Carolyn Lefkowits1, Michael W Rabow2, Alexander E Sherman3, Tuyen K Kiet3, Rachel Ruskin4, John K Chan3, Lee-may Chen3. 1. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, CA 94117, USA. Electronic address: caseylefkowitscj@upmc.edu. 2. Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA 94143-0320, USA. 3. Department of Obstetrics, Gynecology & Reproductive Sciences, Division of Gynecologic Oncology, University of California San Francisco, San Francisco, CA 94117, USA. 4. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, CA 94117, USA.
Abstract
OBJECTIVE: To characterize symptom prevalence in gynecologic oncology outpatients and identify predictors of high symptom burden. METHODS: We performed a retrospective analysis of a convenience sample of symptom surveys from gynecologic oncology patients at a single cancer center over a 20-month period. The survey was based on the Edmonton Symptom Assessment System (ESAS), and assessed pain, depression, anxiety, fatigue and well-being. Information on demographics, disease, treatment and history of chronic pain, depression or anxiety was abstracted from medical records. Data was analyzed with descriptive and t-test statistics. RESULTS: We analyzed 305 surveys from unique patients. Symptom prevalence (severity score>0/10) ranged from 60.1% (pain) to 79.7% (fatigue). Prevalence of moderate to severe symptoms (score≥4/10) ranged from 32% (pain) to 47% (fatigue). There were no differences in symptom burden by site or stage of cancer. Patients with no active disease (38%) were less symptomatic. There was a trend toward higher symptom burden in patients younger than 50years. There was higher symptom burden in patients receiving cancer treatment or with a pre-existing history of pain, anxiety or depression. Patients who expressed an interest in being seen by a symptom management service also had higher symptom burden. CONCLUSIONS: Gynecologic oncology outpatients have a high symptom burden regardless of stage and site of cancer. Patients who are young, on treatment or have a history of chronic pain, depression or anxiety have a higher symptom burden. Consideration should be given to targeting these patients for outpatient palliative care services.
OBJECTIVE: To characterize symptom prevalence in gynecologic oncology outpatients and identify predictors of high symptom burden. METHODS: We performed a retrospective analysis of a convenience sample of symptom surveys from gynecologic oncology patients at a single cancer center over a 20-month period. The survey was based on the Edmonton Symptom Assessment System (ESAS), and assessed pain, depression, anxiety, fatigue and well-being. Information on demographics, disease, treatment and history of chronic pain, depression or anxiety was abstracted from medical records. Data was analyzed with descriptive and t-test statistics. RESULTS: We analyzed 305 surveys from unique patients. Symptom prevalence (severity score>0/10) ranged from 60.1% (pain) to 79.7% (fatigue). Prevalence of moderate to severe symptoms (score≥4/10) ranged from 32% (pain) to 47% (fatigue). There were no differences in symptom burden by site or stage of cancer. Patients with no active disease (38%) were less symptomatic. There was a trend toward higher symptom burden in patients younger than 50years. There was higher symptom burden in patients receiving cancer treatment or with a pre-existing history of pain, anxiety or depression. Patients who expressed an interest in being seen by a symptom management service also had higher symptom burden. CONCLUSIONS: Gynecologic oncology outpatients have a high symptom burden regardless of stage and site of cancer. Patients who are young, on treatment or have a history of chronic pain, depression or anxiety have a higher symptom burden. Consideration should be given to targeting these patients for outpatient palliative care services.
Authors: Janae L Kirsch; Michael E Robinson; Christina S McCrae; Elizabeth L Kacel; Shan S Wong; Seema Patidar; Timothy S Sannes; Stephanie Garey; Jacqueline C Castagno; Deidre B Pereira Journal: Pain Med Date: 2020-01-01 Impact factor: 3.750
Authors: Kelsey R Honerlaw; Meredith E Rumble; Stephen L Rose; Christopher L Coe; Erin S Costanzo Journal: Gynecol Oncol Date: 2015-09-10 Impact factor: 5.482
Authors: Rachel A Pozzar; Marilyn J Hammer; Bruce A Cooper; Kord M Kober; Lee-May Chen; Steven M Paul; Yvette P Conley; Frances Cartwright; Fay Wright; Jon D Levine; Christine Miaskowski Journal: Cancer Nurs Date: 2021-09-23 Impact factor: 2.760
Authors: Nadja Klafke; Cornelia Mahler; Cornelia von Hagens; Gisela Blaser; Martina Bentner; Stefanie Joos Journal: Support Care Cancer Date: 2015-12-02 Impact factor: 3.359