Symptom burden in cancer survivors 1 year after diagnosis

Abstract

Background Few studies have examined risk for severe symptoms during early cancer survivorship. Using baseline data from the American Cancer Society’s Study of Cancer Survivors-I, we examined cancer survivors with high symptom burden, identified risk factors associated with high symptom burden, and evaluated the impact of high symptom burden on health-related quality of life (HRQoL) 1 year post-diagnosis. Methods Participants were enrolled from 11 state cancer registries approximately 1 year after diagnosis and surveyed by telephone or mail. Outcomes measures were the Modified Rotterdam Symptom Checklist and Profile of Mood States-37 (to assess symptom burden) and the Satisfaction with Life Domains Scale-Cancer (to assess HRQoL). Results Of 4903 survivors, 4512 (92%) reported symptoms related to their cancer and/or its treatment. Two-step clustering yielded 2 sub-groups, one with low symptom burden (n=3113) and one with high symptom burden (n=1399). Variables associated with high symptom burden included metastatic cancer (odds ratio [OR], 2.05), number of comorbid conditions (OR, 1.76), remaining on active chemotherapy (OR, 1.93), younger age (OR, 2.31), lacking insurance/being underinsured (OR, 1.57), having lower income (OR, 1.61), being unemployed (OR, 1.27), or being less educated (OR, 1.29). Depression, fatigue, and pain had the greatest impact on HRQoL in survivors with high symptom burden, who also had lower HRQoL (P < .0001). Conclusions More than 1 in 4 cancer survivors had high symptom burden 1 year post-diagnosis, even after treatment termination. These results indicate a need for continued symptom monitoring and management in early posttreatment survivorship, especially for the underserved.

Supportive care needs and health-related quality of life among Chinese lung cancer survivors

“…In these domains, pain, fatigue, worry about treatment results and uncertainty about the future were the major issues that concerned respondents the most, consistent with a previous study's finding that fatigue and pain had the greatest impact on lowering HRQoL [20].…”

The effects of age, education, and treatment on physical, sexual and body concern symptoms among multimorbid, colorectal cancer survivors

“…Prior studies have reported an association between low education attainment and CRC-related psychosocial distress, 14 fear of cancer recurrence, 15 and post-treatment symptom burden. 16 This relationship may suggest less capacity to adapt to persistent physical symptoms and body-image issues, as time since diagnosis advances, among patients with lower education attainment. Higher rates of psychological distress among long-term cancer survivors with lower education attainment may also be a moderating factor for higher physical and body concern symptoms.…”

Setting the Bar: Developing Quality Measures and Education Programs to Define Evidence-Based, Patient-Centered, High-Quality Care

“…The measures set was tested in 42 pilot sites in 2012. Because cancer-and treatment-related symptoms may persist, in some cases, for years after therapy ends (Harrington, Hansen, Moskowitz, Todd, & Feuerstein, 2010;Shi et al, 2011), the first two measures seek evidence of continued assessment of and intervention for clinically significant levels of the symptoms noted in the BCC Measures (e.g., fatigue, psychosocial distress, sleep-wake disturbances) as well as pain, bone health, menopausal symptoms, peripheral neuropathy, and lymphedema, depending on the treatment received by the patient. Modeled, in part, on PEP recommendations summarizing the strength of the evidence for psycho-educational interventions and those from the Institute of Medicine's report From Cancer Patient to Cancer Survivor: Lost in Transition (Hewitt, Greenfield, & Stovall, 2006), the BCS-03 measure looks for documentation of education at the conclusion of treatment related to lymphedema risk, diet and exercise (to support attainment and maintenance of desirable body mass index [BMI] as well as for bone health), available community resources, and signs and symptoms of late effects or disease recurrence to report.…”