Purpose
Despite advances in supportive cancer care, patients experience various interrelated concerns affecting their quality of life. This study aimed to elucidate the frequency, severity, and complex interrelationships of diverse physical, psychological, and social concerns among patients with cancer.
Methods
In this cross-sectional study, a 74-item questionnaire assessing symptoms and problems across 12 categories was administered to 300 patients with various cancer types. Each item was rated from 0 (none) to 3 (severe). Sex and cancer type differences were analyzed. Network analysis examined and visualized the centrality and clustering of patient concerns.
Results
Overall, 127 males and 173 females (median age, 66 years) participated in this study. Cancer types included breast (28.0%), gastrointestinal (27.3%), urologic (17.3%), hepatobiliary/pancreatic (14.7%), gynecological (6.7%), and others (6.0%). Females reported significantly higher overall distress than males (30.4 vs. 22.5, p < 0.01). The most common concerns were physical decline (81.7%), fatigue (80.5%), muscle weakness (65.9%), numbness/pain (63.0%), and hair loss (54.9%). Items with the highest centrality were muscle weakness, nutritional management, fatigue, changes in appearance, and physical decline. Network structures differed between sexes, with males exhibiting higher centrality in sexual function and social concerns and females in psychological symptoms.
Conclusions
This study elucidated the complex symptom interrelationships among the concerns of patients with cancer. Females experienced a greater symptom burden than males. Fatigue, weakness, and nutritional management were central symptoms linked to other concerns. These intricate symptom networks highlight the need for multidisciplinary interventions targeting multiple interconnected concerns to optimize supportive care. Therefore, sex-specific approaches are warranted.
