Identification of Symptom Clusters in Cancer Patients at Palliative Care Clinic

OBJECTIVE: Cancer patients often experience a large number of symptoms together. The aim of this study is to determine the symptom clusters in cancer patients at palliative care clinic. METHODS: Hundred and seventy consecutive patients were enrolled in the study. Memorial Symptom Assessment Scale was used for symptom assessment of the patients. RESULTS: The most experienced symptoms by the patients during the past week before hospitalization in palliative care clinic were lack of energy (95.4%), weight loss (91.2%), lack of appetite (89.4%), pain (88.2%), dry mouth (87.6%), feeling sad (87.6%), feeling nervous (82.9%), worrying (81.2%), and feeling irritable (80.6%). Five symptom clusters were defined. First cluster: pain, feeling nervous, dry mouth, worrying, feeling irritable, weight loss; second cluster: feeling drowsy, numbness/tingling in hands/feet, difficulty in sleeping, dizziness, constipation, I do not look like myself; third cluster: nausea, vomiting; fourth cluster: shortness of breath, difficulty in swallowing, cough, change in the way food tastes; and fifth cluster: feeling bloated, problems with urination, diarrhea, itching, mouth sores, hair loss, swelling of arm or legs, change in the skin. CONCLUSIONS: We encountered various symptom clusters in advanced cancer patients. Identification of symptom clusters and knowledge of cluster composition in oncological population may particularly contribute individualization of the treatment.