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Cited by 61Palliative Care and End-of-Life IssuesPalliative and Oncologic CareCancer survivorship and care

Patients’ experiences and perspectives of multiple concurrent symptoms in advanced cancer: a semi-structured interview study

Dong, Skye T., Butow, Phyllis N., Tong, Allison, Agar, Meera, Boyle, Frances, Forster, Benjamin C., Stockler, Martin, Lovell, Melanie R.·2016·Supportive Care in Cancer
DOI 10.1007/s00520-015-2913-4
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Abstract

Purpose Patients with advanced cancer typically experience multiple concurrent symptoms, which have a detrimental impact on patient outcomes. No studies to date have qualitatively explored advanced cancer patients' perceptions of multiple symptoms in oncology and palliative care settings. Understanding the experience of multiple symptoms can inform integrated clinical pathways for treating, assessing and reducing symptom burden. This study aims to describe the beliefs, attitudes and experiences of patients with multiple symptoms in advanced cancer.Methods Semi-structured interviews were conducted with 58 advanced cancer patients (23 inpatients and 35 outpatients), recruited purposively from two palliative care centres and two hospital-based oncology departments in Sydney, Australia. Transcripts were analysed thematically.Results Six major themes were identified: imminence of death and deterioration (impending death, anticipatory fear); overwhelming loss of control (symptom volatility, debilitating exhaustion, demoralisation, isolation); impinging on autonomy and identity (losing independence, refusal to a diminished self, self-advocacy, reluctance to burden others); psychological adaptation (accepting the impossibility of recovery, seeking distractions, maintaining hope, mindfulness, accommodating self-limitations), burden of self-management responsibility (perpetual self-monitoring, ambiguity in self-report, urgency of decision making, optimising management); and valuing security and empowerment (safety in coordinated care, compassionate care, fear of medical abandonment, dependence on social support). Patients transitioning from oncology to palliative care settings were more vulnerable to self-management burden.Conclusion Multiple symptoms have a profound impact on patients' autonomy, function and psychological state. Multiple symptom management and integrated care is needed to empower advanced cancer patients and reduce their struggles with self-management burden, hopelessness, isolation, fear of abandonment and mortality anxieties.

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  • There is robust evidence that group psychotherapeutic interventions are effective in reducing psychological distress, anxiety, depression, coping skills training, and suffering related to symptoms like pain, are efficient in time and resources, and promote social support.

    “porque existe evidencia robusta de que las intervenciones psicoterapéuticas grupales son eficaces en la reducción del distrés psicológico, ansiedad, depresión, el entrenamiento en habilidades de afrontamiento y la reducción del sufrimiento relacionado con síntomas como el dolor, eficientes en cuanto inversión de tiempo y recursos (23,87)”

    From AVANZACT: protocolo e intervención psicoterapéutica en cáncer avanzado basados en Terapia de Aceptación y Compromiso. (2025) · cites this paper as [23]

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Authors
Dong, S. T., Butow, P. N., Tong, A., Agar, M., Boyle, F., Forster, B. C., Stockler, M., & Lovell, M. R.
Affiliations
  • The University of Sydney (AU)
  • Flinders University (AU)
Corresponding author
Dong, Skye T.
ORCID
Venue
Supportive Care in Cancer
Publisher
Springer Science and Business Media LLC
Published
2015-09-04
Volume
24
Issue
3
Pages
1373-1386
ISSN
  • 0941-4355 (ISSN-L)
  • 1433-7339
DOI
10.1007/s00520-015-2913-4
OpenAlex
W1812912304
Cited by
61
References
45
Citations by year
2026: 2 · 2025: 4 · 2024: 6 · 2023: 10 · 2022: 9 · 2021: 8 · 2020: 7 · 2019: 2 · 2018: 8 · 2017: 5
FWCI
4.63
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Supportive Care in Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • UTS ePRESS (University of Technology Sydney) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
advanced cancer, symptom burden, patient experience, palliative care, loss of autonomy, social isolation, psychological adjustment, hope, patient empowerment
MeSH terms
Aged, Female, Humans, Male, Neoplasms, Palliative Care, Self Care

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