similar composition [34], except for the cancer therapy-related SC. However, because composition of these clusters may vary by factors such as diagnoses and treatment modalities [8], distinct but varying sets of specific treatment-related SCs are to be expected rather than consistent therapy-related SCs across study populations.…”

“…A symptom cluster (SC) is defined as two or more interrelated symptoms that occur concurrently and may or may not share the same etiology [7]. For example, nausea-vomiting and anxiety-depression SCs are commonly identified in cancer research [5], calling for thorough assessment of co-occurring symptoms and coordinated symptom management strategies to prevent negative outcomes such as poor quality of life [8]. …”

Acupuncture for Management of Symptom Clusters in a Patient with Metastatic Breast Cancer: A Case Report

“…[3] Different interventions for treating cancer symptom clusters include exercise-based multimodal interventions, analgesic imagery, cognitivebehavioral therapy, and acupressure and acupuncture-and are still being developed. [4,5] In this case report, we report how one patient's symptoms of fatigue, joint pain, and insomniasymptoms within this common symptom cluster-are treated and alleviated by acupuncture.…”

“…Over the recent decades, acupuncture has been recognized and increasingly been used as a non-pharmacological intervention for variety of cancer-associated symptoms in the United States. [1][2][3][4][5] Here we present a case to illustrate the use of acupuncture in a 35-year-old female with metastatic breast cancer who presented to the UCLA Center for East-West Medicine (CEWM) with physical and psychological symptom clusters of insomnia, anxiety, and joint pain.…”

Sensory changes and lipoprotein ratios in patients with brain cancers during cancer‐related therapy: A prospective cross‐sectional study

“…However, little is known about the symptoms of patients who undergo CRT. Patients with other types of cancer, such as breast, lung, colon, or gastric cancer, experience various unpleasant symptoms during CRT (Argyriou et al, 2014;Kwekkeboom, 2017;Thomas et al, 2014).…”