The importance of symptom surveillance during follow-up care of leukemia, bladder, and colorectal cancer survivors

Support Care Cancer. 2014 Jan;22(1):163-72. doi: 10.1007/s00520-013-1961-x. Epub 2013 Sep 10.

Abstract

Purpose: We examined cancer survivors' experience of bothersome symptoms, association of symptom bother with health-related quality of life (HRQOL), survivors' perception of symptom care, and their symptom-related information needs.

Methods: Using self-report survey measures, survivors of leukemia, bladder, or colorectal cancer who were 2-5 years post-diagnosis and received follow-up care in the past year (N = 623) provided information about the presence of bothersome symptoms, symptom-related information needs, adequacy of symptom-related care, and their physical and mental HRQOL. Multivariable statistical analyses were conducted to identify correlates of symptom bother, inadequate care, and symptom information needs and to examine the association between symptom bother and HRQOL.

Results: Twenty-eight percent of the 606 respondents experienced symptom bother in the past year (46 % of leukemia, 24 % of bladder, and 26 % of colorectal cancer survivors). Younger survivors, those of Hispanic ethnicity, with low income, those with recurrent cancer, and chemotherapy recipients were more likely to report symptom bother (all p < 0.05). Symptom bother was associated with lower physical and mental HRQOL (p < 0.001). While 92 % of survivors with symptoms discussed them with their follow-up care physician, 52 % of these reported receiving inadequate symptom care. Survivors reporting inadequate symptom care were 2.5 times as likely to identify symptom information needs compared to those who received adequate care (p < 0.05).

Conclusions: One in four cancer survivors report symptoms 2-5 years post-diagnosis, and only half of these survivors receive adequate care to address those symptoms. Research that refines and tests symptom care interventions for this population is warranted.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / physiopathology
  • Colorectal Neoplasms / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Leukemia / diagnosis*
  • Leukemia / physiopathology
  • Leukemia / psychology
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / physiopathology
  • Neoplasm Recurrence, Local / psychology
  • Quality of Life
  • Self Report
  • Survivors
  • Symptom Assessment / methods
  • Urinary Bladder Neoplasms / diagnosis*
  • Urinary Bladder Neoplasms / physiopathology
  • Urinary Bladder Neoplasms / psychology