Symptom ‘clusters’ plague sarcoma patients

"If we are able to manage one of the symptoms well, hopefully, the severity of the other symptoms that are very closely related to that symptom will also be reduced," says Alexandre Chan. (Credit: iStockphoto)

Sarcoma is a rare and debilitating cancer that can cause large, aggressive tumors. Patients with the disease experience symptoms such as pain, breathlessness, and nausea.

Little research exists on the prevalence and severity of this symptom burden or medication usage among Asian patients. To address this gap, scientists have evaluated and documented Asian adult sarcoma patients’ physiological and psychological symptom burden on health-related quality of life.

Led by Associate Professor Alexandre Chan from the National University of Singapore’s pharmacy department, the team reports their findings in Supportive Care in Cancer.

Even though the incidence of sarcoma constitutes only 1 percent of all cancers, coauthor Richard Quek of National Cancer Centre Singapore supports the work. “I found the study to be very relevant, because in sarcoma patients, the tumors can grow to the size of a watermelon,” he explains.

The study examines the symptoms and medication usage of 79 sarcoma patients in Singapore, the majority of whom were male, Chinese, and living with a caregiver.

The most widespread physiological symptoms that the patients experienced were tiredness, lack of energy, and difficulty sleeping, with tiredness, difficulty sleeping, and lack of appetite perceived as the most clinically important to them.

Psychological symptoms which patients reported as the most common and clinically important were irritability, worrying, and anxiety.

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Numerous symptoms such as pain, breathlessness, insomnia, and poor appetite were also undertreated among the subjects. All these negatively affected the patients’ quality of life.

The authors find evidence of symptom clustering, in which various symptoms, together with factors relating to the patient, disease, and environment, as well as the patient’s individual physical performance, affect one another.

“If we are able to manage one of the symptoms well, hopefully, the severity of the other symptoms that are very closely related to that symptom will also be reduced,” says Chan.

Moving forward, the research team sees a need to understand the molecular basis of how some of the reported symptoms, such as tiredness, develop among patients. They also plan to develop psycho-social interventions that would help, in particular, the Asian young adult population.

Source: National University of Singapore