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Patient Perceptions of Management of Cancer-Related Pain, Fatigue, and Emotional Distress in Community Oncology Centers

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In a study reported in the Journal of Clinical Oncology, Smith et al found that a high proportion of patients in community cancer centers did not report discussing, getting advice, or receiving desired help for cancer-related pain, fatigue, or emotional distress.

The study involved surveys of patients from 17 hospital-based community cancer centers participating in the National Cancer Institute Community Cancer Centers Program. Patients had local/regional breast cancer (82%) or colon cancer (18%). Overall, 2,487 patients completed surveys (61% response rate).

Key Findings

The investigators reported the following study findings:

  • 76%, 78%, and 59% of patients reported talking to a clinician about pain, fatigue, and distress, respectively; 70%, 61%, and 54% reported receiving advice on managing the symptoms.
  • 61% of patients experienced pain; 74%, fatigue; and 46%, distress. Among those reporting each symptom, 58% reported receiving help they wanted for pain, 40% for fatigue, and 45% for distress.
  • Patients experiencing symptoms were significantly more likely to have talked about and received advice on managing these symptoms.
  • Patients who were receiving or recently completed curative treatment reported more symptoms and better symptom care vs patients who had less recently received curative treatment.

The investigators concluded, “In our sample, 30% to 50% of patients with cancer in community cancer centers did not report discussing, getting advice, or receiving desired help for pain, fatigue, or emotional distress. This finding suggests that there is room for improvement in the management of these three common cancer-related symptoms. Higher proportions of talk and advice among those experiencing symptoms imply that many discussions may be patient-initiated. Lower rates of talk and advice among those who are further in time from treatment suggest the need for more assessment among longer-term survivors, many of whom continue to experience these symptoms. These findings seem to be especially important given the high prevalence of these symptoms in our sample.”

Tenbroeck G. Smith, MA, of the Behavioral and Epidemiology Research Group, American Cancer Society, is the corresponding author for the Journal of Clinical Oncology article.

Disclosure: The study was funded by the American Cancer Society Intramural Research Department and the National Cancer Institute. For full disclosures of the study authors, visit jco.ascopubs.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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