Somatic symptoms in cancer patients trajectory over 12 months and impact on functional status and disability

Kurt Kroenke, Shelley Johns, Dale Theobald, Jingwei Wu, Wanzhu Tu

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose: Cross-sectional studies have established the prevalence and functional impairment of somatic symptoms in cancer patients. The purpose of this study was to determine the trajectory and adverse consequences of such symptoms over time. Methods: Secondary analysis of longitudinal data from 405 cancer patients enrolled in a telecare management trial for pain and/or depression. Somatic symptom burden was measured with a 22-item scale at baseline, 1, 3, 6, and 12 months. Outcomes included the SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, the Sheehan Disability Scale (SDS) score, and self-reported total disability days. Mixed methods repeated measures analyses were conducted to determine whether antecedent change in somatic symptom burden predicted functional status and disability. Results: Symptoms were highly prevalent at baseline, with 15 of the 22 symptoms endorsed by more than half of the patients. A rather constant cross-sectional prevalence over 12 months at the group level belied a quite different trajectory at the patient level where the median persistence, resolution, and incidence rates for 14 of the most common symptoms were 39 %, 37 %, and 24 %, respectively. A clinically significant (i.e., five points) reduction in somatic symptom burden predicted improvement in PCS, MCS, and SDS (all P < 0.001), as well as a lower likelihood of ≥14 disability days in the past 4 weeks (odds ratio, 0.84; 95 % CI, 0.74 to 0.95). Conclusions: Somatic symptoms remain burdensome in cancer patients over 12 months and symptom improvement predicts significantly better functional status and less disability.

Original languageEnglish
Pages (from-to)765-773
Number of pages9
JournalSupportive Care in Cancer
Volume21
Issue number3
DOIs
StatePublished - Mar 2013

Fingerprint

Neoplasms
Pain Management
Cross-Sectional Studies
Odds Ratio
Medically Unexplained Symptoms
Incidence

Keywords

  • Cancer
  • Disability
  • Functional status
  • Prognosis
  • Somatic symptoms
  • Symptom burden

ASJC Scopus subject areas

  • Oncology

Cite this

Somatic symptoms in cancer patients trajectory over 12 months and impact on functional status and disability. / Kroenke, Kurt; Johns, Shelley; Theobald, Dale; Wu, Jingwei; Tu, Wanzhu.

In: Supportive Care in Cancer, Vol. 21, No. 3, 03.2013, p. 765-773.

Research output: Contribution to journalArticle

@article{3074d16f09b7486b896c7406852c4e22,
title = "Somatic symptoms in cancer patients trajectory over 12 months and impact on functional status and disability",
abstract = "Purpose: Cross-sectional studies have established the prevalence and functional impairment of somatic symptoms in cancer patients. The purpose of this study was to determine the trajectory and adverse consequences of such symptoms over time. Methods: Secondary analysis of longitudinal data from 405 cancer patients enrolled in a telecare management trial for pain and/or depression. Somatic symptom burden was measured with a 22-item scale at baseline, 1, 3, 6, and 12 months. Outcomes included the SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, the Sheehan Disability Scale (SDS) score, and self-reported total disability days. Mixed methods repeated measures analyses were conducted to determine whether antecedent change in somatic symptom burden predicted functional status and disability. Results: Symptoms were highly prevalent at baseline, with 15 of the 22 symptoms endorsed by more than half of the patients. A rather constant cross-sectional prevalence over 12 months at the group level belied a quite different trajectory at the patient level where the median persistence, resolution, and incidence rates for 14 of the most common symptoms were 39 {\%}, 37 {\%}, and 24 {\%}, respectively. A clinically significant (i.e., five points) reduction in somatic symptom burden predicted improvement in PCS, MCS, and SDS (all P < 0.001), as well as a lower likelihood of ≥14 disability days in the past 4 weeks (odds ratio, 0.84; 95 {\%} CI, 0.74 to 0.95). Conclusions: Somatic symptoms remain burdensome in cancer patients over 12 months and symptom improvement predicts significantly better functional status and less disability.",
keywords = "Cancer, Disability, Functional status, Prognosis, Somatic symptoms, Symptom burden",
author = "Kurt Kroenke and Shelley Johns and Dale Theobald and Jingwei Wu and Wanzhu Tu",
year = "2013",
month = "3",
doi = "10.1007/s00520-012-1578-5",
language = "English",
volume = "21",
pages = "765--773",
journal = "Supportive Care in Cancer",
issn = "0941-4355",
publisher = "Springer Verlag",
number = "3",

}

TY - JOUR

T1 - Somatic symptoms in cancer patients trajectory over 12 months and impact on functional status and disability

AU - Kroenke, Kurt

AU - Johns, Shelley

AU - Theobald, Dale

AU - Wu, Jingwei

AU - Tu, Wanzhu

PY - 2013/3

Y1 - 2013/3

N2 - Purpose: Cross-sectional studies have established the prevalence and functional impairment of somatic symptoms in cancer patients. The purpose of this study was to determine the trajectory and adverse consequences of such symptoms over time. Methods: Secondary analysis of longitudinal data from 405 cancer patients enrolled in a telecare management trial for pain and/or depression. Somatic symptom burden was measured with a 22-item scale at baseline, 1, 3, 6, and 12 months. Outcomes included the SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, the Sheehan Disability Scale (SDS) score, and self-reported total disability days. Mixed methods repeated measures analyses were conducted to determine whether antecedent change in somatic symptom burden predicted functional status and disability. Results: Symptoms were highly prevalent at baseline, with 15 of the 22 symptoms endorsed by more than half of the patients. A rather constant cross-sectional prevalence over 12 months at the group level belied a quite different trajectory at the patient level where the median persistence, resolution, and incidence rates for 14 of the most common symptoms were 39 %, 37 %, and 24 %, respectively. A clinically significant (i.e., five points) reduction in somatic symptom burden predicted improvement in PCS, MCS, and SDS (all P < 0.001), as well as a lower likelihood of ≥14 disability days in the past 4 weeks (odds ratio, 0.84; 95 % CI, 0.74 to 0.95). Conclusions: Somatic symptoms remain burdensome in cancer patients over 12 months and symptom improvement predicts significantly better functional status and less disability.

AB - Purpose: Cross-sectional studies have established the prevalence and functional impairment of somatic symptoms in cancer patients. The purpose of this study was to determine the trajectory and adverse consequences of such symptoms over time. Methods: Secondary analysis of longitudinal data from 405 cancer patients enrolled in a telecare management trial for pain and/or depression. Somatic symptom burden was measured with a 22-item scale at baseline, 1, 3, 6, and 12 months. Outcomes included the SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, the Sheehan Disability Scale (SDS) score, and self-reported total disability days. Mixed methods repeated measures analyses were conducted to determine whether antecedent change in somatic symptom burden predicted functional status and disability. Results: Symptoms were highly prevalent at baseline, with 15 of the 22 symptoms endorsed by more than half of the patients. A rather constant cross-sectional prevalence over 12 months at the group level belied a quite different trajectory at the patient level where the median persistence, resolution, and incidence rates for 14 of the most common symptoms were 39 %, 37 %, and 24 %, respectively. A clinically significant (i.e., five points) reduction in somatic symptom burden predicted improvement in PCS, MCS, and SDS (all P < 0.001), as well as a lower likelihood of ≥14 disability days in the past 4 weeks (odds ratio, 0.84; 95 % CI, 0.74 to 0.95). Conclusions: Somatic symptoms remain burdensome in cancer patients over 12 months and symptom improvement predicts significantly better functional status and less disability.

KW - Cancer

KW - Disability

KW - Functional status

KW - Prognosis

KW - Somatic symptoms

KW - Symptom burden

UR - http://www.scopus.com/inward/record.url?scp=84874118928&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84874118928&partnerID=8YFLogxK

U2 - 10.1007/s00520-012-1578-5

DO - 10.1007/s00520-012-1578-5

M3 - Article

C2 - 22941116

AN - SCOPUS:84874118928

VL - 21

SP - 765

EP - 773

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

IS - 3

ER -