Most diagnoses occurred in 2014 (46%; N = 25) or 2015 (13%; N = 7). Prior radiation or a different chemotherapy regimen was reported by 46% of participants (N = 25)[JP1] .

Cycle/week of chemotherapy or number of radiation treatment was coded and divided into first cycle/week, second cycle/week, third cycle/week to halfway point, halfway point to second-to-last cycle/week, and last cycle/week. Nine participants (5%) reported palliative treatment until end of life and 15 (27%) could not remember at what point in their treatment plan they were.

Participants were asked to rate their distress level over the previous week using the number scale on the thermometer (Table 3). The most common response was 0 (22%; N = 12), followed closely by 1 (16%; N = 9), and 2 (15%; N = 8). Only 1 patient called the nurse navigator to locate more resources, and this was related to insurance and financial needs.

TABLE 3. Distress Levels Reported

Level Percent Reporting Level (N)
0 22% (12)
1 16% (9)
2 15% (8)
3 11% (6)
4 9% (5)
5 3% (2)
6 9% (5)
7 2% (1)
8 6% (3)
9 6% (3)
10 2% (1)

Self-report of problems Participants were asked to check “Yes” or “No” for each item on a list of 38 problems, divided into 5 categories (Table 4). Practical problems, ranked in order of percentage of “Yes” responses, were: insurance/financial (32.7%), treatment decisions (27.3%), transportation (10.9%), work/school (5.5%), housing (3.6%), and child care (0%). Family problems, per the same ranking order, were: family health issues (21.8%), dealing with a partner (12.7%), dealing with children (10.9%), and ability to have children (0%). Emotional problems, per the same ranking order, were: worry (43.6%), fears (40%), sadness (38.2%), loss of interest in usual activities (34.5%), nervousness (30.9%), and depression (27.3%). Spiritual/religious concerns are not divided into subcategories; only 7.3% of respondents checked “Yes” for this item.

TABLE 4. Responses to Problems On NCCN Distress Thermometer

Problem No Percent (N) Yes Percent (N)
Practical Problems
Child Care 100 (55) 0
Housing 96.4 (53) 3.6 (2)
Insurance/financial 67.3 (37) 32.7 (18)
Transportation 89.1 (49) 10.9 (6)
Work/school 94.5 (52) 5.5 (3)
Treatment decisions 72.7 (40) 27.3 (15)
Family Problems
Dealing with children 94.5 (52) 10.9 (3)
Dealing with partner 87.3 (48) 12.7 (7)
Ability to have children 100 (55) 0
Family health issues 78.2 (43) 21.8 (12)
Emotional Problems
Depression 72.7 (40) 27.3 (15)
Fears 60 (33) 40 (22)
Nervousness 69.1 (38) 30.9 (17)
Sadness 61.8 (34) 38.2 (21)
Worry 56.4 (31) 43.6 (24)
Loss of interest in usual activities 65.5 (36) 34.5 (19)
Spiritual/religious concerns 92.7 (51) 7.3 (4)
Physical Problems
Appearance 70.9 (39) 29.1 (16)
Bathing/dressing 89.1 (49) 10.9 (6)
Breathing 81.8 (45) 18.2 (10)
Changes in urination 90.9 (50) 9.1 (5)
Constipation 60 (33) 40 (22)
Diarrhea 74.5 (41) 25.5 (14)
Eating 67.3 (37) 32.7 (18)
Fatigue 36.4 (20) 63.6 (35)
Feeling swollen 76.4 (42) 23.6 (13)
Fevers 92.7 (51) 7.3 (4)
Getting around 70.9 (39) 29.1 (16)
Indigestion 74.5 (41) 25.5 (14)
Memory/concentration 60 (33) 40 (22)
Mouth sores 89.1 (49) 10.9 (6)
Nausea 63.6 (35) 36.4 (20)
Nose dry/congested 74.5 (41) 25.5 (14)
Pain 54.5 (30) 45.5 (25)
Sexual 89.1 (49) 10.9 (6)
Skin dry/itchy 56.4 (31) 43.6 (24)
Sleep 61.8 (34) 38.2 (21)
Tingling in hands/feet 72.7 (40) 27.3 (15)
Key: NCCN, National Comprehensive Cancer Network.

Ranked in order of percentage of “Yes” responses, physical problems were: fatigue (63.6%), pain (45.5%), dry or itchy skin (43.6%), memory/concentration (40%), constipation (40%), sleep (38.2%), nausea (36.4%), eating (32.7%), appearance (29.1%), getting around (29.1%), tingling in hands/feet (27.3%), nose dry/congested (25.5%), diarrhea (25.5%), indigestion (25.5%), feeling swollen (23.6%), breathing (18.2%), bathing/dressing (10.9%), mouth sores (10.9%), sexual (10.9%), changes in urination (9.1%), and fevers (7.3%).