Holistic, patient-centered symptom management for metastatic cancer: A comparison pilot study

Abstract

ObjectivesTo determine the relative effectiveness of this holistic approach on metastatic cancer, breast (BC), genitourinary (GU), gynecologic (GYN), and lung (LC) cancer survival rates were compared to those from a similar oncology study investigating the impact of patient symptom reporting. As a secondary outcome, survival for BC, GU, GYN, LC, pancreatic (PC), and colon (CC) cancer patients from one through five years after metastatic cancer diagnosis was compared to normative data from the Surveillance, Epidemiology, and End Results Program (SEER) database. MethodsSurvival for breast, genitourinary, gynecologic, and lung cancers at one through five years was compared to (1) similar data from an electronic symptom self-reporting study; and (2) normative data from the Surveillance, Epidemiology, and End Results Program (SEER) using estimated survival curves and 95 % confidence intervals. ResultsCharts for 104 patients with metastatic breast, genitourinary (bladder and kidney), gynecologic (endometrial and ovarian), lung (non-small cell), pancreatic, and colon cancers were analyzed, and survival calculated. When analyzing only breast, genitourinary, gynecologic, and lung cancers to rates from the comparable study, the clinic’s one-year survival was significantly higher than with the comparable data (80.8 % vs. 75.1 % respectively) evidenced by 95 % confidence intervals. Comparison of the current population data (including all cancer types) and normative SEER data rendered statistically significant results for survival at 1, 2, 3, 4, and 5 years, evidenced by 95 % confidence intervals. ConclusionsThe clinic data showed survival that was higher than the computerized symptom monitoring arm of current reported research. Additionally, it was further increased when compared to normative SEER data. This suggested that results produced by electronic platforms used in large academic settings can be successfully reproduced by community oncology practices through non-electronic approaches to active symptom management and shared decision-making.