Cancer Symptom Clusters: Clinical and Research Methodology

Kirkova, Jordanka; Aktaş, Aynur; Walsh, Declan; Davis, Mellar P.

doi:10.1089/jpm.2010.0507

Cited by 110 publications

(112 citation statements)

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“…Following the challenge from the Symptom Management Research Group at the University of California, San Francisco, to the scientific community to consider the concept of a "symptom cluster" (17) and the publication of a state of the science lecture on symptom cluster research in oncology patients (18), a number of review articles have examined the conceptual and methodological issues associated with defining the characteristics of a symptom cluster (19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Three topics were the foci for the discussion of the "state of the science" in the area of defining characteristics of symptom clusters, namely conceptual issues, empiric identification of symptom clusters, and changes in symptom clusters over time.…”

Section: State Of the Sciencementioning

confidence: 99%

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Miaskowski

Barsevick

Berger

et al. 2017

JNCI J Natl Cancer Inst

326

330

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An overview of proceedings, findings, and recommendations from the workshop on "Advancing Symptom Science Through Symptom Cluster Research" sponsored by the National Institute of Nursing Research (NINR) and the Office of Rare Diseases Research, National Center for Advancing Translational Sciences, is presented. This workshop engaged an expert panel in an evidenced-based discussion regarding the state of the science of symptom clusters in chronic conditions including cancer and other rare diseases. An interdisciplinary working group from the extramural research community representing nursing, medicine, oncology, psychology, and bioinformatics was convened at the National Institutes of Health. Based on expertise, members were divided into teams to address key areas: defining characteristics of symptom clusters, priority symptom clusters and underlying mechanisms, measurement issues, targeted interventions, and new analytic strategies. For each area, the evidence was synthesized, limitations and gaps identified, and recommendations for future research delineated. The majority of findings in each area were from studies of oncology patients. However, increasing evidence suggests that symptom clusters occur in patients with other chronic conditions (eg, pulmonary, cardiac, and end-stage renal disease). Nonetheless, symptom cluster research is extremely limited and scientists are just beginning to understand how to investigate symptom clusters by developing frameworks and new methods and approaches. With a focus on personalized care, an understanding of individual susceptibility to symptoms and whether a "driving" symptom exists that triggers other symptoms in the cluster is needed. Also, research aimed at identifying the mechanisms that underlie symptom clusters is essential to developing targeted interventions.Patients with chronic conditions, such as cancer and other rare diseases, experience an array of multiple co-occurring symptoms (eg, pain, fatigue, sleep disturbance). When these symptoms remain underdiagnosed and undertreated, they have a negative impact on patient-reported outcomes (PROs) including functional performance, cognitive status, and quality of life (QOL). A reduction in symptom burden in these patients has the potential to improve their capacity to live well over their entire lives. To achieve this goal, a transformation is needed in how multiple co-occurring symptoms are assessed and managed in order to improve patient outcomes and stimulate a reduction in health care utilization and costs. A strategic plan that advances REVIEW

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Section: State Of the Sciencementioning

confidence: 99%

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Miaskowski

Barsevick

Berger

et al. 2017

JNCI J Natl Cancer Inst

326

330

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“…They were not able to correlate symptoms with disease stage or separate treatment related symptoms from cancer related symptoms (Kirkova et al, 2011a). However, a comprehensive clinical review of cancer symptom clusters showed that disease and treatment related symptoms are influenced by primary cancer site, disease stage and antitumor treatment (Kirkova et al, 2011b).…”

Section: Introductionmentioning

confidence: 96%

Symptoms in the cancer patient – Of importance for their caregivers' quality of life and mental health?

Valeberg

Grov

2013

European Journal of Oncology Nursing

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Subtitle: Cancer patients' symptoms affecting caregivers' quality of life and mental health Results:The main result showed that the symptom burden was close to equal when we compared the cancer patients in the palliative and the curative phase respectively. The whole sample of patients seemed extremely tired because they score high on items capturing fatigue or weakness. They also had problems with pain and constipation. For patients having trouble sleeping, the caregivers' reported higher level of depression, whilst caregivers' gender had impact on the caregivers' anxiety. The younger the patients the more impact on caregivers' QOL mental health. Conclusion:In this study no significant differences were revealed when comparing symptom burden among cancer patients in different stages of the disease. Caregivers reported more depression when patients had trouble sleeping and more declined mental quality of life when patients were younger. Female caregivers reported more anxiety than male caregivers.

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“…CRF is sometimes described as part of a cluster of symptoms together with anorexia, depression, and/or pain [6]. However, this is done mainly by cluster analysis of symptoms mentioned in literature, and clinical relevance has not yet been proven [6].…”

Section: Introductionmentioning

confidence: 99%

Aiming for a Better Understanding and Management of Cancer-Related Fatigue

Neefjes

Vorst

Blauwhoff‐Buskermolen

et al. 2013

The Oncologist

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Cancer-related fatigue (CRF) is a serious symptom of patients with cancer and deteriorates their daily quality of life. Whereas fatigue is a common problem in the general population, with a prevalence of about 30%, up to 99% of patients with cancer have fatigue of more intense severity. CRF is directly related to the biology of cancer, but it can also be caused by anticancer treatment. We reviewed current evidence about the potential pathophysiological mechanisms causing CRF. Clinical methods to determine the presence and severity of CRF and potential treatment options to reduce CRF will be discussed. After reading this review, the reader will have knowledge of the current understanding of CRF and will be able to give evidence-based advice to patients with CRF. The Oncologist 2013;18:1135-1143Implications for Practice: Cancer-related fatigue (CRF) is a common problem in patients with cancer and has a major impact on quality of life. The causes of CRF are multifactorial and not fully understood. To get a better insight into the underlying mechanisms and the potential treatment possibilities of CRF, we provide an overview of currently available literature on this subject. Because current treatment options other than antitumor therapy for some of the patients are scarce and only directed at symptoms, further investigation of CRF is warranted to develop rational treatment options.

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Cancer Symptom Clusters: Clinical and Research Methodology

Cited by 110 publications

References 100 publications

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Symptoms in the cancer patient – Of importance for their caregivers' quality of life and mental health?

Aiming for a Better Understanding and Management of Cancer-Related Fatigue

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