Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May;53(5):880-886.
doi: 10.1016/j.jpainsymman.2016.12.332. Epub 2017 Jan 3.

Symptom Clusters Change Over Time in Women Receiving Adjuvant Chemotherapy for Breast Cancer

Randa M Albusoul  1 , Ann M Berger  2 , Caryl L Gay  3 , Susan L Janson  3 , Kathryn A Lee  4
Affiliations

Symptom Clusters Change Over Time in Women Receiving Adjuvant Chemotherapy for Breast Cancer

Randa M Albusoul et al. J Pain Symptom Manage. 2017 May.

Abstract

Context: Patients with breast cancer receiving chemotherapy (CTX) experience multiple concurrent symptoms, but little is known about how symptoms change during and after treatment. Knowledge of the identity and trajectory of symptom clusters (SCs) would enhance measurement and management.

Objectives: We aimed to identify SCs and their change over time from baseline to completion of breast cancer CTX.

Methods: SCs were identified and assessed for change in 219 women from Nebraska at four times: baseline, during cycles #3 and #4 of CTX, and one month after finishing CTX. Ten symptoms were measured: two using the Hospital Anxiety and Depression Scale and eight using the Symptom Experience Scale. Exploratory factor analysis was conducted at each time point, then changes in SCs were evaluated at different times.

Results: Two SCs were identified before and after initiating CTX: gastrointestinal and treatment-related. The number and type of symptoms in each cluster differed over time. Clusters were dynamic during CTX with changes in the number and type of symptoms. Only one treatment-related SC, which consisted of fatigue, pain, and sleep disturbance, was identified after CTX completion.

Conclusion: SCs during CTX appear to be dynamic, changing over time from before until after CTX completion. Repeated assessments of SCs reveal symptoms that are present and when patients are most burdened and in need of additional support.

Keywords: Breast cancer; chemotherapy; longitudinal study; oncology; symptom clusters; symptom experience.

PubMed Disclaimer

References

    1. American Cancer Society. [Accessed June 8, 2016];Cancer facts and figures. 2016 Available from: http://www.cancer.org/acs/groups/content/@research/documents/document/ac....
    1. National Institute of Nursing Research. [Accessed April 28, 2012];Bringing science to life: NINR strategic plan. 2012 Available from: http://www.ninr.nih.gov/NR/rdonlyres/8BE21801-0C52-44C2-9EEA-142483657FB....
    1. Cimprich B, Ronis DL. Attention and symptom distress in women with and without breast cancer. Nurs Res. 2001;50:86–94. - PubMed
    1. Kirkova J, Aktas A, Walsh D, Mellar P. Cancer symptom clusters: clinical and research methodology. J Palliat Med. 2011;14:1149–1166. - PubMed
    1. Lacasse C, Beck S. Clinical assessment of symptom clusters. Semin Oncol Nurs. 2007;23:106–112. - PubMed

Publication types

MeSH terms