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Age and gender differences in symptom intensity and symptom clusters among patients with metastatic cancer

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Abstract

Background

Few studies have explored demographic variations in symptom patterns. Our goals were to examine age and gender differences in symptom intensity and symptom clusters among outpatients with advanced cancer.

Methods

Symptom scores by the Edmonton Symptom Assessment System (ESAS) were collected for patients attending the Oncology Palliative Care Clinics at Princess Margaret Hospital from 2005 to 2007. Symptom intensity was compared between individuals aged ≤60 and >60 years and between males and females. Principal component analysis (PCA) was performed to determine inter-relationships of the nine ESAS symptoms and to compare symptom clusters within age and gender subgroups.

Results

From a total of 1,358 patients, 49.8% were male and 50.2% were female. The median age was 64 (range 19 to 99): 39.6% were ≤60 and 60.4% were >60. The most common primary cancer sites were gastrointestinal (27%), lung (15%), and breast (11%). Younger patients reported worse pain (4.9 vs. 4.5, p = 0.02) and better appetite (4.7 vs. 5.3, p = 0.002) than older patients. Females reported poorer scores than males for nausea (2.6 vs. 2.2, p = 0.02). Analyses of symptom clusters revealed that fatigue and drowsiness were included in the cluster of pain, nausea, and appetite in younger but not older patients. In men, pain clustered together with depression and anxiety; for women, physical and psychological symptoms formed separate clusters.

Conclusions

In patients with advanced cancers, symptom patterns differ according to age and gender. Palliative interventions tailored for symptoms that are more prominent in specific patient subgroups may offer greater therapeutic benefit.

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Authors and Affiliations

  1. Division of Medical Oncology, British Columbia Cancer Agency, University of British Columbia, Vancouver, Canada

    Winson Y. Cheung

  2. Department of Kinesiology and Health Science, York University, Toronto, Canada

    Lucia Gagliese

  3. Division of Medical Oncology and Hematology, University of Toronto, Toronto, Canada

    Camilla Zimmermann

  4. Department of Biostatistics, University Health Network, Toronto, Canada

    Lisa W. Le

  5. Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, 610 University Ave., 16-712, Toronto, ON, Canada, M5G 2M9

    Lucia Gagliese & Camilla Zimmermann

Authors
  1. Winson Y. Cheung
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  2. Lisa W. Le
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  3. Lucia Gagliese
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  4. Camilla Zimmermann
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Corresponding author

Correspondence to Camilla Zimmermann.

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Cheung, W.Y., Le, L.W., Gagliese, L. et al. Age and gender differences in symptom intensity and symptom clusters among patients with metastatic cancer. Support Care Cancer 19, 417–423 (2011). https://doi.org/10.1007/s00520-010-0865-2

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  • DOI: https://doi.org/10.1007/s00520-010-0865-2

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