Patients With Cancer Experience Greatest Symptom Burden Soon After Diagnosis

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Patient experience in the early stages after cancer diagnosis has not been fully studied.
Patient experience in the early stages after cancer diagnosis has not been fully studied.
The following article features coverage from the National Association of Clinical Nurse Specialists (NACNS) 2018 Annual Conference in Austin, Texas. Click here to read more of Oncology Nurse Advisor's conference coverage. 

High rates of moderate-to-severe symptom burden occur among patients with cancer soon after diagnosis regardless of site, according to a study published in the Journal of Clinical Oncology.

Although symptom burden is increased throughout all points of a patient's experience with cancer, studies evaluating patient-reported outcomes (PROs) to improve quality of life have placed emphasis on end-of-life care or advanced disease; patient experience in the early stages after diagnosis has not been fully explored.

For this observational retrospective study, 729,861 Edmonton Symptom Assessment System (ESAS) scores from 120,745 patients that were recorded in the Symptom Management Reporting Database within 12 months of cancer diagnosis were evaluated. ESAS scores, a PRO tool that measures classic cancer symptomatology (eg, pain, tiredness, drowsiness, nausea) were obtained at outpatient visits.

Analysis revealed that the odds of increased symptom burden were the greatest during the first month of diagnosis. For nausea, odds of higher ESAS scores were greater for up to 6 months post diagnosis.

A multivariate analysis showed that significant predictors of having greater odds of moderate-to-severe symptom scores were urban residence, cancer site, higher comorbidity, younger age, female sex, and lower income.

Results of the study showed that patients are at increased risk of experiencing various symptoms soon after receiving a diagnosis of cancer. The authors concluded that “patient subgroups who are at higher risk of experiencing moderate-to-severe symptoms should be targeted for tailored supportive care interventions.”


Bubis LD, Davis L, Mahara A, et al. Symptom burden in the first year after cancer diagnosis: an analysis of patient-reported outcomes [published online March 2, 2018]. J Clin Oncol. doi: 10.1200/JCO.2017.76.0876

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