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Metastatic breast cancer patients’ expectations and priorities for symptom improvement

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Abstract

Purpose

Little research has examined cancer patients’ expectations, goals, and priorities for symptom improvement. Thus, we examined these outcomes in metastatic breast cancer patients to provide patients’ perspectives on clinically meaningful symptom improvement and priorities for symptom management.

Methods

Eighty women with metastatic breast cancer participated in a survey with measures of comorbidity, functional status, engagement in roles and activities, distress, quality of life, and the modified Patient-Centered Outcomes Questionnaire that focused on 10 common symptoms in cancer patients.

Results

On average, patients reported low to moderate severity across the 10 symptoms and expected symptom treatment to be successful. Patients indicated that a 49% reduction in fatigue, 48% reduction in thinking problems, and 43% reduction in sleep problems would represent successful symptom treatment. Cluster analysis based on ratings of the importance of symptom improvement yielded three clusters of patients: (1) those who rated thinking problems, sleep problems, and fatigue as highly important, (2) those who rated pain as moderately important, and (3) those who rated all symptoms as highly important. The first patient cluster differed from other subgroups in severity of thinking problems and education.

Conclusions

Metastatic breast cancer patients report differing symptom treatment priorities and criteria for treatment success across symptoms. Considering cancer patients’ perspectives on clinically meaningful symptom improvement and priorities for symptom management will ensure that treatment is consistent with their values and goals.

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Acknowledgments

The authors thank Susan Daily, the study participants, and the breast oncology team at the Indiana University Simon Cancer Center.

Funding

This work was supported by the National Cancer Institute (T32CA117865 and K05CA175048, PI: Victoria Champion; K07CA168883, PI: Catherine Mosher) and the Walther Cancer Foundation (0175.01).

Author information

Authors and Affiliations

  1. Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA

    Danielle B. Tometich, Catherine E. Mosher, Adam T. Hirsh & Kevin L. Rand

  2. Indiana University School of Medicine, 340 W 10th St #6200, Indianapolis, IN, 46202, USA

    Shelley A. Johns, Marianne S. Matthias & Samantha D. Outcalt

  3. Center for Health Services Research, Regenstrief Institute, 1101 W 10th St, Indianapolis, IN, 46202, USA

    Shelley A. Johns, Marianne S. Matthias & Samantha D. Outcalt

  4. VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, 1481 W 10th St, Indianapolis, IN, 46202, USA

    Marianne S. Matthias & Samantha D. Outcalt

  5. Department of Communication Studies, Indiana University-Purdue University Indianapolis, 425 University Blvd, Indianapolis, IN, 46202, USA

    Marianne S. Matthias

  6. Department of Psychiatry, Indiana University School of Medicine, 340 W 10th St #6200, Indianapolis, IN, 46202, USA

    Samantha D. Outcalt

  7. Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Dr, Indianapolis, IN, 46202, USA

    Bryan P. Schneider, Anna Maria V. Storniolo, Erin V. Newton & Kathy D. Miller

  8. Banner MD Anderson Cancer Center, 2946 E Banner Gateway Dr, Gilbert, AZ, 85234, USA

    Lida Mina

Authors
  1. Danielle B. Tometich
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  2. Catherine E. Mosher
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Correspondence to Danielle B. Tometich.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Tometich, D.B., Mosher, C.E., Hirsh, A.T. et al. Metastatic breast cancer patients’ expectations and priorities for symptom improvement. Support Care Cancer 26, 3781–3788 (2018). https://doi.org/10.1007/s00520-018-4244-8

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