The symptom burden of cancer: Evidence for a core set of cancer‐related and treatment‐related symptoms from the Eastern Cooperative Oncology Group Symptom Outcomes and Practice Patterns study
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BACKGROUND: A set of common cancer‐related and treatment‐related symptoms has been proposed for quality of care assessment and clinical research. Using data from a large, multicenter, prospective study, the authors assessed the effects of disease site and stage on the percentages of patients rating these proposed symptoms as moderate to severe. METHODS: The severity of 13 symptoms proposed to represent “core” oncology symptoms was rated by 3106 ambulatory patients with cancer of the breast, prostate, colon/rectum, or lung, regardless of disease stage or phase of care; 2801 patients (90%) repeated the assessment 4 to 5 weeks later. RESULTS: At the time of the initial assessment, approximately 33% of the patients reported ≥ 3 symptoms in the moderate‐to‐severe range; 11 of the 13 symptoms were rated as moderate to severe by at least 10% of all patients and 6 were rated as moderate to severe by at least 20% of those receiving active treatment. Fatigue/tiredness was the most severe symptom, followed by disturbed sleep, pain, dry mouth, and numbness/tingling. More patients with lung cancer and patients receiving active treatment reported moderate to severe symptoms. Percentages of symptomatic patients increased by disease stage, less adequate response to therapy, and declining Eastern Cooperative Oncology Group performance status. The percentages of patients reporting moderate to severe symptoms were stable across both assessments. CONCLUSIONS: The results of the current study support a core set of moderate to severe symptoms that are common across outpatients with solid tumors, that can guide consideration of progression‐free survival as a trial outcome, and that should be considered in clinical care and in assessments of quality of care and treatment benefit. Cancer 2013;119:4333–4340 . © 2013 American Cancer Society .
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Many advanced cancer patients have symptoms that interfere with functioning.
“Many advanced cancer patients have symptoms that interfere with functioning.1–3”
From Symptom experiences in advanced cancer: Relationships to acceptance and commitment therapy constructs (2021) · cites this paper as [1]
The Results report that moderate-to-severe symptoms became more common as disease stage worsened, and the Discussion associates greater symptom burden with poorer performance status. These passages support that many patients with advanced cancer have symptoms, but they do not establish that the symptoms themselves interfere with functioning. (LLM, conf=0.83)
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- Authors
- Cleeland, C. S., Zhao, F., Chang, V. T., Sloan, J. A., O'Mara, A. M., Gilman, P. B., Weiss, M., Mendoza, T. R., Lee, J., & Fisch, M. J.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Dana-Farber Cancer Institute (US)
- VA New Jersey Health Care System (US)
- Mayo Clinic (US)
- Community Oncology and Prevention Trials Research Group Division of Cancer Prevention National Cancer Institute Bethesda Maryland
- Lankenau Medical Center (US)
- Marshfield Clinic (US)
- Corresponding author
- Cleeland, Charles S.
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2013-09-24
- Volume
- 119
- Issue
- 24
- Pages
- 4333-4340
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- PMC
- PMC3860266
- OpenAlex
- W1758232956
- Cited by
- 316
- References
- 19
- Citations by year
- 2026: 17 · 2025: 36 · 2024: 24 · 2023: 29 · 2022: 34 · 2021: 29 · 2020: 31 · 2019: 19 · 2018: 23 · 2017: 20 · 2016: 21 · 2015: 17 · 2014: 15 · 2013: 1
- FWCI
- 9.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CA- 016672, CA026582)
- University of Texas MD Anderson Cancer Center ((CA016672), P30-CA-016672)
- National Cancer Institute (CA026582, CA 016672, R01CA026582, U10CA037403, CA13650, U10 CA37403, U10CA035412, U10 CA13650, U10CA013650, U10CA063847, U10 CA35412, U10CA015488, P30CA015083, P30CA016672, U10 CA15488)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- cancer symptoms, treatment-related symptoms, symptom burden, fatigue, sleep disorders, pain, xerostomia, numbness and tingling, lung cancer, breast cancer, prostate cancer, colon and rectal cancer, disease stage, performance status, quality of care evaluation, progression-free survival
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Neoplasms, Prospective Studies, Surveys and Questionnaires, Severity of Illness Index, Cost of Illness, Disease-Free Survival, Young Adult, Symptom Assessment, Drug-Related Side Effects and Adverse Reactions
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