The Symptoms of Advanced Cancer: Identification of Clinical and Research Priorities by Assessment of Prevalence and Severity

Abstract

In advanced cancer, when cure is impossible, symptoms should be the focus of attention. We report the first prospective, systematic analysis of the severity of 37 symptoms in 1000 patients with advanced cancer, using the Paradox relational database. Pain, easy fatigue, and anorexia were consistently among the 10 most prevalent symptoms associated with cancer at all sites. When pain, anorexia, weakness, anxiety, lack of energy, easy fatigue, early satiety, constipation, and dyspnea were present, 60%-80% of patients rated them as moderate or severe, i.e. of clinical importance. The most common symptoms were also the most severe. In general the same symptoms were clinically important at most primary sites. Clinically important dyspnea, hoarseness, hiccough, and dysphagia were more common in men; anxiety, nausea, vomiting, and early satiety in women. Clinically important dyspepsia, nausea, and vomiting occurred more frequently in gynecological cancers.

Components of the anorexia–cachexia syndrome: gastrointestinal symptom correlates of cancer anorexia

“…Females in this study experienced more nausea and vomiting, which confirms our previous reports [20][21][22]. These observations need to be considered when interpreting symptom profiles in cancer patients.…”

“…Anorexia may be conceived of as an isolated symptom (perhaps suggesting a centrally mediated etiology due to hypothalamic dysfunction) or perhaps part of a more complex symptom cluster that includes other gastrointestinal symptoms (which might reflect peripheral dysfunction). Patient demographics in this study resembled those from our previous symptom studies [20,21,28,37,42,45]. Hence, we believe that this survey generally represents the experience of patients with advanced cancer.…”

“…1) was empirically designed based upon prior studies by our group [20,21]. The survey assessed anorexia severity based upon a numerical scale (0 = no appetite, 10 = normal appetite) and a categorical scale (mild, moderate, severe).…”

The impact of a palliative medicine consultation service in medical oncology

“…A previous study carried out by the Palliative Care Service at the Cleveland Clinic Foundation from 1990 to 1992 evaluated the symptoms of 1,000 advanced cancer patients [13,14,15]. The same 38-symptom list was used to collect symptoms.…”

Upper gastrointestinal symptoms in patients with advanced cancer: relationship to nutritional and performance status

“…In particular, anorexia is one of the symptoms most often found in patients with advanced cancer. Its prevalence can actually be more than 50% within the population in palliative treatment [9,10].…”