CLEVELAND, OhioPain is the most common symptom of patients with
advanced cancer, followed by fatigue. Other common symptoms, in order
of frequency, are anorexia, dry mouth, constipation, early satiety,
dyspnea, weight loss, sleep problems, and depression, Kristine A.
Nelson, MD, said at a symposium on palliative medicine held at the
Cleveland Clinic Foundation.
A study of 1,000 patients with advanced cancer conducted at the
Cleveland Clinic identified these 10 symptoms as the most common
(Donnelly S et al: Journal of Palliative Care 11:27-32, 1995). A
majority of patients described them as moderate to severe. These
are significant symptoms, Dr. Nelson said.
Even patients who are just beginning cancer treatment with a good
prognosis exhibit many of these symptoms, Dr. Nelson said. Indeed,
more symptoms are apparent in early stages of cancer than later stages.
Symptoms affect quality of life and can become more severe with
advanced cancer. Some symptoms can be anticipated and prevented. For
these reasons, the physician should take a problem-solving diagnostic
approach to symptom management, Dr. Nelson said. The physician should
regularly ask patients what symptoms they are experiencing, consider
psychological influences on symptoms, and treat all symptoms
aggressively using the least invasive techniques possible.