Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Journal of Cancer Survivorship
Erschienen in: Journal of Cancer Survivorship 2/2007

01.06.2007

Symptom burden in cancer survivorship

verfasst von: V. Shannon Burkett, Charles S. Cleeland

Erschienen in: Journal of Cancer Survivorship | Ausgabe 2/2007

Einloggen, um Zugang zu erhalten

Abstract

Introduction

The subjective experience of cancer survivorship can be assessed by various patient-reported outcome (PRO) methods, including measures of symptom burden and health-related quality of life (HRQOL). Symptom burden includes the presence and severity of multiple symptoms and the level of distress caused by symptoms that go untreated or unrelieved. The concept of symptom burden is more limited in scope than HRQOL but may provide information that better describes the status of various stages of survivorship. This paper contrasts symptom burden with general HRQOL and addresses the importance of including symptom burden as research tool throughout the trajectory of cancer survivorship.

Methods

We summarized studies that illustrate both HRQOL and symptoms as outcomes of treatment and of descriptive studies of cancer survivorship. Survivorship was operationally defined as beginning at the completion of primary anticancer treatment.

Results

HRQOL and symptom burden measures both provide meaningful but conceptually different data. Both types of measures are important in portraying aspects of cancer survivorship over time, although symptom burden may provide sufficient information to inform treatment decisions and identify long-term effects of cancer therapies.

Conclusions

Cancer survivors are at risk for multiple severe and persistent symptoms, and assessing and monitoring the severity and impact of these multiple symptoms is critical to understanding the survivorship experience. The inclusion of multiple symptom measures along with the development of new and better methods of long-term symptom tracking in survivors is a critical step in improving the heath status of survivors.

Implications for cancer survivors

Late and long-term effects seen in cancer survivors have historically been understudied. Symptom burden is an important area of assessment that can be used to specifically describe the symptoms that distress survivors. More descriptive data in this growing population may help identify biological processes in symptom production and maintenance, and facilitate in the development of better treatment and prevention to enhance cancer survivorship.
Literatur
1.
Alfano, C. M., McGregor, B. A., Kuniyuki, A., Reeve, B. B., Bowen, D. J., Baumgartner, K. B., et al. (2006). Psychometric properties of a tool for measuring hormone-related symptoms in breast cancer survivors. Psychooncology, 15(11), 985–1000.PubMedCrossRef
2.
Antoni, M. H., Lehman, J. M., Kilbourn, K. M., Boyers, A. E., Culver, J. L., Alferi, S. M., et al. (2001). Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology, 20(1), 20–32.PubMedCrossRef
3.
Ashing-Giwa, K. T. (2005). The contextual model of HRQoL: A paradigm for expanding the HRQoL framework. Quality of Life Research, 14(2), 297–307.PubMedCrossRef
4.
Aziz, N. M. (2002). Cancer survivorship research: Challenge and opportunity. Journal of Nutrition, 132(11 Suppl), 3494S–3503S.
5.
Bailey, R. K., Geyen, D. J., Scott-Gurnell, K., Hipolito, M. M., Bailey, T. A., & Beal, J. M. (2005). Understanding and treating depression among cancer patients. International Journal of Gynecological Cancer, 15(2), 203–208.PubMedCrossRef
6.
Barsevick, A. M., Whitmer, K., Nail, L. M., Beck, S. L., & Dudley, W. N. (2006). Symptom cluster research: Conceptual, design, measurement, and analysis issues. Journal of Pain and Symptom Management, 31(1), 85–95.PubMedCrossRef
7.
Bender, C. M., Ergyn, F. S., Rosenzweig, M. Q., Cohen, S. M., & Sereika, S. M. (2005). Symptom clusters in breast cancer across 3 phases of the disease. Cancer Nursing, 28(3), 219–225.PubMedCrossRef
8.
Borgaonkar, M. R., & Irvine, E. J. (2000). Quality of life measurement in gastrointestinal and liver disorders. Gut, 47(3), 444–454.PubMedCrossRef
9.
Bottomley, A., Flechtner, H., Efficace, F., Vanvoorden, V., Coens, C., Therasse, P., et al. (2005). Health related quality of life outcomes in cancer clinical trials. European Journal of Cancer, 41(12), 1697–1709.PubMedCrossRef
10.
Bruera, E., Kuehn, N., Miller, M. J., Selmser, P., & Macmillan, K. (1991). The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. Journal of Palliative Care, 7(2), 6–9.PubMed
11.
Buchanan, D. R., O’Mara, A. M., Kelaghan, J. W., & Minasian, L. M. (2005). Quality-of-life assessment in the symptom management trials of the National Cancer Institute-supported Community Clinical Oncology Program. Journal of Clinical Oncology, 23(3), 591–598.PubMedCrossRef
12.
Bush, N. E., Haberman, M., Donaldson, G., & Sullivan, K. M. (1995). Quality of life of 125 adults surviving 6–18 years after bone marrow transplantation. Social Science & Medicine, 40(4), 479–490.CrossRef
13.
Cella, D., Davis, K., Breitbart, W., & Curt, G. (2001). Cancer-related fatigue: Prevalence of proposed diagnostic criteria in a United States sample of cancer survivors. Journal of Clinical Oncology, 19(14), 3385–3391.PubMed
14.
Chang, V. T., Hwang, S. S., Kasimis, B., & Thaler, H. T. (2004). Shorter symptom assessment instruments: The Condensed Memorial Symptom Assessment Scale (CMSAS). Cancer Invest, 22(4), 526–536.PubMedCrossRef
15.
Cleeland, C. S. (2001). Cancer-related fatigue: New directions for research. Introduction. Cancer, 92(6 Suppl), 1657–1661.PubMedCrossRef
16.
Cleeland, C. S. (2007). Symptom burden: Multiple symptoms and their impact as patient-reported outcomes. Journal of the National Cancer Institute, (in press).
17.
Cleeland, C. S., Bennett, G. J., Dantzer, R., Dougherty, P. M., Dunn, A. J., Meyers, C. A., et al. (2003). Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism? A cytokine-immunologic model of cancer symptoms. Cancer, 97(11), 2919–2925.PubMedCrossRef
18.
Cleeland, C. S., Mendoza, T. R., Wang, X. S., Chou, C., Harle, M. T., Morrissey, M., et al. (2000). Assessing symptom distress in cancer patients: the M.D. Anderson Symptom Inventory. Cancer, 89(7), 1634–1646.PubMedCrossRef
19.
Cleeland C. S., & Reyes-Gibby, C. C. (2002). When is it justified to treat symptoms? Measuring symptom burden. Oncology (Williston.Park), 16(9 Suppl 10), 64–70.
20.
De Boer, A. G., Genovesi, P. I., Sprangers, M. A., Van Sandick, J. W., Obertop, H., & Van Lanschot, J. J. (2000). Quality of life in long-term survivors after curative transhiatal oesophagectomy for oesophageal carcinoma. British Journal of Surgery, 87(12), 1716–1721.PubMedCrossRef
21.
De Haes, J. C. (1988). Quality of life: Conceptual and theoretical considerations. In M. Watson, S. Greer, & C. Thomas (Eds.), Psychosocial oncology (pp. 61–70). Oxford: Pergamon.
22.
De Haes, J. C., Van Knippenberg, F. C., & Neijt, J. P. (1990). Measuring psychological and physical distress in cancer patients: Structure and application of the Rotterdam Symptom Checklist. British Journal of Cancer, 62(6), 1034–1038.PubMed
23.
Dodd, M. J., Miaskowski, C., & Paul, S. M. (2001). Symptom clusters and their effect on the functional status of patients with cancer. Oncology Nursing Forum, 28(3), 465–470.PubMed
24.
Donnelly, S., Walsh, D., & Rybicki, L. (1995). The symptoms of advanced cancer: Identification of clinical and research priorities by assessment of prevalence and severity. Journal Of Palliative Care, 11(1), 27–32.PubMed
25.
Fallowfield, L., Cella, D., Cuzick, J., Francis, S., Locker, G., & Howell, A. (2004). Quality of life of postmenopausal women in the Arimidex, Tamoxifen, alone or in Combination (ATAC) Adjuvant Breast Cancer Trial. Journal of Clinical Oncology, 22(21), 4261–4271.PubMedCrossRef
26.
Fossa, S. D., Dahl, A. A., & Haaland, C. F. (1999). Health-related quality of life in patients treated for testicular cancer. British Journal of Cancer, 9(5), 425–429.
27.
Ganz, P. A. (2001). Late effects of cancer and its treatment. Seminars in Oncology Nursing, 17(4), 241–248.PubMedCrossRef
28.
Ganz, P. A. (2006). Monitoring the physical health of cancer survivors: A survivorship-focused medical history. Journal of Clinical Oncology, 24(32), 5105–5111.PubMedCrossRef
29.
Ganz, P. A., Coscarelli, A., Fred, C., Kahn, B., Polinsky, M. L., & Petersen, L. (1996). Breast cancer survivors: Psychosocial concerns and quality of life. Breast Cancer Research and Treatment, 38(2), 183–199.PubMedCrossRef
30.
Ganz, P. A., Kwan, L., Stanton, A. L., Krupnick, J. L., Rowland, J. H., Meyerowitz, B. E., et al. (2004). Quality of life at the end of primary treatment of breast cancer: First results from the moving beyond cancer randomized trial. Journal of the National Cancer Institute, 96(5), 376–387.PubMedCrossRef
31.
Ganz, P. A., Rowland, J. H., Meyerowitz, B. E., & Desmond, K. A. (1998). Impact of different adjuvant therapy strategies on quality of life in breast cancer survivors. Recent Results in Cancer Research, 152, 396–411.PubMed
32.
Gaston-Johansson, F., Fall-Dickson, J. M., Bakos, A. B., & Kennedy, M. J. (1999). Fatigue, pain, and depression in pre-autotransplant breast cancer patients. Cancer Practice, 7(5), 240–247.PubMedCrossRef
33.
Grond, S., Zech, D., Diefenbach, C., & Bischoff, A. (1994). Prevalence and pattern of symptoms in patients with cancer pain: a prospective evaluation of 1635 cancer patients referred to a pain clinic. Journal of Pain and Symptom Management, 9(6), 372–382.PubMedCrossRef
34.
Grothey, A. (2005). Clinical management of oxaliplatin-associated neurotoxicity. Clinical Colorectal Cancer, 5 Suppl 1, S38–S46.CrossRef
35.
36.
Hammerlid, E., Silander, E., Hornestam, L., & Sullivan, M. (2001). Health-related quality of life three years after diagnosis of head and neck cancer-a longitudinal study. Head and Neck, 23(2), 113–125.PubMedCrossRef
37.
Hammerlid, E., & Taft, C. (2001). Health-related quality of life in long-term head and neck cancer survivors: A comparison with general population norms. British Journal of Cancer, 84(2), 149–156.PubMedCrossRef
38.
Hart, B. L. (1988). Biological basis of the behavior of sick animals. Neuroscience and Biobehavioral Reviews, 12(2), 123–137.PubMedCrossRef
39.
Hewitt, M. E., Greenfield, S., Stovall, E. (Eds.) (2005). From cancer patient to cancer survivor: Lost in transition. Washington, DC: National Academies Press.
40.
Huguenin, P. U., Taussky, D., Moe, K., Meister, A., Baumert, B., Lutolf, U. M., et al. (1999). Quality of life in patients cured from a carcinoma of the head and neck by radiotherapy: The importance of the target volume. International Journal of Radiation Oncology, Biology, Physics, 45(1), 47–52.PubMedCrossRef
41.
Kelley, K. W., Bluthe, R. M., Dantzer, R., Zhou, J. H., Shen, W. H., Johnson, R. W., et al. (2003). Cytokine-induced sickness behavior. Brain, Behavior, and Immunity, 17 Suppl 1, S112–S118.CrossRef
42.
Kent, S., Bluthe, R. M., Kelley, K. W., & Dantzer, R. (1992). Sickness behavior as a new target for drug development. Trends in Pharmacological Sciences, 13(1), 24–28.PubMedCrossRef
43.
Kim, H. J., McGuire, D. B., Tulman, L., & Barsevick, A. M. (2005). Symptom clusters: Concept analysis and clinical implications for cancer nursing. Cancer Nursing, 28(4), 270–282.PubMedCrossRef
44.
Kirkova, J., Davis, M. P., Walsh, D., Tiernan, E., O'Leary, N., LeGrand, S. B., et al. (2006). Cancer symptom assessment instruments: A systematic review. Journal of Clinical Oncology, 24(9), 1459–1473.PubMedCrossRef
45.
Klinkenberg, M., Willems, D. L., van der, W. G., & Deeg, D. J. (2004). Symptom burden in the last week of life. Journal of Pain and Symptom Management, 27(1), 5–13.PubMedCrossRef
46.
Kurzrock, R. (2001). The role of cytokines in cancer-related fatigue. Cancer, 92(6 Suppl), 1684–1688.PubMedCrossRef
47.
Lee, B. N., Dantzer, R., Langley, K. E., Bennett, G. J., Dougherty, P. M., Dunn, A. J., et al. (2004). A cytokine-based neuroimmunologic mechanism of cancer-related symptoms. Neuroimmunomodulation, 11(5), 279–292.PubMedCrossRef
48.
Miaskowski, C., Dodd, M., & Lee, K. (2004). Symptom clusters: the new frontier in symptom management research. Journal of the National Cancer Institute. Monographs, 32, 17–21.
49.
Miaskowski, C., & Lee, K. A. (1999). Pain, fatigue, and sleep disturbances in oncology outpatients receiving radiation therapy for bone metastasis: A pilot study. Journal of Pain and Symptom Management, 17(5), 320–332.PubMedCrossRef
50.
Mols, F., Vingerhoets, A. J., Coebergh, J. W., & van de Poll-Franse L. V. (2005). Quality of life among long-term breast cancer survivors: A systematic review. European Journal of Cancer, 41(17), 2613–2619.PubMedCrossRef
51.
Paice, J. A. (2004). Assessment of symptom clusters in people with cancer. Journal of the National Cancer Institute. Monographs, 32, 98–102.
52.
Patrick, D. L., Ferketich, S. L., Frame, P. S., Harris, J. J., Hendricks, C. B., Levin, B., et al. (2004). National Institutes of Health State-of-the-Science Conference Statement: Symptom management in cancer: Pain, depression, and fatigue, July 15–17, 2002. Journal of the National Cancer Institute. Monographs, 32, 9–16.
53.
Portenoy, R. K., Thaler, H. T., Kornblith, A. B., Lepore, J. M., Friedlander-Klar, H., Kiyasu, E., et al. (1994). The Memorial Symptom Assessment Scale: An instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer, 30A(9), 1326–1336.PubMedCrossRef
54.
Rauch, P., Miny, J., Conroy, T., Neyton, L., & Guillemin, F. (2004). Quality of life among disease-free survivors of rectal cancer. Journal of Clinical Oncology, 22(2), 354–360.PubMedCrossRef
55.
Reyes-Gibby, C. C., Aday, L. A., Anderson, K. O., Mendoza, T. R., & Cleeland, C. S. (2006). Pain, depression, and fatigue in community-dwelling adults with and without a history of cancer. Journal of Pain and Symptom Management, 32(2), 118–128.PubMedCrossRef
56.
Ross, J. R., Goller, K., Hardy, J., Riley, J., Broadley, K., A’hern, R., et al. (2005). Gabapentin is effective in the treatment of cancer-related neuropathic pain: A prospective, open-label study. Journal of Palliative Medicine, 8(6), 1118–1126.PubMedCrossRef
57.
Rudberg, L., Carlsson, M., Nilsson, S., & Wikblad, K. (2002). Self-perceived physical, psychologic, and general symptoms in survivors of testicular cancer 3 to 13 years after treatment. Cancer Nursing, 25(3), 187–195.PubMedCrossRef
58.
Schwartz, C. E., & Sprangers, M. A. (1999). Methodological approaches for assessing response shift in longitudinal health-related quality-of-life research. Social Science & Medicine, 48(11), 1531–1548.CrossRef
59.
Silveira, M. J., Kabeto, M. U., & Langa, K. M. (2005). Net worth predicts symptom burden at the end of life. Journal of Palliative Medicine, 8(4), 827–837.PubMedCrossRef
60.
Sprangers, M. A. G., & Schwartz, C. E. (1999). Integrating response shift into health-related quality of life research: A theoretical model. Social Science & Medicine, 48(11), 1507–1515.CrossRef
61.
Steineck, G., Bergmark, K., Henningsohn, L., al-Abany, M., Dickman, P. W., & Helgason, A. (2002). Symptom documentation in cancer survivors as a basis for therapy modifications. Acta Oncologica, 41(3), 244–252.PubMedCrossRef
62.
Valentine, A. D., & Meyers, C. A. (2001). Cognitive and mood disturbance as causes and symptoms of fatigue in cancer patients. Cancer, 92(6 Suppl), 1694–1698.PubMedCrossRef
63.
Van Weert, E., Hoekstra-Weebers, J., Grol, B., Otter, R., Arendzen, H. J., Postema, K., et al. (2005). A multidimensional cancer rehabilitation program for cancer survivors: Effectiveness on health-related quality of life. Journal of Psychosomatic Research, 58(6), 485–496.PubMedCrossRef
64.
Wang, X. S., Fairclough, D. L., Liao, Z., Komaki, R., Chang, J. Y., Mobley, G. M., et al. (2006). Longitudinal study of the relationship between chemoradiation therapy for non-small-cell lung cancer and patient symptoms. Journal of Clinical Oncology, 24(27), 4485–4491.PubMedCrossRef
65.
Webster’s Third New International Dictionary of the English Language, U. (1966). (15th ed.) Springfield, MA: Merriam.
66.
Zambroski, C. H., Moser, D. K., Bhat, G., & Ziegler, C. (2005). Impact of symptom prevalence and symptom burden on quality of life in patients with heart failure. European Journal of Cardiovascular Nursing, 4(3), 198–206.PubMedCrossRef
Metadaten
Titel
Symptom burden in cancer survivorship
verfasst von
V. Shannon Burkett
Charles S. Cleeland
Publikationsdatum
01.06.2007
Erschienen in
Journal of Cancer Survivorship / Ausgabe 2/2007
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-007-0017-y

Weitere Artikel der Ausgabe 2/2007

Journal of Cancer Survivorship 2/2007 Zur Ausgabe

OriginalPaper

Short term correlates of the Neuro Emotional Technique for cancer-related traumatic stress symptoms: A pilot case series

OriginalPaper

Discussion of fertility preservation with newly diagnosed patients: oncologists’ views

OriginalPaper

Physical activity, long-term symptoms, and physical health-related quality of life among breast cancer survivors: A prospective analysis

Editorial

Well being among cancer survivors

OriginalPaper

Return to paid work after cancer: A British experience

OriginalPaper

Diabetes mellitus among cancer survivors

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

23.04.2024 Medikamente in Schwangerschaft und Stillzeit Nachrichten

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise