The Symptom Experience of Patients With Advanced Pancreatic Cancer: An Integrative Review

Abstract

Background: Pancreatic cancer is a devastating disease with limited treatment options. More than 80% of pancreatic cancers are diagnosed in advanced stages and often have debilitating symptoms, making symptom management paramount, yet the symptom experience of patients with advanced pancreatic cancer (APC) is not well understood.

Objective: The purpose of this integrative review is to synthesize the current evidence regarding the symptom experience of patients with APC.

Method: An integrative literature review was conducted to identify the patient symptom experience in studies published from 2005 to 2015.

Results: Sixteen studies met the inclusion criteria. All studies used a quantitative approach; 44% were quasi-experimental, 31% were descriptive, and 25% were correlational. Physical symptoms, especially pain, were the primary focus in most studies. Fatigue, loss of appetite, and impaired sense of well-being were prevalent and reported by patients to be of high intensity. Few studies examined psychological symptoms in patients with APC, although anxiety and depression were noted.

Conclusion: Findings suggest that physical and psychological symptoms are prevalent, some with high intensity. Preselection of symptom inventories limits our ability to fully understand the symptom experience of patients with APC. Future qualitative work is needed to provide a more in-depth understanding of symptoms, especially symptom quality and distress level, from patients' perspectives. More studies are needed to explore psychological symptoms and the interaction of physical and psychological symptoms.

Implications for practice: Findings help healthcare givers to better understand the symptom experience of their APC patients.