The Relation between the Severity of Pain and Common Symptoms in Patients with Metastatic Cancer

Abstract

Background: There is a relation between the severity of pain and common symptoms in patients with metastatic cancer.Aim: This study was done to explore this relation among Egyptian patients with advanced cancer.Methods: The study included 120 adult metastatic cancer patients with pain from two cancer centers in Cairo and Sharkia,Egypt. Pain and other common symptoms were assessed using the Arabic version of the Edmonton Symptom AssessmentSystem (ESAS). The Eastern Cooperative Oncology Group (ECOG) performance scale was used to assess performancestatus.Results: The prevalence of ESAS symptoms was high among patients with cancer pain (tiredness, 94%; drowsiness, 63%;nausea, 60%; lack of appetite, 77%; shortness of breath, 53%; depression, 88%; anxiety, 83%; poor wellbeing, 96%). TheECOG performance scale was 1 in 21 (17.5%) patients, 2 in 57 (47.5%), 3 in 38 (31.7%) and 4 in 4 (3.3%). The averageESAS score was 33.9 ± 13.8, 48.9 ± 14.7, 58 ± 15.4 and 70 ± 5.5 among patients with ECOG score 1, 2, 3 and 4;respectively (p < 0.001). There was no significant difference in the average score of any of the ESAS items according tothe site of metastases. There was a significant positive correlation between the pain score and the scores of tiredness(p < 0.001), nausea (p=0.037), lack of appetite (p < 0.001), shortness of breath (p=0.001), depression (p < 0.001), anxiety(p < 0.001) and poor wellbeing (p < 0.001).Conclusion: Egyptian patients with cancer pain experience high symptom burden. The severity of pain strongly correlateswith the presence and severity of other ESAS symptoms. Systematic assessment of other symptoms is indispensable inpatients with cancer pain for proper control of symptoms and improving quality of life.