Symptom clusters and prognosis in advanced cancer

Excerpt

In the USA in 2009, an estimated 1,479,350 new cases at all cancer sites are expected; 562,340 people are expected to die of cancer [1]. Cancer is the second most frequent cause of death in the USA. Life expectancy (survival) is an important predicted outcome of the natural history of an illness. As the disease progresses, survival prediction is particularly important to appropriate decision making and advance care planning. Clinical and biologic predictors of survival in cancer patients vary by the disease stage [2]. For instance, performance status, quality of life (QoL), and some biochemical parameters have been used to develop prognostic scores in advanced cancer patients [3‐7]. Individual symptoms of cancer anorexia–cachexia syndrome (e.g., anorexia, weight loss, and dysphagia), delirium, dyspnea, and fatigue have also been reported to be independent predictors of survival in persons receiving palliative care [8‐10]. Such well-known associations between specific symptoms and clinical outcomes might be more pronounced in those who present with symptom clusters (SC). …