Symptom and quality of life survey of medical oncology patients at a veterans affairs medical center - A role for symptom assessment

BACKGROUND. The current study was conducted to assess symptom prevalence an d symptom intensity and their relation to quality of life in medical oncolo gy patients at a Veterans Affairs medical center. METHODS. Consecutive inpatients and outpatients were asked to complete the Functional Assessment Cancer Therapy (FACT-G), Memorial Symptom Assessment Scale (MSAS), and the Brief Pain Inventory. Symptoms then were analyzed by their relation to Karnofsky performance status (KPS) and quality of life. RESULTS. Two hundred forty patients participated. The median number of symp toms was 8 per patient (range, 0-30 symptoms). The 5 most prevalent symptom s were lack of energy (62%), pain (59%), dry mouth (54%), shortness of brea th (50%), and difficulty sleeping (45%). Patients with moderate intensity p ain had a median number of 11 symptoms and patients with moderate intensity lack of energy had a median number of 13 symptoms. The number of intense s ymptoms increased as the KPS decreased (P < 0.001). Patients with moderatel y intense pain or fatigue also were more likely to experience nausea, dyspn ea, and lack of appetite. The number of symptoms rated as present on the MS AS was found to correlate significantly with the FACT-G Sum Quality of Life score. CONCLUSIONS. Intense symptoms were highly prevalent in this population. The presence of pain, lack of energy, or poor performance status should lead t o comprehensive symptom assessment. Patients free of disease nevertheless s till may experience intense symptoms. The number of symptoms present may be a helpful guide to quality of life. Routine comprehensive symptom assessme nt may identify a significant fraction of patients who urgently require int ensive symptom palliation. (C) 2000 American Cancer Society.