Cancer Symptoms More Important Than Diagnosis for Palliative Care

Results of a recent survey showed that for patients with cancer requiring palliative care, some symptoms and care needs are not strongly associated with specific diagnoses, published in Supportive Care in Cancer (online July 20, 2017; doi:10.1007/s00520-017-3831-4).

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While advancements have been made in palliative care in recent years, acute care hospitals currently serve as the only option for certain patients with acute palliative care needs. Limited data exists on the extent of symptoms and palliative care needs of patients with cancer in acute care hospital settings.

A Swedish study led by Anna Sandgren, PhD, Linneaus University, aimed to describe and compare diagnoses, symptoms, and care needs in patients with cancer in need of palliative care. Researchers assessed patients’ needs in two mid-sized hospitals (from 2007 to 2012) in a county council without specialized, around-the-clock palliative care. Nurses and doctors in these hospitals were tasked with completing questionnaires that assessed patients with cancer in multiple hospital wards to provide data on demographics, symptoms, care needs, and diagnosis.

In 2007 and 2012, 2972 and 2843 questionnaires were completed, respectively. Researchers found that during the two years, 589 hospitalized patients (10%) were assessed as having cancer in a palliative phase. The most frequently diagnosed cancers were lung, colorectal, and prostate.

Mean number of symptoms and care needs reported as cause for hospitalization per patient was 2.9, with the highest average (3.5) reported among patients with stomach or esophagus cancer.

Deterioration and pain were the most commonly reported symptoms (42% each) in both men and women patients and were associated with pancreatic cancer (P = .003 and P = .019, respectively). Nausea was found to be among the top four reported symptoms for women patients but not for men (P < .01).

Researchers reported that different symptoms were associated with different cancers; hematologic malignancies were associated with infections and blood transfusions (P < .001), breast cancer with pleurocentesis (P = .002), and stomach or esophagus cancer with nausea (P < .001).

Authors of the study concluded that “the fact that symptoms and care needs were not strongly associated with certain diagnoses implies that care should focus on symptoms rather than the specific diagnosis.”—Zachary Bessette