Abstract B41: An evaluation of palliative care needs among South African patients attending oncology services in a metropolitan setting

Abstract

Abstract Introduction: Research shows that patients in Africa with advanced cancer who are receiving palliative care have a higher symptom prevalence than that reported from the developed world. It is evident that few cancer patients in South Africa receive specialist palliative care at the end of their lives and few studies document the symptom burden experienced by cancer patients in South Africa. This study investigates the prevalence of symptoms experienced by patients with advanced cancer presenting to two oncology services in Cape Town and identifies palliative care needs. Methodology: The study population was patients aged 18 years or older who had a diagnosis of cancer of stage 3 or 4. The primary cancer groups were breast, prostate, oesophageal, lung, cervical, colon, rectal cancers and sarcomas and head and neck tumors. All patients who met the criteria and were referred were approached and invited to take part in the study. For those consenting to participate, a single interview was held during which demographic information and disease-related data were recorded and the questionnaires were completed. The tools used have been previously been applied in South African populations and have sound psychometric properties. They are: the APCA African Palliative Outcome Scale (APCA POS), the Memorial Symptom Assessment Scale Short Form (MSAS-SF), the Centre for Epidemiological Studies on Depression (CES-D) and the Eastern Co-operative Oncology Group Performance Scale (ECOG). All tools were appropriately translated. Informal family caregivers were invited to participate in the three APCA POS questions for caregivers, if the participant agreed. Findings: Drowsiness, pain, lack of energy and shortness of breath were among the most prevalent physical symptoms. Fatigue (63%) and pain (61%) were reported by well over half of participants. The most prevalent physical symptoms were considered burdensome by the majority of the affected participants. Psychological symptoms were also prevalent, namely worrying (51%), feeling nervous (44%), feeling sad (41%) and feeling irritable (40%). More than 25% of participants who reported worrying or feeling nervous, experienced these symptoms frequently or almost constantly. Despite this, over 60% of the participants were found not to be at risk of depression according to the CES-D and felt life was worthwhile and felt at peace. Just over 10% of participants were found to be at risk of major depression. Physical and psychological symptoms occur at all levels of functional status. Conclusion: There is a high burden of palliative care need in this population. Citation Format: Lindsay Farrant, Richard Harding, Rene Krause, David Anderson, Jeanette Parkes, Liz Gwyther. An evaluation of palliative care needs among South African patients attending oncology services in a metropolitan setting [abstract]. In: Proceedings of the AACR International Conference: New Frontiers in Cancer Research; 2017 Jan 18-22; Cape Town, South Africa. Philadelphia (PA): AACR; Cancer Res 2017;77(22 Suppl):Abstract nr B41.