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Meagan Whisenant



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    P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.15-29 - Defining the Symptom Burden of Non-Small Cell Lung Cancer (ID 12361)

      12:00 - 13:30  |  Presenting Author(s): Meagan Whisenant

      • Abstract
      • Slides

      Background

      Symptom burden is disease and treatment symptom severity and its impact on daily functioning. Symptom monitoring has demonstrated improved cancer patient outcomes, including quality of life, resource utilization, ability to continue treatment, and survival. The use of disease-specific patient-reported outcomes (PRO) measures facilitates individualized symptom monitoring and management. The purpose of this study was to describe symptom experience from the patient perspective and identify key symptoms for a PRO measure of non-small cell lung cancer (NSCLC) symptom burden.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Patients with NSCLC described their symptom experience in single qualitative interviews. Content analysis was used to define the content for a PRO measure of NSCLC symptom burden.

      4c3880bb027f159e801041b1021e88e8 Result

      Mean age of the 40 patients interviewed was 66.1 years (standard deviation = 10.9); 60.0% were male, 77.5% were white, and 56.4% had stage IV disease. Content analysis found a total of 32 symptoms, 6 reported by ≥ 20% of participants (see Table 1). Symptoms varied based on treatment modality (chemotherapy versus radiation therapy), but not stage of disease. Numbness or tingling and sore mouth were described only by patients who had received chemotherapy. Patients volunteered ways in which symptoms impacted daily activities and relationships.

      Table 1. Patient quotes from qualitative interviews describing the 6 most common symptoms (reported by ≥ 20% of participants)
      Symptom Participant Quote
      Shortness of breath

      “The heaviness, it’s like a—wow, I don’t know how to explain it—like a rock and hard to breathe sometimes, just shortness of breath. Of course, the more I try to walk, or whatever, I’m more short of breath.”

      ‒ 67-year-old female
      Cough

      “I had a real bad cough. I think I actually even broke a couple of ribs coughing so much.”

      ‒ 52-year-old male

      Distress

      “Terrifying. There’s no ways about it. You know, it’s a terrifying experience, especially when it’s dropped in your lap and you have to deal with it. You go through a lot physically and mentally.”

      ‒ 67-year-old male
      Fatigue

      “I'm more tired. I take a lot of naps where I never had been a nap person. Before I had all my energy, and I was doing lots of things, and now I'm wore out. I wake up, and I'm wore out.”

      ‒ 53-year-old male
      Pain

      “You keep trying to move it to make it feel better and no matter where you put it, it doesn’t feel any better … most of the time it will bother me after I get out of bed in the morning for a while. And then if I go try to take a nap, I’ll go ahead and take something for pain because I can’t lay there and—I just keep moving it and moving it and nothing helps.”

      - 68-year-old male
      Constipation

      “I didn’t have a bowel movement. I had always taken the stool softeners because they told me to do that. And I kept thinking, “Well, it’s going to work. It’s going to work.” Finally, I was in so much pain that I couldn’t stand anymore, so I went to the hospital … and they ended up physically removing, which was horrible.”

      ‒ 68-year-old female

      8eea62084ca7e541d918e823422bd82e Conclusion

      Patients with NSCLC experience numerous symptoms related to disease and treatment. Shortness of breath, cough, distress, fatigue, pain, and constipation were commonly reported symptoms, suggesting that clinicians should routinely and proactively monitor the presence and severity of these symptoms in NSCLC clinical care. In patients receiving chemotherapy, attention to specific treatment-related symptoms, including symptoms of neuropathy and sore mouth, is needed. While stage of disease does not produce unique symptoms, the severity of the symptoms may possibly vary by stage of disease. Clinicians should also be aware that symptoms result in interference with daily activities, relationships, life plans, treatment adherence, and mood.

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