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Factors associated with patient-reported subjective well-being among advanced lung or non-colonic gastrointestinal cancer patients

Published online by Cambridge University Press:  07 March 2017

Sriram Yennurajalingam ,
Yu Jung Kim ,
Yi Zhang ,
Jichan Park ,
Joseph Arthur ,
Gary B. Chisholm ,
Janet L. Williams  and
Eduardo Bruera
Sriram Yennurajalingam*
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Yu Jung Kim
Affiliation:
Division of Hematology and Medical Oncology, Department of Internal Medicine; Seoul National University, Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
Yi Zhang
Affiliation:
Department of Medical Oncology, Shanghai University of Traditional Chinese Medicine, Shuguang Hospital, Shanghai, China
Jichan Park
Affiliation:
Division of Hematology and Oncology, Department of Internal Medicine; Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
Joseph Arthur
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Gary B. Chisholm
Affiliation:
Department of Gynecology Oncology, and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Janet L. Williams
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Eduardo Bruera
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
*
Address correspondence and reprint requests to: Sriram Yennurajalingam, Department of Palliative, Rehabilitation, and Integrative Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030. E-mail: [email protected].
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Abstract

Objective:

The aim of this study was to determine the factors associated with a feeling of well-being using the Edmonton Symptom Assessment Scale (ESAS)–Feeling of Well-Being item (ESAS–FWB; where 0 = best and 10 = worst) among advanced lung or non-colonic gastrointestinal cancer patients who were referred to an outpatient palliative care clinic (OPCC). We also examined the association of performance on the ESAS–FWB with overall survival (OS).

Method:

We reviewed the records of consecutive patients with incurable advanced lung cancer and non-colonic gastrointestinal cancer presenting to an OPCC from 1 January 2008 through to 31 December 2013. Descriptive statistics were employed to summarize patient characteristics. Multivariate regression analysis was used to determine the factors associated with ESAS–FWB severity. We also examined the association of ESAS–FWB scores and survival using Kaplan–Meier survival analysis.

Results:

A total of 826 evaluable patients were analyzed (median age = 62 years, 57% male). Median ESAS–FWB scores were five times the interquartile range (5 × IQR; 3–7). ESAS–FWB score was found to be significantly associated with ESAS fatigue (OR = 2.31, p < 0.001); anxiety (OR = 1.98, p < 0.001); anorexia (OR = 2.31, p < 0.001); cut down, annoyed, guilty, eye opener (CAGE) score (hazard ratio [HR] = 1.80, p = 0.008); and family caregiver distress (HR = 1.93, p = 0.002). A worse ESAS–FWB score was significantly associated with decreased OS (r = –0.18, p < 0.001). However, ESAS–FWB score was not independently associated with OS in the final multivariate model (p = 0.35), which included known major clinical prognostic factors.

Conclusions:

Worse ESAS–FWB scores were significantly associated with high scores on ESAS fatigue, anorexia, anxiety, CAGE, and family caregiver distress. More research is necessary to understand how palliative care interventions are capable of improving the contributory factors related to ESAS–FWB score.

Keywords

Feeling of well-beingAdvanced cancerOutpatient supportive careSymptom control
Type
Original Articles
Information
Palliative & Supportive Care , Volume 16 , Special Issue 1: Special Instruments – Assessment and Measure Issues in Palliative Care , February 2018 , pp. 23 - 31
Copyright
Copyright © Cambridge University Press 2017 

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References

REFERENCES

Ballatori, E., Roila, F., Ruggeri, B., et al. (2010). The uniscale assessment of quality of life: Applications to oncology. In Preedy, V. & Watson, R. (Eds.), Handbook of Disease Burdens and Quality of Life Measures, pp. 179–194. New York: Springer Science.Google Scholar
Barbera, L., Seow, H., Howell, D., et al. (2010). Symptom burden and performance status in a population-based cohort of ambulatory cancer patients. Cancer, 116(24), 5767–5776. Epub ahead of print Nov 8. Available from http://onlinelibrary.wiley.com/doi/10.1002/cncr.25681/full.CrossRefGoogle Scholar
Braun, D., Gupta, D. & Staren, E. (2011). Quality of life assessment as a predictor of survival in non-small cell lung cancer. BMC Cancer, 11(1), 353. Available from http://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-11-353.Google Scholar
Breitbart, W., Rosenfeld, B., Roth, A., et al. (1997). The Memorial Delirium Assessment Scale. Journal of Pain and Symptom Management, 13(3), 128–137. Available from http://www.delirant.info/DreamHC/Download/MDAS.pdf.Google Scholar
Brown, C.G., Brodsky, J. & Cataldo, J.K. (2013). Lung cancer stigma, anxiety, depression and quality of life. Journal of Psychosocial Oncology, 32(1), 59–73. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4634635/.CrossRefGoogle Scholar
Bruera, E., Kuehn, N., Miller, M.J., et al. (1991). The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients. Journal of Palliative Care, 7(2), 6–9.Google Scholar
Bush, S.H., Parsons, H.A., Palmer, J.L., et al. (2010). Single- vs. multiple-item instruments in the assessment of quality of life in patients with advanced cancer. Journal of Pain and Symptom Management, 39(3), 564–571. Available from http://www.jpsmjournal.com/article/S0885-3924(10)00085-0/pdf.CrossRefGoogle ScholarPubMed
Calman, K.C. (1984). Quality of life in cancer patients: An hypothesis. Journal of Medical Ethics, 10(3), 124–127. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1374977/.CrossRefGoogle ScholarPubMed
Carvajal, A., Centeno, C., Watson, R., et al. (2011). A comprehensive study of psychometric properties of the Edmonton Symptom Assessment System (ESAS) in Spanish advanced cancer patients. European Journal of Cancer, 47(12), 1863–1872. Epub ahead of print Apr 22.Google Scholar
Cassell, J.E. (2013). The Nature of Healing: The Modern Practice of Medicine. New York: Oxford University Press.Google Scholar
Chang, V.T., Hwang, S.S. & Feuerman, M. (2000). Validation of the Edmonton Symptom Assessment Scale. Cancer, 88(9), 2164–2171. Available from http://onlinelibrary.wiley.com/doi/10.1002/(SICI)1097-0142(20000501)88:9%3C2164::AID-CNCR24%3E3.0.CO;2-5/full.Google Scholar
Cheung, W.Y., Barmala, N., Zarinehbaf, S., et al. (2009). The association of physical and psychological symptom burden with time to death among palliative cancer outpatients. Journal of Pain and Symptom Management, 37(3), 297–304. Available from http://www.jpsmjournal.com/article/S0885-3924(08)00388-6/pdf.Google Scholar
Derogatis, L.R., Abeloff, M.D. & Melisaratos, N. (1979). Psychological coping mechanisms and survival time in metastatic breast cancer. The Journal of the American Medical Association, 242(14), 1504–1508.Google Scholar
Eid, M. & Larsen, R.J. (2008). The Science of Subjective Well-Being. New York: The Guilford Press.Google Scholar
Ewing, J.A. (1984). Detecting alcoholism: The CAGE Questionnaire. The Journal of the American Medical Association, 252(14), 1905–1907.Google Scholar
Ganz, P.A., Lee, J.J. & Siau, J. (1991). Quality of life assessment: An independent prognostic variable for survival in lung cancer. Cancer, 67(12), 3131–3135. Available from http://onlinelibrary.wiley.com/doi/10.1002/1097-0142(19910615)67:12%3C3131::AID-CNCR2820671232%3E3.0.CO;2-4/pdf.Google Scholar
Lin, H.R. & Bauer-Wu, S.M. (2003). Psycho-spiritual well-being in patients with advanced cancer: An integrative review of the literature. Journal of Advanced Nursing, 44(1), 69–80.Google Scholar
Paice, J.A. (2004). Assessment of symptom clusters in people with cancer. Journal of the National Cancer Institute. Monographs, 32, 98–102. Available from https://academic.oup.com/jncimono/article-lookup/doi/10.1093/jncimonographs/lgh009.Google Scholar
Parsons, H.A., Delgado-Guay, M.O., El Osta, B., et al. (2008). Alcoholism screening in patients with advanced cancer: Impact on symptom burden and opioid use. Journal of Palliative Medicine, 11(7), 964–968. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988458/.Google Scholar
Pereira, J., Green, E., Molloy, S., et al. (2014). Population-based standardized symptom screening: Cancer Care Ontario's Edmonton Symptom Assessment System and performance status initiatives. Journal of Oncology Practice, 10(3), 212–214. Epub ahead of print Apr 22. Available from http://ascopubs.org/doi/pdf/10.1200/JOP.2014.001390.Google Scholar
Qi, Y., Schild, S.E., Mandrekar, S.J., et al. (2009). Pretreatment quality of life is an independent prognostic factor for overall survival in patients with advanced stage non-small cell lung cancer. Journal of Thoracic Oncology, 4(9), 1075–1082. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2954489/.Google Scholar
Rummans, T.A., Clark, M.M., Sloan, J.A., et al. (2006). Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: A randomized controlled trial. Journal of Clinical Oncology, 24(4), 635–642. Available from http://ascopubs.org/doi/pdf/10.1200/JCO.2006.06.209.Google Scholar
Ryan, T., Ingleton, C., Gardiner, C., et al. (2013). Symptom burden, palliative care need and predictors of physical and psychological discomfort in two UK hospitals. BMC Palliative Care, 12(1), 1–9. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599055/.Google Scholar
Schonwetter, R., Robinson, B. & Ramirez, G. (1994). Prognostic factors for survival in terminal lung cancer patients. Journal of General Internal Medicine, 9(7), 366–371.Google Scholar
Selby, D., Chakraborty, A., Myers, J., et al. (2011). High scores on the Edmonton Symptom Assessment Scale identify patients with self-defined high symptom burden. Journal of Palliative Medicine, 14(12), 1309–1316.CrossRefGoogle ScholarPubMed
Sloan, J.A., Loprinzi, C.L., Kuross, S.A., et al. (1998). Randomized comparison of four tools measuring overall quality of life in patients with advanced cancer. Journal of Clinical Oncology, 16(11), 3662–3673. Available from http://ascopubs.org/doi/pdf/10.1200/JCO.1998.16.11.3662.Google Scholar
Tanco, K., Park, J.C., Cerana, A., et al. (2017). A systematic review of instruments assessing dimensions of distress among caregivers of adult and pediatric cancer patients. Palliative & Supportive Care, 15(1), 110–124. Epub ahead of print Mar 29, 2016.CrossRefGoogle ScholarPubMed
Vodermaier, A., Linden, W., Rnic, K., et al. (2014). Prospective associations of depression with survival: A population-based cohort study in patients with newly diagnosed breast cancer. Breast Cancer Research and Treatment, 143(2), 373–384. Epub ahead of print Dec 13, 2013. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3889923/.Google Scholar
Walsh, D., Donnelly, S. & Rybicki, L. (2000). The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Supportive Care in Cancer, 8(3), 175–179.Google Scholar
Wang, X.S., Shi, Q., Lu, C., et al. (2010). Prognostic value of symptom burden for overall survival in patients receiving chemotherapy for advanced non-small cell lung cancer. Cancer, 116(1), 137–145. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3148693/.Google Scholar
Yennurajalingam, S., Urbauer, D.L., Casper, K.L.B., et al. (2011). Impact of a palliative care consultation team on cancer-related symptoms in advanced cancer patients referred to an outpatient supportive care clinic. Journal of Pain and Symptom Management, 41(1), 49–56. Epub ahead of print Aug 24, 2010. Available from http://www.jpsmjournal.com/article/S0885-3924(10)00502-6/pdf.Google Scholar
Zubrod, C.G., Schneiderman, M., Frei, E., et al. (1960). Appraisal of methods for the study of chemotherapy of cancer in man: Comparative therapeutic trial of nitrogen mustard and triethylene thiophosphoramide. Journal of Chronic Diseases, 11(1), 7–33. Available from http://jameslindlibrary.org/wp-data/uploads/2014/06/Zubrod-etal-1960-whole-article.pdf.Google Scholar