Kolhapur Cancer Center, India
* Corresponding author
Tata Medical Centre, India

Article Main Content

The spectrum of symptoms for an oncologist or oncosurgeon about gastrointestinal (GI) and hepatobiliary (HB) cancers varies from the spectrum of symptoms that a palliative care physician ascertains. There is a paucity of data regarding GI and HB cancer symptomatology in a palliative care outset. Hence, we conducted this study to understand the same and identify the most common symptom clusters among these cancers. The present study was retrospective observational study conducted on patients referred to palliative care department of Tata medical center, Kolkata, India. A total of 495 patient’s case records were reviewed with GI and HB cancers. Age, gender, co-morbidities, Eastern Cooperative Oncology Group (ECOG) status, symptomatology, physical examination findings, and histopathological diagnosis were reviewed from the case records and documented. Symptomatology included pain, nausea, vomiting, anxiety, depression, constipation, anorexia, early satiety and loose stools. The mean age of the patients was 57.73 ± 12.50 years with male: female ratio of 1.60. The most common organ system involved was gall bladder (22.63%) followed by pancreas (16.97%). The most common symptom was abdominal pain (63.64%) followed by anorexia (28.08%) and constipation (21.62%) and the least common ones were loose stools (3.84%) and neuropsychiatric symptoms (4.85%). Nausea-vomiting cluster (38.10%) and abdominal pain-nausea/vomiting (28.38%) cluster were most common among stomach carcinomas. Abdominal pain-constipation cluster (23.21%) was more common among gall bladder carcinomas. Future studies directing to identify these symptoms and clusters over the quality of life of advanced cancer patients are warranted.

References

  1. García-Baquero Merino MT. Palliative Care: Taking the Long View. Front Pharmacol 2018;9:1140.
    DOI  |   Google Scholar
  2. Cruz-Oliver DM. Palliative Care: An Update. Mo Med 2017;114(2):110–5.
     Google Scholar
  3. Kelley AS, Morrison RS. Palliative Care for the Seriously Ill. N Engl J Med 2015;373(8):747–55.
    DOI  |   Google Scholar
  4. Rome RB, Luminais HH, Bourgeois DA, Blais CM. The role of palliative care at the end of life. Ochsner J 2011;11(4):348–52.
     Google Scholar
  5. Zamanzadeh V, Jasemi M, Valizadeh L, Keogh B, Taleghani F. Effective factors in providing holistic care: a qualitative study. Indian J Palliat Care 2015;21(2):214–24.
    DOI  |   Google Scholar
  6. Hackett J. The Importance of Holistic Care at the End of Life. Ulster Med J 2017;86(2):143–4.
     Google Scholar
  7. Steel JL, Kim KH, Dew MA, Unruh ML, Antoni MH, Olek MC, et al. Cancer-related symptom clusters, eosinophils, and survival in hepatobiliary cancer: an exploratory study. J Pain Symptom Manage 2010;39(5):859–71.
    DOI  |   Google Scholar
  8. Sun V, Ferrell B, Juarez G, Wagman LD, Yen Y, Chung V. Symptom concerns and quality of life in hepatobiliary cancers. Oncol Nurs Forum 2008;35(3):E45-52.
    DOI  |   Google Scholar
  9. Jensen LF, Hvidberg L, Pedersen AF, Vedsted P. Symptom attributions in patients with colorectal cancer. BMC Fam Pract 2015;16:115.
    DOI  |   Google Scholar
  10. Axon A. Symptoms and diagnosis of gastric cancer at early curable stage. Best Pract Res Clin Gastroenterol 2006;20(4):697–708.
    DOI  |   Google Scholar
  11. Bowles MJ, Benjamin IS. ABC of the upper gastrointestinal tract: Cancer of the stomach and pancreas. BMJ 2001;323(7326):1413–6.
    DOI  |   Google Scholar
  12. Maconi G, Manes G, Porro G-B. Role of symptoms in diagnosis and outcome of gastric cancer. World J Gastroenterol 2008;14(8):1149–55.
    DOI  |   Google Scholar
  13. Jiménez A, Madero R, Alonso A, Martínez-Marín V, Vilches Y, Martínez B, et al. Symptom clusters in advanced cancer. J Pain Symptom Manage 2011;42(1):24–31.
    DOI  |   Google Scholar
  14. Tai SY, Lee CY, Wu CY, Hsieh HY, Huang JJ, Huang CT, et al. Symptom severity of patients with advanced cancer in palliative care unit: Longitudinal assessments of symptoms improvement. BMC Palliat Care 2016;15(1):1–7.
    DOI  |   Google Scholar
  15. Chaiviboontham S, Viwatwongkasem C, Hanucharurnkul S, McCorkle R. Symptom clusters in Thais with advanced cancer. Pacific Rim Int J Nurs Res 2011;15(4):265–77.
     Google Scholar