Predictors of the multidimensional symptom experience of lung cancer patients receiving chemotherapy

Melisa L. Wong, Steven M. Paul, Bruce A. Cooper, Laura B. Dunn, Marilyn Hammer, Yvette P. Conley, Fay Wright, Jon D. Levine, Louise C. Walter, Frances Cartwright, Christine Miaskowski

Research output: Contribution to journalArticle

Abstract

Purpose: Few studies have examined interindividual variability in the symptom experience of lung cancer patients. We aimed to identify the most prevalent, severe, and distressing symptoms, and risk factors associated with increased symptom burden. Methods: Lung cancer patients (n = 145) reported occurrence, severity, and distress for 38 symptoms on the Memorial Symptom Assessment Scale 1 week after chemotherapy. Using multidimensional subscales, risk factors for higher global distress, physical, and psychological symptoms were evaluated using simultaneous linear regression. Results: Mean age was 64.0 years and 56.6% were female. Mean Karnofsky Performance Status score was 79.1 (SD 14.6) and mean Self-Administered Comorbidity Questionnaire score was 7.3 (SD 3.9). The most distressing and prevalent symptom was fatigue. Problems with sexual interest/activity had the highest mean severity rating. Patients with lower functional status (p = 0.001) and higher comorbidity (p = 0.02) reported higher global distress. Similarly, lower functional status (p = 0.003) and higher comorbidity (p = 0.04) were associated with a higher physical symptom burden along with lower body mass index (p = 0.02). Higher psychology symptom burden was associated with lower functional status (p = 0.01), younger age (p = 0.02), non-metastatic disease (p = 0.03), higher number of prior treatments (p = 0.04), and income (p = 0.03). Conclusions: Fatigue was the most distressing and prevalent symptom among lung cancer patients receiving chemotherapy. Lower functional status was associated with a higher burden of global distress, physical, and psychological symptoms. Younger age and non-metastatic disease were additional risk factors for increased psychological symptoms. Together, these risk factors can help clinicians identify lung cancer patients at increased need for aggressive symptom management.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalSupportive Care in Cancer
DOIs
StateAccepted/In press - Feb 3 2017

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Lung Neoplasms
Drug Therapy
Psychology
Comorbidity
Fatigue
Karnofsky Performance Status
Symptom Assessment
Sexual Behavior
Linear Models
Body Mass Index
Therapeutics

Keywords

  • Chemotherapy
  • Distress
  • Fatigue
  • Lung cancer
  • Multiple symptoms
  • Symptom burden

ASJC Scopus subject areas

  • Oncology

Cite this

Predictors of the multidimensional symptom experience of lung cancer patients receiving chemotherapy. / Wong, Melisa L.; Paul, Steven M.; Cooper, Bruce A.; Dunn, Laura B.; Hammer, Marilyn; Conley, Yvette P.; Wright, Fay; Levine, Jon D.; Walter, Louise C.; Cartwright, Frances; Miaskowski, Christine.

In: Supportive Care in Cancer, 03.02.2017, p. 1-9.

Research output: Contribution to journalArticle

Wong, ML, Paul, SM, Cooper, BA, Dunn, LB, Hammer, M, Conley, YP, Wright, F, Levine, JD, Walter, LC, Cartwright, F & Miaskowski, C 2017, 'Predictors of the multidimensional symptom experience of lung cancer patients receiving chemotherapy', Supportive Care in Cancer, pp. 1-9. https://doi.org/10.1007/s00520-017-3593-z
Wong, Melisa L. ; Paul, Steven M. ; Cooper, Bruce A. ; Dunn, Laura B. ; Hammer, Marilyn ; Conley, Yvette P. ; Wright, Fay ; Levine, Jon D. ; Walter, Louise C. ; Cartwright, Frances ; Miaskowski, Christine. / Predictors of the multidimensional symptom experience of lung cancer patients receiving chemotherapy. In: Supportive Care in Cancer. 2017 ; pp. 1-9.
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AU - Wong, Melisa L.

AU - Paul, Steven M.

AU - Cooper, Bruce A.

AU - Dunn, Laura B.

AU - Hammer, Marilyn

AU - Conley, Yvette P.

AU - Wright, Fay

AU - Levine, Jon D.

AU - Walter, Louise C.

AU - Cartwright, Frances

AU - Miaskowski, Christine

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N2 - Purpose: Few studies have examined interindividual variability in the symptom experience of lung cancer patients. We aimed to identify the most prevalent, severe, and distressing symptoms, and risk factors associated with increased symptom burden. Methods: Lung cancer patients (n = 145) reported occurrence, severity, and distress for 38 symptoms on the Memorial Symptom Assessment Scale 1 week after chemotherapy. Using multidimensional subscales, risk factors for higher global distress, physical, and psychological symptoms were evaluated using simultaneous linear regression. Results: Mean age was 64.0 years and 56.6% were female. Mean Karnofsky Performance Status score was 79.1 (SD 14.6) and mean Self-Administered Comorbidity Questionnaire score was 7.3 (SD 3.9). The most distressing and prevalent symptom was fatigue. Problems with sexual interest/activity had the highest mean severity rating. Patients with lower functional status (p = 0.001) and higher comorbidity (p = 0.02) reported higher global distress. Similarly, lower functional status (p = 0.003) and higher comorbidity (p = 0.04) were associated with a higher physical symptom burden along with lower body mass index (p = 0.02). Higher psychology symptom burden was associated with lower functional status (p = 0.01), younger age (p = 0.02), non-metastatic disease (p = 0.03), higher number of prior treatments (p = 0.04), and income (p = 0.03). Conclusions: Fatigue was the most distressing and prevalent symptom among lung cancer patients receiving chemotherapy. Lower functional status was associated with a higher burden of global distress, physical, and psychological symptoms. Younger age and non-metastatic disease were additional risk factors for increased psychological symptoms. Together, these risk factors can help clinicians identify lung cancer patients at increased need for aggressive symptom management.

AB - Purpose: Few studies have examined interindividual variability in the symptom experience of lung cancer patients. We aimed to identify the most prevalent, severe, and distressing symptoms, and risk factors associated with increased symptom burden. Methods: Lung cancer patients (n = 145) reported occurrence, severity, and distress for 38 symptoms on the Memorial Symptom Assessment Scale 1 week after chemotherapy. Using multidimensional subscales, risk factors for higher global distress, physical, and psychological symptoms were evaluated using simultaneous linear regression. Results: Mean age was 64.0 years and 56.6% were female. Mean Karnofsky Performance Status score was 79.1 (SD 14.6) and mean Self-Administered Comorbidity Questionnaire score was 7.3 (SD 3.9). The most distressing and prevalent symptom was fatigue. Problems with sexual interest/activity had the highest mean severity rating. Patients with lower functional status (p = 0.001) and higher comorbidity (p = 0.02) reported higher global distress. Similarly, lower functional status (p = 0.003) and higher comorbidity (p = 0.04) were associated with a higher physical symptom burden along with lower body mass index (p = 0.02). Higher psychology symptom burden was associated with lower functional status (p = 0.01), younger age (p = 0.02), non-metastatic disease (p = 0.03), higher number of prior treatments (p = 0.04), and income (p = 0.03). Conclusions: Fatigue was the most distressing and prevalent symptom among lung cancer patients receiving chemotherapy. Lower functional status was associated with a higher burden of global distress, physical, and psychological symptoms. Younger age and non-metastatic disease were additional risk factors for increased psychological symptoms. Together, these risk factors can help clinicians identify lung cancer patients at increased need for aggressive symptom management.

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KW - Multiple symptoms

KW - Symptom burden

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