ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2009
Symptom clusters in patients with advanced cancers.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
65 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Symptoms During Outpatient Cancer Treatment and Options for Their ManagementDeutsches Arzteblatt international · 2021Pooled it
- Acupuncture vs. Massage for Insomnia and Pain in Advanced Cancer: Exploratory RCT.Journal of pain and symptom management · 2026Trial
- Trial
- The effect of weekly specialist palliative care teleconsultations in patients with advanced cancer -a randomized clinical trial.BMC medicine · 2017Trial
- Determination of cutpoints for low and high number of symptoms in patients with advanced cancer.Journal of palliative medicine · 2012Trial
- Health-related quality of life as prognostic factor for response, progression-free survival, and survival in women with metastatic breast cancer.Medical oncology (Northwood, London, England) · 2012Trial
- Gastrointestinal symptom profiles after resection of esophageal or gastric cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Observational
- Symptom Improvement and Interrelated ESAS Domains Following Outpatient Palliative Care in Hungarian Cancer Patients.Journal of clinical medicine · 2026Article
- Longitudinal symptom network patterns in cancer patients during the end of life.Scientific reports · 2025Article
- Baseline Characteristics of Individuals with Metastatic Cancer Enrolled in the Alberta Cancer Exercise Study and 12-Week Findings for Symptom-Related and Physical Fitness Measures.Current oncology (Toronto, Ont.) · 2025Article
- Using Machine Learning Approaches on Dynamic Patient-Reported Outcomes to Cluster Cancer Treatment-Related Symptoms.Current oncology (Toronto, Ont.) · 2025Article
- Scoping review of anticancer drug utilization in lung cancer patients at the end of life.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Article
- Article
- SMART-ESAS: Smartphone Monitoring and Assessment in Real Time of Edmonton Symptom Assessment System Scores for Patients With Cancer.JCO global oncology · 2024Article
- Symptom Clusters in Patients With Advanced Cancer: A Prospective Longitudinal Cohort Study to Examine Their Stability and Prognostic Significance.The oncologist · 2024Article
- Strengthening psychological well-being of Indonesian females with breast cancer through the religious-based caring program: A quasi-experimental study among Muslim population.Belitung nursing journal · 2024Article
- Symptom severity and trajectories among adolescent and young adult patients with cancer.JNCI cancer spectrum · 2023Article
- Validation of the Arabic Version of the Edmonton Symptom Assessment System.International journal of environmental research and public health · 2023Article
- Spiritual well-being, symptoms and performance of patients under palliative care.Revista brasileira de enfermagem · 2023Article
- Palliative care outpatients in a German comprehensive cancer center-identifying indicators for early and late referral.BMC palliative care · 2022Article
5 more citing papers are in PubMed but not listed here.
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
goals of workIt has been observed that certain cancer symptoms frequently occur together. Prior research on symptom patterns has focused mainly on inpatients, early stage cancers, or a single cancer type or metastatic site. Our aim was to explore symptom clusters among outpatients with different advanced cancers. MATERIALS AND
methodsSymptom scores by the Edmonton Symptom Assessment Scale (ESAS) were routinely collected for patients attending the Oncology Palliative Care Clinics at Princess Margaret Hospital from January 2005 to October 2007. Principal component analysis (PCA) was performed for the entire patient cohort and within specific disease sites to determine inter-relationships of the nine ESAS symptoms. MAIN
resultsA total of 1,366 patients was included: 682 (50%) were male and 684 (50%) were female. The median age was 64 years (range 18 to 74 years). The most common primary cancer sites were gastrointestinal (27%), lung (14%), and breast (11%). The three most distressful symptoms were fatigue, poor general well-being, and decreased appetite. PCA of symptoms for the entire patient cohort revealed two major symptom clusters: cluster 1 included fatigue, drowsiness, nausea, decreased appetite, and dyspnea, which accounted for 45% of the total variance; cluster 2 included anxiety and depression, which accounted for 10% of the total variance. There was high internal reliability in the clusters (Cronbach's alpha coefficient approximately 0.80). PCA of symptoms within the various primary cancer sites revealed differences in the pattern of symptom clusters.
conclusionsIn patients with advanced cancers, distinct symptom clusters can be identified, which are influenced by primary cancer site. Treatments directed at symptom clusters rather than individual symptoms may provide greater therapeutic benefit. Further prospective studies are warranted in order to develop more effective targeted palliative interventions for the advanced cancer patient population.
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