Abstract
The spectrum of symptoms for an oncologist or oncosurgeon about gastrointestinal (GI) and hepatobiliary (HB) cancers varies from the spectrum of symptoms that a palliative care physician ascertains. There is a paucity of data regarding GI and HB cancer symptomatology in a palliative care outset. Hence, we conducted this study to understand the same and identify the most common symptom clusters among these cancers. The present study was retrospective observational study conducted on patients referred to palliative care department of Tata medical center, Kolkata, India. A total of 495 patient’s case records were reviewed with GI and HB cancers. Age, gender, co-morbidities, Eastern Cooperative Oncology Group (ECOG) status, symptomatology, physical examination findings, and histopathological diagnosis were reviewed from the case records and documented. Symptomatology included pain, nausea, vomiting, anxiety, depression, constipation, anorexia, early satiety and loose stools. The mean age of the patients was 57.73 ± 12.50 years with male: female ratio of 1.60. The most common organ system involved was gall bladder (22.63%) followed by pancreas (16.97%). The most common symptom was abdominal pain (63.64%) followed by anorexia (28.08%) and constipation (21.62%) and the least common ones were loose stools (3.84%) and neuropsychiatric symptoms (4.85%). Nausea-vomiting cluster (38.10%) and abdominal pain-nausea/vomiting (28.38%) cluster were most common among stomach carcinomas. Abdominal pain-constipation cluster (23.21%) was more common among gall bladder carcinomas. Future studies directing to identify these symptoms and clusters over the quality of life of advanced cancer patients are warranted.
Highlights
Palliative care is an interdisciplinary approach to improve the quality of life and lessen the suffering among people with a life-threatening illness [1], [2]
The spectrum of symptoms for an oncologist or oncosurgeon about gastrointestinal (GI) and hepatobiliary (HB) cancers varies from the spectrum of symptoms that a palliative care physician ascertains
Nausea-vomiting cluster (38.10%) and abdominal painnausea/vomiting (28.38%) cluster were most common among stomach carcinoma
Summary
Palliative care is an interdisciplinary approach to improve the quality of life and lessen the suffering among people with a life-threatening illness [1], [2]. The spectrum of symptoms for an oncologist or oncosurgeon about gastrointestinal (GI) and hepatobiliary (HB) cancers varies from the spectrum of symptoms that a palliative care physician ascertains. A palliative care physician believes in a holistic approach to the patients in need [5], [6]. Palliative care starts at the time of diagnosis. In settings across middleincome countries like India, there is a gap between specialist palliative care physicians and the number of patients in need. The initiation of palliative care is started late in the trajectory of the disease [1], [4]. There is a paucity of data regarding GI and HB cancer symptomatology in a palliative care outset. We conducted this study to understand the symptoms of different GI and HB cancers and identify the most common symptom clusters
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