Cancer Symptom Clusters by Primary Site (414-A)

Abstract

1.Recognize cancer symptom cluster (SC) concept by discussing the influence of patient and disease characteristics.2.Discuss cancer site-specific SCs, which may help design more specific assessment tools in clinical practice and research. Background. Symptom clusters (SCs) may be influenced by cancer site. This can help understand cluster pathophysiology and mechanisms. Such information is necessary to design assessment tools and target palliative interventions. Research objectives. Explore SCs among inpatients with various advanced cancers based on diagnosis. Methods. Cluster analysis of 25 symptoms from 922 advanced cancer patients identified clusters; a correlation ≥ 0.68 defined a cluster. Only symptoms with prevalence > 15% were included analysis. Results. 50% males; median age 64 years (range, 18-74 years). The SCs for the cancer sites that were leading cause of cancer-related mortality in the United States were reported. A. Lung (n = 228): (1) easy fatigue, lack of energy, weakness, dry mouth; (2) anorexia, satiety; (3) depression, anxiety; (4) nausea, vomiting, taste change; (5) bloating, belching; (6) dizzy spells, dyspepsia; (7) hoarseness, dysphagia; (8) cough, dyspnea; (9) pain, constipation B. Colorectal (n = 74): (1) depression, anxiety, dizzy spells, taste change; (2) anorexia, satiety; (3) weight loss, weakness; (4) easy fatigue, lack of energy, dry mouth, sleep problems; (5) bloating, belching, dyspepsia; (6) cough, dyspnea, hoarseness; (7) edema, confusion; (8) nausea, vomiting C. Pancreas (n=53): (1) easy fatigue, lack of energy, weakness; (2) dyspnea, weight loss; (3) edema, confusion; (4) dysphagia, dyspepsia; (5) satiety, constipation, anxiety; (6) sleep problems, belching; (7) depression, bloating; (8) anorexia, taste changes; (9) hoarseness, dry mouth, pain, cough; (10) nausea, vomiting Nausea-vomiting consistently clustered regardless of site. Depression-anxiety and anorexia-satiety clusters were common in lung, colorectal, and gynecologic cancers. Conclusion. Distinct SCs were associated with various cancers. Certain symptoms consistently aggregated (ie, nausea-vomiting, depression-anxiety). Easy fatigue clustered with lack of energy, weakness, dry mouth, or sleep problems. Implications for research, policy, or practice. Certain SCs were consistent; this raised a possibility that the mechanism for SCs may not vary across different cancer diagnoses. We should screen those at highest risk for cancer site-specific SCs. Physical Aspects of Care