Symptom clusters in patients with breast cancer receiving radiation therapy

Chow, Selina; Wan, Bo; Pidduck, William; Zhang, Liying; DeAngelis, Carlo; Chan, Stephanie; Yee, Caitlin; Drost, Leah; Leung, Eric; Sousa, Philomena; Lewis, Donna; Lam, Henry; Chow, Ronald; Lock, Michael; Chow, Edward

doi:10.1016/j.ejon.2019.07.004

Cited by 35 publications

(36 citation statements)

References 19 publications

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“…Finally, at least two of the following psychological symptoms, namely sadness, worry, anxiety and depression (the Psychological Cluster), were shown in eight studies to co‐occur in patients prior to receiving treatment 20,28,30,32–35,38 . Interestingly, (fatigue and/or sleep disturbance), were also shown to exhibit an association with some of the symptoms in this cluster, namely anxiety and depression, 30,33,34 suggesting that the symptoms in both clusters may mutually influence their occurrence.…”

Section: Resultsmentioning

confidence: 98%

“…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%

“…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. Chow et al also found slight changes in the composition of this symptom cluster, in terms of the additional symptoms that clustered with depression‐anxiety when different methodologies of cluster analysis were used.…”

Section: Resultsmentioning

confidence: 99%

“…The symptom cluster nausea‐lack of appetite‐diarrhoea (the Gastrointestinal Cluster) was reported in seven studies examining the symptom clusters among patients who had completed treatment 17,19,22,32,36,38,41 . However, this symptom cluster was less consistently reported among these seven studies, as at least one of the symptoms in the cluster was found to not be associated with this cluster in six of these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, certain uncommon symptom clusters identified by Li et al, 33 including the ‘Neurocognitive‐Psychoneurocognitive’ Cluster, ‘Musculoskeletal’ Cluster, ‘Vasomotor’ Cluster, ‘Sexual’ Cluster and ‘Urinary’ Cluster, remained generally stable among patients over the 18 months of cancer treatment. Interestingly, however, Chow et al 32 showed that whereas symptom clustering through exploratory factor analysis yielded generally stable symptom clusters among patients pre‐ and post‐radiotherapy treatment, symptom cluster identification via principal component analysis or hierarchical cluster analysis did not. Such a finding lends further support to the observation that the methodologies used for cluster analysis can lead to variations in cluster identification in symptom cluster studies.…”

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: 98%