Symptom Clusters in Patients With Pancreatic Cancer Undergoing Surgical Resection: Part I

Burrell, Sherry A.; Yeo, Theresa P.; Smeltzer, Suzanne C.; Leiby, Benjamin E.; Lavu, Harish; Kennedy, Eugene P.; Yeo, Charles J.

doi:10.1188/18.onf.e36-e52

Cited by 20 publications

(24 citation statements)

References 51 publications

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“…Although a psychological symptom cluster was reported in previous studies of patients with breast, 19,35,37 lung, 36,38 and heterogeneous cancer diagnoses, 16,39e44 it was found in only three of the six studies of symptom clusters in patients with GI cancers. 11,13,14 Across the four symptom cluster studies in GI cancers (i.e., our study and the other three 11,13,14 ), anxiety and depression were the two consistent symptoms. However, in other studies that used the MSAS, 45e47 worrying, feeling sad, feeling nervous, feeling irritable, difficulty in concentrating, lack of energy, and feeling drowsy were the common symptoms in the psychological cluster.…”

Section: Psychological Symptom Clustersupporting

confidence: 54%

“…52 In the present study, across all symptom dimensions, nausea (50.9%), change in the way food tastes (49.9%), and dry mouth (44.4%) were the most prevalent symptoms within the CTX-related cluster. In a previous study of patients with pancreatic cancer, 14 nausea and change in the way food tastes were included in the gustatory (i.e., change in taste, dry mouth) or a discomfort (i.e., nausea) symptom cluster. In another study of patients with hepatocellular cancer, 10 loss of appetite, nausea, and change in taste loaded on the pain-appetite symptom cluster and itching was included in the itching-constipation cluster.…”

Section: Ctx-related Symptom Clustermentioning

confidence: 99%

“…9e14 Across these six studies, two evaluated patients with pancreatic cancer, 9,14 two evaluated patients with hepatocellular carcinoma, 10,11 one evaluated patients with esophageal cancer, 12 and one compared symptom clusters in younger versus older survivors with colorectal cancer. 13 The instruments used to create the symptom clusters were highly variable in terms of the number of symptoms evaluated (i.e., 6 13 to 19 11 ) and were primarily cancer diagnosis specific (e.g., FACT-Hepatobiliary Questionnaire 10,11,14 ). The majority of these studies used exploratory factor analysis (EFA) 11,14 or principal component analysis 10,12,13 to identify the symptom clusters.…”

Section: Introductionmentioning

confidence: 99%

“…13 The instruments used to create the symptom clusters were highly variable in terms of the number of symptoms evaluated (i.e., 6 13 to 19 11 ) and were primarily cancer diagnosis specific (e.g., FACT-Hepatobiliary Questionnaire 10,11,14 ). The majority of these studies used exploratory factor analysis (EFA) 11,14 or principal component analysis 10,12,13 to identify the symptom clusters. Across these six studies, while the number of symptom clusters ranged from one 9 to five, 14 no common symptom cluster was identified.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of these studies used exploratory factor analysis (EFA) 11,14 or principal component analysis 10,12,13 to identify the symptom clusters. Across these six studies, while the number of symptom clusters ranged from one 9 to five, 14 no common symptom cluster was identified. 9e14 Although these studies provide information on symptom clusters in a select number of GI cancers, given their limitations, particularly the use of diseasespecific instruments, it is difficult to compare findings across symptom cluster studies that used more generic instruments (e.g., MSAS, 15 MD Anderson Symptom Inventory 16 ).…”

Section: Introductionmentioning

confidence: 99%

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Symptom Clusters in Patients With Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience

Han

Reding

Cooper

et al. 2019

Journal of Pain and Symptom Management

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Context. Patients with gastrointestinal (GI) cancers undergoing chemotherapy (CTX) experience multiple cooccurring symptoms. Objectives. The aim of this study was to describe the occurrence, severity, and distress of 38 symptoms and to identify symptom clusters based on three symptom dimensions (i.e., occurrence, severity, and distress) in patients with GI cancers receiving CTX (n ¼ 399). We compared whether the numbers and types of symptom clusters differed based on the dimension of the symptom experience used to create the clusters. Methods. A modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence, severity, and distress of 38 symptoms before the initiation of the patient's next dose of CTX. Exploratory factor analysis was used to determine the symptom clusters. Results. These patients experienced 13.0 (AE7.1) symptoms before their second or third dose of CTX. For all three symptom dimensions, four symptom clusters were identified, namely psychological distress, CTX-related, GI, and weight change. The number and types of symptom clusters were relatively similar using all three symptom dimensions. However, some variability was found in the specific symptoms within each of the clusters. Conclusion. Our findings suggest that patients with GI cancers experience multiple cooccurring symptoms. Consistent with previous studies of patients with a variety of cancer diagnoses, psychological and GI clusters are common. Clinicians need to assess for and tailor interventions for these symptom clusters.

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Section: Psychological Symptom Clustersupporting

confidence: 54%

Section: Ctx-related Symptom Clustermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Symptom Clusters in Patients With Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience

Han

Reding

Cooper

et al. 2019

Journal of Pain and Symptom Management

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Population-Level Symptom Assessment Following Pancreaticoduodenectomy for Adenocarcinoma

et al. 2019

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; and the Pancreas Cancer Population Outcomes Research Group IMPORTANCE Postoperative morbidity associated with pancreaticoduodenectomy (PD) for pancreatic adenocarcinoma (PA) remains as high as 70%. However, to our knowledge, few studies have examined quality of life in this patient population. OBJECTIVE To identify symptom burden and trajectories and factors associated with high symptom burden following PD for PA. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study of patients undergoing PD for PA diagnosed between 2009 and 2015 linked population-level administrative health care data to routinely prospectively collected Edmonton Symptom Assessment System (ESAS) scores from 2009 to 2015, with a data analysis undertaken in 2018. EXPOSURES Baseline characteristics, including age, sex, income quintile, rurality, immigration status, and comorbidity burden, as well as treatment characteristics, including year of surgery and receipt of chemotherapy. MAIN OUTCOME AND MEASURES The outcome of interest was moderate to severe symptoms (defined as ESAS Ն4) for anxiety, depression, drowsiness, lack of appetite, nausea, pain, shortness of breath, tiredness, and impaired well-being. The monthly prevalence of moderate to severe symptoms was presented graphically for each symptom. Multivariable regression models identified factors associated with the reporting of moderate to severe symptoms. RESULTS We analyzed 6058 individual symptom assessments among 615 patients with PA who underwent resection (285 women [46.3%]) with ESAS data. Tiredness (443 [72%]), impaired well-being (418 [68%]), and lack of appetite (400 [65%]) were most commonly reported as moderate to severe. The proportion of patients with moderate to severe symptoms was highest immediately after surgery (range, 14%-66% per symptom) and decreased over time, stabilizing around 3 months (range, 8%-42% per symptom). Female sex, higher comorbidity, and lower income were associated with a higher risk of reporting moderate to severe symptoms. Receipt of adjuvant chemotherapy was not associated with the risk of moderate to severe symptoms. CONCLUSIONS AND RELEVANCE There is a high prevalence of symptoms following PD for PA, with improvement over the first 3 months following surgery. In what to our knowledge is the largest cohort reporting on symptom burden for this population, we have identified factors associated with symptom severity. These findings will aid in managing patients' perioperative expectations and designing strategies to improve targeted symptom management.

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Caring experiences of family caregivers of patients with pancreatic cancer: an integrative literature review

Kim

Baek

2022

Support Care Cancer

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Symptom Clusters in Patients With Pancreatic Cancer Undergoing Surgical Resection: Part I

Abstract: Findings may be used to provide anticipatory patient and family guidance and to inform clinical assessments of symptoms and symptom clusters in this population.

Cited by 20 publications

References 51 publications

Symptom Clusters in Patients With Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience

Symptom Clusters in Patients With Gastrointestinal Cancers Using Different Dimensions of the Symptom Experience

Population-Level Symptom Assessment Following Pancreaticoduodenectomy for Adenocarcinoma

Caring experiences of family caregivers of patients with pancreatic cancer: an integrative literature review

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