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Symptom prevalence, frequency, severity, and distress during chemotherapy for patients with colorectal cancer

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Abstract

Purpose

Early detection and improvements in treatment have increased survival after colorectal cancer (CRC), but studies investigating the multidimensional nature of treatment-related symptoms are rare. The aim of this study was therefore to describe the prevalence, frequency, and severity of symptoms and the distress they cause during the early treatment of patients with CRC undergoing chemotherapy.

Methods

Consecutive outpatients were asked to rate their symptoms during cycle 2 or 3 of chemotherapy, using the Memorial Symptom Assessment Scale.

Results

A total of 104 patients, 58 men and 46 women, evaluated their symptoms of the preceding week at one point during the treatment. The mean number of symptoms was 10.3 (SD, 7.7; range, 0–32). Highly prevalent symptoms were numbness/tingling in the hands/feet (64 %), lack of energy (62 %), feeling drowsy (49 %), and nausea (45 %). Symptoms with the highest scores for frequency, severity, and distress were lack of energy followed by difficulty in sleeping and numbness in the hands/feet. Lack of energy was noted as occurring almost constantly by 26 % and was rated as being severe or very severe by 12 % and as quite distressing or very distressing by 15 %.

Conclusions

This study shows that patients with CRC receiving chemotherapy experience several distressing symptoms early in the treatment phase. In order to provide symptom control, oncology staff should consider evaluating the patient’s symptoms early during treatment and plan adequate measures to minimize the impact of treatment-induced toxicity.

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Acknowledgments

We thank the research nurses Monica Rösliden and Cecilia Blad for monitoring the data collection in the survey. We also want to thank members of the research team who planned the large project that this study is part of Hans Starkhammar, Susanne Borén, Viktoria Markusson, and Ursula Falkmer. This study was supported by the Medical Research Council of Southeast Sweden and the Division of Nursing Science at the Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University.

Clinical implications

The results suggest that regular symptom assessment is important even at the beginning of chemotherapy treatment in order to be able to provide effective treatment for symptoms as soon as they occur. In addition, it may be important to include dimensions such as severity and distress as a complement to assessing the frequency of a symptom.

Conflict of interest

The authors have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Oncology, Ryhov County Hospital, 55185, Jönköping, Sweden

    Gunilla Pettersson

  2. Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, 581 83, Linköping, Sweden

    Carina Berterö & Sussanne Börjeson

  3. Department of Social and Welfares Studies, Linköping University, 601 74, Norrköping, Sweden

    Mitra Unosson

  4. Department of Oncology, County Council of Östergötland, 58183, Linköping, Sweden

    Sussanne Börjeson

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  1. Gunilla Pettersson
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Corresponding author

Correspondence to Gunilla Pettersson.

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Pettersson, G., Berterö, C., Unosson, M. et al. Symptom prevalence, frequency, severity, and distress during chemotherapy for patients with colorectal cancer. Support Care Cancer 22, 1171–1179 (2014). https://doi.org/10.1007/s00520-013-2069-z

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  • DOI: https://doi.org/10.1007/s00520-013-2069-z

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