Perceived stress is associated with a higher symptom burden in cancer survivors

Abstract

Background Although multiple co‐occurring symptoms are a significant problem for cancer survivors, to the authors' knowledge little is known regarding the phenotypic characteristics associated with a higher symptom burden. The objectives of the current study were to evaluate the occurrence, severity, and distress associated with 32 symptoms and examine the phenotypic and stress characteristics associated with a higher symptom burden. Methods A total of 623 cancer survivors completed a demographic questionnaire, as well as measures of functional status, comorbidity, and global (Perceived Stress Scale) and cancer‐related (Impact of Event Scale–Revised) stress. The Memorial Symptom Assessment Scale was used to evaluate symptom burden. Multiple linear regression analysis was used to determine the phenotypic characteristics associated with a higher symptom burden. Results The mean number of symptoms was 9.1 (±5.2). The most common, severe, and distressing symptoms were lack of energy, problems with sexual interest/activity, and hair loss, respectively. Poorer functional status, a higher level of comorbidity, and a history of smoking as well as higher Perceived Stress Scale and Impact of Event Scale–Revised scores were associated with a higher symptom burden. The overall model explained approximately 45.6% of the variance in symptom burden. Conclusions Although cancer survivors report a high number of co‐occurring symptoms of moderate severity and distress, in the current study, no disease or treatment characteristics were found to be associated with a higher symptom burden. Clinicians need to assess for general and disease‐specific stressors and provide referrals for stress management interventions. Future studies need to examine the longitudinal relationships among symptom burden, functional status, and level of comorbidity, as well as the mechanisms that underlie the associations between stress and symptom burden.

Acupuncture versus cognitive behavioral therapy for pain among cancer survivors with insomnia: an exploratory analysis of a randomized clinical trial

“…Epidemiology studies corroborate the bidirectional relationship between pain and insomnia, where pain affects sleep onset and maintenance, and sleep impairments may further exacerbate pain 6,7 . Pain and insomnia also contribute to the progression of fatigue and mental distress that further worsen symptom burden, leading to poor quality of life [8][9][10] . In breast cancer patients, pain and psychological symptoms like insomnia and depression are associated with early discontinuation and non-adherence to adjuvant hormonal therapy and, consequently, poor clinical prognosis [11][12][13][14] .…”

Using Shared Medical Appointments for Delivering Patient-Centered Care to Cancer Survivors: A Feist-Weiller Cancer Center Pilot Study

“…Additionally, patients also endorsed a perceived improvement in appetite (21 of 39, 53.8%) and pain (14 of 39, 35.9%). It is well known that despite the advancements in interventions targeting symptom management, cancer survivors continue to deal with a high burden of symptoms ( 18 ). In a large retrospective study that included 4,903 cancer survivors, 4,512 patients (92%) reported having symptoms related to their cancer or anti-cancer therapy 1 year after therapy ( 19 ).…”

Newly diagnosed patients with advanced non-small cell lung cancer: A clinical description of those with moderate to severe depressive symptoms

“…Descriptive statistics, including frequencies, means, standard deviations, and ranges, were used to summarize all sociodemographic and disease-related characteristics and measure responses. To determine depressive symptom severity groups, established cut-offs for the PHQ-9 were used [33]: none/mild (1-7), moderate (8)(9)(10)(11)(12)(13)(14), and severe (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). Analyses tested the hypothesis that overall group differences would be found, with negative functioning/symptoms outcomes ordered such that severe > moderate > none/mild.…”

“…A meta-analytic study revealed stress assessed at some time after lung cancer diagnosis to heighten risk for premature cancer death (n = 23 studies; hazard ratio = 1.17; 95 % CI = 1.03-1.34) [20]. Potential contributors to the latter effects are the covariation of heightened stress with physical symptom exacerbation [21][22][23][24][25][26] and depressive symptoms [23,27].…”