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. 2015 Dec;139(3):553-8.
doi: 10.1016/j.ygyno.2015.09.079. Epub 2015 Sep 30.

Retrospective review of symptoms and palliative care interventions in women with advanced cervical cancer

Yu Jung Kim  1 , Mark F Munsell  2 , Ji Chan Park  3 , Larissa A Meyer  4 , Charlotte C Sun  4 , Alaina J Brown  4 , Diane C Bodurka  4 , Janet L Williams  5 , Dana M Chase  6 , Eduardo Bruera  5 , Lois M Ramondetta  7
Affiliations

Retrospective review of symptoms and palliative care interventions in women with advanced cervical cancer

Yu Jung Kim et al. Gynecol Oncol. 2015 Dec.

Abstract

Objective: The objective of this study was to delineate and measure the symptom distress experienced by patients with advanced cervical cancer at the time of palliative care (PC) referral.

Methods: A total of 156 patients with advanced cervical cancer were referred to PC from 2010 to 2012. Of these, 88 patients had completed the Edmonton Symptom Assessment System (ESAS) and were included in the analysis.

Results: The mean age was 45years (25-76), 47% were white, 18% were African American, and 33% were Hispanic. Fifty-one percent were married, 64% had no advance directives, and 75% had recurrent disease. Clinically significant symptoms recorded by patient reported outcome measurement (defined as ESAS scores ≥4) were pain (81%), anorexia (72%), a poor feeling of well-being (70%), fatigue (69%), and insomnia (54%). The chief complaint recorded for the visit was pain in 94% of patients. According to the PC specialists' assessment, pain (96%), emotional distress (77%), and constipation (50%) were predominant symptoms. Various PC interventions including opioids, laxatives, and expressive supportive counseling were provided. Clinically significant symptoms including nausea, depression, anxiety, and feeling of well-being were significantly improved at follow-up visits.

Conclusion: More than half of patients with advanced cervical cancer were significantly burdened with pain, anorexia, a poor feeling of well-being, fatigue, insomnia, and constipation at the time of PC referral. This research is an integral step towards developing a standardized tool for assessing symptoms in women diagnosed with cervical cancer and thus maximizing effectiveness of patient centered care.

Keywords: Advanced cervical cancer; Palliative care intervention; Symptom.

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Conflict of interest statement

Conflict of Interest Statement

The authors declare no conflicts of interest.

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