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
. 2021 Nov;29(11):6259-6269.
doi: 10.1007/s00520-021-06132-w. Epub 2021 Apr 13.

Identifying classes of the pain, fatigue, and depression symptom cluster in long-term prostate cancer survivors-results from the multi-regional Prostate Cancer Survivorship Study in Switzerland (PROCAS)

Salome Adam  1   2 , Melissa S Y Thong  3 , Eva Martin-Diener  2 , Bertrand Camey  4 , Céline Egger Hayoz  4 , Isabelle Konzelmann  5 , Seyed Mohsen Mousavi  6   7 , Christian Herrmann  6   7 , Sabine Rohrmann  2   8 , Miriam Wanner  2   8 , Katharina Staehelin  9 , Räto T Strebel  10 , Marco Randazzo  11   12 , Hubert John  12 , Hans-Peter Schmid  13 , Anita Feller  1 , Volker Arndt  1   14
Affiliations

Identifying classes of the pain, fatigue, and depression symptom cluster in long-term prostate cancer survivors-results from the multi-regional Prostate Cancer Survivorship Study in Switzerland (PROCAS)

Salome Adam et al. Support Care Cancer. 2021 Nov.

Abstract

Purpose: Aside from urological and sexual problems, long-term (≥5 years after initial diagnosis) prostate cancer (PC) survivors might suffer from pain, fatigue, and depression. These concurrent symptoms can form a cluster. In this study, we aimed to investigate classes of this symptom cluster in long-term PC survivors, to classify PC survivors accordingly, and to explore associations between classes of this cluster and health-related quality of life (HRQoL).

Methods: Six hundred fifty-three stage T1-T3N0M0 survivors were identified from the Prostate Cancer Survivorship in Switzerland (PROCAS) study. Fatigue was assessed with the EORTC QLQ-FA12, depressive symptoms with the MHI-5, and pain with the EORTC QLQ-C30 questionnaire. Latent class analysis was used to derive cluster classes. Factors associated with the derived classes were determined using multinomial logistic regression analysis.

Results: Three classes were identified: class 1 (61.4%) - "low pain, low physical and emotional fatigue, moderate depressive symptoms"; class 2 (15.1%) - "low physical fatigue and pain, moderate emotional fatigue, high depressive symptoms"; class 3 (23.5%) - high scores for all symptoms. Survivors in classes 2 and 3 were more likely to be physically inactive, report a history of depression or some other specific comorbidity, be treated with radiation therapy, and have worse HRQoL outcomes compared to class 1.

Conclusion: Three distinct classes of the pain, fatigue, and depression cluster were identified, which are associated with treatment, comorbidities, lifestyle factors, and HRQoL outcomes. Improving classification of PC survivors according to severity of multiple symptoms could assist in developing interventions tailored to survivors' needs.

Keywords: Classes; Depression; Fatigue; Pain; Prostate cancer; Symptom cluster.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Mean scores of physical fatigue, emotional fatigue, pain, and depressive symptoms*, by class of pain-fatigue-depression cluster.
See this image and copyright information in PMC

References

    1. Grossman RL, Heath AP, Ferretti V, Varmus HE, Lowy DR, Kibbe WA, et al. The missing voice of patients in drug-safety reporting. N Engl J Med. 2010;363(1):1–3. doi: 10.1056/NEJMp1002530. - DOI - PubMed
    1. Cleeland CS, Bennett GJ, Dantzer R, Dougherty PM, Dunn AJ, Meyers CA, Miller AH, Payne R, Reuben JM, Wang XS, Lee BN. Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism? Cancer. 2003;97(11):2919–2925. doi: 10.1002/cncr.11382. - DOI - PubMed
    1. National Institutes of Health Symptom management in cancer: pain, depression and fatigue: State-of-the-Science Conference Statement. J Pain Palliat Care. 2003;17(1):77–97. - PubMed
    1. Berry DL. Patient-reported symptoms and quality of life integrated into clinical cancer care. Semin Oncol Nurs. 2011;27(3):203–210. doi: 10.1016/j.soncn.2011.04.005. - DOI - PMC - PubMed
    1. Fan G, Filipczak L, Chow E. Symptom clusters in cancer patients: a review of the literature. Curr Oncol. 2007;14(4):173–179. doi: 10.3747/co.2007.145. - DOI - PMC - PubMed

LinkOut - more resources