THE SYMPTOMS OF ADVANCED CANCER - IDENTIFICATION OF CLINICAL AND RESEARCH PRIORITIES BY ASSESSMENT OF PREVALENCE AND SEVERITY

In advanced cancer, when cure is impossible, symptoms should be the fo cus of attention. We report the first prospective, systematic analysis of the severity of 37 symptoms in 1000 patients with advanced cancer, using the Paradox relational database. Pain, easy fatigue, and anorex ia were consistently among the 10 most prevalent symptoms associated w ith cancer at all sites. When pain, anorexia, weakness, anxiety, lack of energy, easy fatigue, early satiety, constipation, and dyspnea were present, 60%-80% of patients rated them as moderate or severe, i.e. o f clinical importance. The most common symptoms were also the most sev ere. In general the same symptoms were clinically important at most pr imary sites. Clinically important dyspnea, hoarseness, hiccough, and d ysphagia were more common in men; anxiety, nausea, vomiting, and early satiety in women. Clinically important dyspepsia, nausea, and vomitin g occurred more frequently in gynecological cancers.