Symptom clusters and quality of life in breast cancer survivors after cancer treatment in a tertiary hospital in Korea

Nho, Ju-Hee; Kim, Sung Reul; Park, Min Ho; Kweon, Sun-Seog

doi:10.1111/ecc.12919

Cited by 33 publications

(25 citation statements)

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“…The included studies were published between 2005 and 2020. Of these 32 studies, 13 were cross‐sectional, 13–25 11 were longitudinal, 26–36 while the remaining eight involved a randomised clinical trial design 37–44 . Among these included studies, 16 involved the secondary analysis of the data of existing studies, 14,17,18,20,27,31,33–39,42–44 of which six were observational studies involving secondary analysis of data from randomised clinical trials 37–39,42–44 .…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies examining the symptom clusters reported by patients who had completed breast cancer treatment reported the clustering of fatigue and sleep disturbance 17,18,24,30,37,40,41,44 . Only two of these studies reported that pain was associated with this symptom cluster 30,37 .…”

Section: Resultsmentioning

confidence: 99%

“…The symptom cluster of depression‐anxiety (the Psychological Cluster) among breast cancer patients who had completed treatment was reported in 10 studies 19,20,23,24,30,32,34,36,40,42 . None of these studies showed that this cluster existed independently, except Chow et al, 32 who used hierarchical cluster analysis for symptom clustering.…”

Section: Resultsmentioning

confidence: 99%

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Symptom clusters experienced by breast cancer patients at various treatment stages: A systematic review

Law

et al. 2021

Cancer Medicine

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Breast cancer patients often experience symptoms that adversely affect their quality of life. It is understood that many of these symptoms tend to cluster together: while they might have different manifestations and occur during different phases of the disease trajectory, the symptoms often have a common aetiology that is a potential target for intervention. Understanding the symptom clusters associated with breast cancer might usefully inform the development of effective care plans for affected patients. The aim of this paper is to provide an updated systematic review of the known symptom clusters among breast cancer patients during and/or after cancer treatment. A search was conducted using five databases for studies reporting symptom clusters among breast cancer patients. The search yielded 32 studies for inclusion. The findings suggest that fatigue‐sleep disturbance and psychological symptom cluster (including anxiety, depression, nervousness, irritability, sadness, worry) are the most commonly‐reported symptom clusters among breast cancer patients. Further, the composition of symptom clusters tends to change across various stages of cancer treatment. While this review identified some commonalities, the different methodologies used to identify symptom clusters resulted in inconsistencies in symptom cluster identification. It would be useful if future studies could separately examine the symptom clusters that occur in breast cancer patients undergoing a particular treatment type, and use standardised instruments across studies to assess symptoms. The review concludes that further studies could usefully determine the biological pathways associated with various symptom clusters, which would inform the development of effective and efficient symptom management strategies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Symptom clusters experienced by breast cancer patients at various treatment stages: A systematic review

Law

et al. 2021

Cancer Medicine

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“…Finally, while our focus was on the specific combination of pain, fatigue and depression among prostate cancer survivors, clusters of different combinations of symptoms among survivors of other cancers have been reported [see, e.g. [51][52][53][54]. Prostate cancer survivors are at risk of a wide range of symptoms as a result of their cancer and its treatment [6,55] and, while it was not our intention to explore which symptoms cooccur among prostate cancer survivors, research to investigate this would be valuable.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Pain, fatigue and depression symptom cluster in survivors of prostate cancer

Baden

Drummond

et al. 2020

Support Care Cancer

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Purpose Pain, fatigue and depression are common sequelae of a cancer diagnosis. The extent to which these occur together in prostate cancer survivors is unknown. We (i) investigated prevalence of the pain-fatigue-depression symptom cluster and (ii) identified factors associated with experiencing the symptom cluster among prostate cancer survivors. Methods Men in Ireland diagnosed with prostate cancer 2-18 years previously were identified from population-based cancer registries and sent postal questionnaires. Cancer-related pain and fatigue were measured using the EORTC QLQ-C30 and depression using the DASS-21. Cut-offs to define 'caseness' were pain ≥ 25, fatigue ≥ 39 and depression ≥ 10. Associations between survivor-related factors, clinical variables and specific prostate cancer physical symptoms and the symptom cluster were assessed using multivariate logistic regression. Results A total of 3348 men participated (response rate = 54%). Twenty-four percent had clinically significant pain, 19.7% had clinically significant fatigue, and 14.4% had depression; 7.3% had all three symptoms. In multivariate analysis, factors significantly associated with the symptom cluster were living in Northern Ireland, experiencing back pain at diagnosis and being affected by incontinence, loss of sexual desire, bowel problems, gynecomastia and hot flashes post-treatment. There was a strong association between the cluster and health-related quality of life. Conclusions The pain-fatigue-depression symptom cluster is present in 1 in 13 prostate cancer survivors. Physical after-effects of prostate cancer treatment are associated with this cluster. More attention should be paid to identifying and supporting survivors who experience multiple symptoms; this may help health-related quality of life improve among the growing population of prostate cancer survivors.

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“…BCS frequently report cognitive and psychosomatic symptoms including emotional distress (i.e., anxiety and depressive symptoms) (Maass et al, 2015), fatigue (Bower et al, 2006), perceived cognitive impairments (Runowicz et al, 2016), posttraumatic stress (Arnaboldi et al, 2017), and insomnia (Palesh et al, 2012(Palesh et al, , 2017. Although these symptoms are independently assessed, they often co-occur and are interrelated (Fagundes et al, 2015;Koutrouli et al, 2016;Nho et al, 2018). Importantly, cancer surveillance models call for the prevention, early intervention, and management of cancer-related side effects (Kenyon et al, 2014).…”

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confidence: 99%

A Cross-Sectional Exploration of Cytokine–Symptom Networks in Breast Cancer Survivors Using Network Analysis

et al. 2020

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Purpose The purpose of this study is to (a) visualize the symptom–cytokine networks (perceived stress, fatigue, loneliness, perceived cognitive impairment, daytime sleepiness, sleep quality, and 13 cytokines) and (b) explore centrality metrics of symptom–cytokine networks in breast cancer survivors who completed chemotherapy treatment. Methods Cross-sectional analysis of data collected from 66 breast cancer survivors who were on average three years post chemotherapy completion. Perceived stress, fatigue, loneliness, perceived cognitive impairment, daytime sleepiness, and sleep quality were measured with self-report instruments, and a panel of 13 cytokines was measured from serum using multiplex assays. Symptoms and cytokines were simultaneously evaluated with correlations, network analysis, and community analysis. Results Network analysis revealed the nodes with the greatest degree and closeness were interleukin-2, granulocyte-macrophage colony-stimulating factor, interleukin-13, and perceived cognitive impairment. Node betweenness was highest for perceived cognitive impairment and interleukin-2. Community analysis revealed two separate communities of nodes within the network (symptoms and the cytokines). Several edges connected the two communities including perceived cognitive impairment, stress, fatigue, depression, interleukin-2, granulocyte-macrophage colony-stimulating factor, interleukin-8, interleukin-13, and interleukin-10. Partial correlation analyses revealed significant negative relationships between interleukin-2 and fatigue, loneliness, stress, and perceived cognitive impairment ( rs = −.27 to −.37, ps < .05) and a significant negative relationship between perceived cognitive impairment and granulocyte-macrophage colony-stimulating factor ( r = −.34, p < .01). Conclusions Our analyses support that perceived cognitive impairment, stress, loneliness, depressive symptoms, and fatigue co-occur and extend the literature by suggesting that interleukin-2 may contribute to the underlying mechanistic pathway of these co-occurring symptoms. Our findings add to a growing body of literature that is shifting to study symptoms as they co-occur, or cluster, rather than individual symptoms.

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Symptom clusters and quality of life in breast cancer survivors after cancer treatment in a tertiary hospital in Korea

Cited by 33 publications

References 33 publications

Symptom clusters experienced by breast cancer patients at various treatment stages: A systematic review

Symptom clusters experienced by breast cancer patients at various treatment stages: A systematic review

Pain, fatigue and depression symptom cluster in survivors of prostate cancer

A Cross-Sectional Exploration of Cytokine–Symptom Networks in Breast Cancer Survivors Using Network Analysis

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