A cross-sectional analysis of symptom burden among adult cancer patients in a Filipino tertiary care cancer center.

Abstract

98 Background: Palliative and supportive care has been shown to improve quality of life (QOL) and survival and reduce caregiver burden and costs, but remains poorly integrated into cancer care in the Philippines. Understanding symptom burden profile among patients will guide policy-making in a limited/moderate resource setting. Methods: This cross-sectional study was conducted among adult Filipino cancer patients. Demographic and clinical data were collected from medical records and patient interviews. Symptom severity and interference were assessed using the M.D. Anderson Symptom Inventory. Symptom prevalence and mean severity scores were determined. Pearson correlation analysis was used to examine relationships between symptom severity and interference. Results: Participants (n = 251)were aged 18-80 years; the majority were aged < 60, females, or with good performance status (PS). Breast, head-and-neck and gastrointestinal primaries were most common; 45% had advanced disease. Moderate and severe symptoms were prevalent across stages. Fatigue (65%), pain (62%), sadness (62%), and anxiety/distress (58%) were the most prevalent, most severe and most interfering. In metastatic disease, sadness was most prevalent, and fatigue, most serious; among those with poor PS, disturbed sleep was most prevalent and most serious. Pain was more disabling among females, and fatigue and sadness, among the elderly. Conclusions: This is the first study to describe symptom burden among adult Filipino cancer patients. The clinical impact of symptoms is determined by their concurrence and the patient’s demographic and clinical profile. Symptom burden is highest for fatigue, pain, sadness, and anxiety/distress. Comprehensive symptom evaluation and tailored approach to care is necessary for optimal management. While a clinical practice guideline (CPG) has been adopted for use at our institute, effective CPGs for the screening, assessment and management of fatigue, depression and anxiety/distress have yet to be identified and implemented.