Difference in symptom burden and distress among cancer patients undergoing antineoplastic treatment

AdultsOlder AdultsNutritionChronic disease
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Introduction: Cancer affects people of all ages. However, factors affecting quality of life may vary among different age groups. The purpose of this study was to assess differences in nutritional status, symptom burden, and distress among cancer patients undergoing antineoplastic treatment.

Methods: A retrospective chart review was conducted in patients referred to the Cancer Rehabilitation Program at the McGill University Health Centre between November 2013 and August 2019. All patients were undergoing cancer treatment at that time. Patients were divided into young (<50 y), middle (50-69 y), and old (≥70 y) age groups. Distress and its contributing factors were assessed using the Distress Thermometer (DT) and the Canadian Problem Checklist (CPC), respectively. Nutritional status was evaluated with the Abridged Patient-Generated Subjective Global Assessment (aPG-SGA) and symptoms with the revised Edmonton Symptom Assessment Scale (ESAS-r).

Results: Sample size was 310 (53 young ;41.9±6.7 y, 163 middle; 60.2±5.4 y, and 94 old; 75.7±4.9 y). There was no significant difference in aPG-SGA total score among different age groups. For ESAS-r scores, fatigue and drowsiness were significantly higher in the young group relative to the middle group (p<0.05). Distress thermometer scores were significantly higher in the young relative to the old group (4.56±2.70 vs 3.35±2.81; p<0.05). Finances and work/school were two factors of distress with the largest differences among age groups. The young group reported significantly more financial and school/work problems relative to the middle and old group. The middle group expressed more frustration and anger than the old, but not the young group.

Conclusion: Fatigue, drowsiness, and problems in practical and emotional domains differed between ages, especially between the young and old groups. This research will contribute towards finding the best suitable treatment for cancer patients by taking age into consideration.


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