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Somatic symptoms in cancer patients trajectory over 12 months and impact on functional status and disability

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Abstract

Purpose

Cross-sectional studies have established the prevalence and functional impairment of somatic symptoms in cancer patients. The purpose of this study was to determine the trajectory and adverse consequences of such symptoms over time.

Methods

Secondary analysis of longitudinal data from 405 cancer patients enrolled in a telecare management trial for pain and/or depression. Somatic symptom burden was measured with a 22-item scale at baseline, 1, 3, 6, and 12 months. Outcomes included the SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, the Sheehan Disability Scale (SDS) score, and self-reported total disability days. Mixed methods repeated measures analyses were conducted to determine whether antecedent change in somatic symptom burden predicted functional status and disability.

Results

Symptoms were highly prevalent at baseline, with 15 of the 22 symptoms endorsed by more than half of the patients. A rather constant cross-sectional prevalence over 12 months at the group level belied a quite different trajectory at the patient level where the median persistence, resolution, and incidence rates for 14 of the most common symptoms were 39 %, 37 %, and 24 %, respectively. A clinically significant (i.e., five points) reduction in somatic symptom burden predicted improvement in PCS, MCS, and SDS (all P < 0.001), as well as a lower likelihood of ≥14 disability days in the past 4 weeks (odds ratio, 0.84; 95 % CI, 0.74 to 0.95).

Conclusions

Somatic symptoms remain burdensome in cancer patients over 12 months and symptom improvement predicts significantly better functional status and less disability.

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Conflict of interest

The authors have no conflicts of interest to declare with respect to the contents of this paper.

Author information

Authors and Affiliations

  1. VA HSR&D Center of Excellence for Implementing Evidence-Based Practice, 5th Floor, Regenstrief Institute, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA

    Kurt Kroenke

  2. Department of Medicine, Indiana University, Indianapolis, IN, 46202, USA

    Kurt Kroenke, Jingwei Wu & Wanzhu Tu

  3. Regenstrief Institute, Inc., Indianapolis, IN, 46202, USA

    Kurt Kroenke & Wanzhu Tu

  4. Community Home Health Hospice and Symptom Management Group, Indianapolis, IN, 46256, USA

    Dale Theobald

  5. School of Nursing, Indiana University, Indianapolis, IN, 46202, USA

    Shelley A. Johns

Authors
  1. Kurt Kroenke
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  2. Shelley A. Johns
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  3. Dale Theobald
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  4. Jingwei Wu
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  5. Wanzhu Tu
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Corresponding author

Correspondence to Kurt Kroenke.

Additional information

Funding: This study was supported by a grant from the National Cancer Institute to Dr. Kroenke (R01 CA-115369)

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Kroenke, K., Johns, S.A., Theobald, D. et al. Somatic symptoms in cancer patients trajectory over 12 months and impact on functional status and disability. Support Care Cancer 21, 765–773 (2013). https://doi.org/10.1007/s00520-012-1578-5

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  • DOI: https://doi.org/10.1007/s00520-012-1578-5

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