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Oral symptoms in patients with advanced cancer: an observational study using a novel oral symptom assessment scale

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Abstract

Purpose

The aim of this study was to utilise a novel oral assessment tool (the Oral Symptom Assessment Scale/OSAS) to investigate oral symptoms in a cohort of advanced cancer patients receiving specialist palliative care.

Methods

Participants were asked to complete the OSAS, which asks about the presence of 20 oral symptoms in the previous week (and, if present, about the frequency, the severity, and the amount of distress caused by the symptoms). Patients were also asked to complete the Memorial Symptom Assessment Scale – Short Form, and to rate their performance status.

Results

Two hundred fifty participants completed the study, and 244 (97.5%) participants reported at least one oral symptom on the OSAS. The median number of oral symptoms reported was five (range, 1 to 18), with dry mouth being the most common symptom (83.5% participants). The total number of oral symptoms was higher in younger participants (p = 0.012), female participants (p = 0.048), and those with a worse performance status (p < 0.001). No other oral symptoms were reported by more than two participants. Statistical analysis identified a number of potential oral symptom clusters.

Conclusions

Oral symptoms (and related oral problems) are common in patients with advanced cancer, and are associated with significant morbidity in this group of patients.

Trial registration

CancerTrials.gov registry reference number: NCT04404920

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References

  1. Davies A (2010) Oral care in advanced cancer patients. In: Davies AN, Epstein JB (eds) Oral complications of cancer and its management. Oxford University Press, Oxford, pp 279–289

    Chapter  Google Scholar 

  2. Kirkova J, Davis MP, Walsh D, Tiernan E, O’Leary N, LeGrand SB, Lagman RL, Russell KM (2006) Cancer symptom assessment instruments: a systematic review. J Clin Oncol 24:1459–1473

    Article  Google Scholar 

  3. Shah S, Davies AN (2001) Medical records vs. patient self-rating. J Pain Symptom Manag 22:805–806

    Article  CAS  Google Scholar 

  4. Davies A, Epstein J (2010) Introduction. In: Davies AN, Epstein JB (eds) Oral complications of cancer and its management. Oxford University Press, Oxford, pp 1–9

    Chapter  Google Scholar 

  5. Rydholm M, Strang P (2002) Physical and psychosocial impact of xerostomia in palliative cancer care: a qualitative interview study. Int J Palliat Nurs 8:318–323

    Article  Google Scholar 

  6. Li X, Kolltveit KM, Tronstad L, Olsen I (2000) Systemic diseases caused by oral infection. Clin Microbiol Rev 13:547–558

    Article  CAS  Google Scholar 

  7. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655

    Article  CAS  Google Scholar 

  8. Chang VT, Hwang SS, Feuerman M, Kasimis BS, Thaler HT (2000) The Memorial Symptom Assessment Scale short form (MSAS-SF). Cancer 89:1162–1171

    Article  CAS  Google Scholar 

  9. Portenoy RK, Thaler HT, Kornblith AB, McCarthy Lepore J, Friedlander-Klar H, Kiyasu E, Sobel K, Coyle N, Kemeny N, Norton L, Scher H (1994) The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30(A):1326–1336

    Article  Google Scholar 

  10. Fischer DJ, Epstein JB, Yao Y, Wilkie DJ (2014) Oral health conditions affect functional and social activities of terminally ill cancer patients. Support Care Cancer 22:803–810

    Article  CAS  Google Scholar 

  11. Davies AN, Broadley K, Beighton D (2001) Xerostomia in patients with advanced cancer. J Pain Symptom Manag 22:820–825

    Article  CAS  Google Scholar 

  12. Tranmer JE, Heyland D, Dudgeon D, Groll D, Squires-Graham M, Coulson K (2003) Measuring the symptom experience of seriously ill cancer and noncancer hospitalized patients near the end of life with the Memorial Symptom Assessment Scale. J Pain Symptom Manag 25:420–429

    Article  Google Scholar 

  13. Chaushu G, Bercovici M, Dori S, Waller A, Taicher S, Kronenberg J, Talmi YP (2000) Salivary flow and its relation with oral symptoms in terminally ill patients. Cancer 88:984–987

    Article  CAS  Google Scholar 

  14. Davies AN, Broadley K, Beighton D (2002) Salivary gland hypofunction in patients with advanced cancer. Oral Oncol 38:680–685

    Article  Google Scholar 

  15. Shorthose K, Davies A (2003) Symptom prevalence in palliative care. Palliat Med 17:723–724

    Article  Google Scholar 

  16. Sweeney MP, Bagg J (2000) The mouth and palliative care. Am J Hosp Palliat Care 17:118–124

    Article  CAS  Google Scholar 

  17. Davies AN, Brailsford SR, Beighton D (2006) Oral candidosis in patients with advanced cancer. Oral Oncol 42:698–702

    Article  Google Scholar 

  18. Astvad K, Johansen HK, Holby N, Steptoe P, Ishoy T (2015) Oropharyngeal candidiasis in palliative care patients in Denmark. J Palliat Med 18:940–944

    Article  Google Scholar 

  19. Sweeney P (2005) Oral hygiene. In: Davies A, Finlay I (eds) Oral care in advanced disease. Oxford University Press, Oxford, pp 21–35

    Google Scholar 

  20. Sweeney MP, Bagg J, Baxter WP, Aitchison TC (1998) Oral disease in terminally ill cancer patients with xerostomia. Oral Oncol 34:123–126

    Article  CAS  Google Scholar 

  21. Wiseman MA (2000) Palliative care dentistry. Gerodontology 17:49–51

    Article  CAS  Google Scholar 

  22. Gordon SR, Berkey DB, Call RL (1985) Dental need among hospice patients in Colorado: a pilot study. Gerodontics 1:125–129

    CAS  PubMed  Google Scholar 

  23. Dong ST, Butow PN, Costa DS, Lovel MR, Agar M (2014) Symptom clusters in patients with advanced cancer: a systematic review of observational studies. J Pain Symptom Manag 48:411–450

    Article  Google Scholar 

  24. Walsh D, Rybicki L (2006) Symptom clustering in advanced cancer. Support Care Cancer 14:831–836

    Article  Google Scholar 

  25. Streiner DL, Norman GR (2008) Health measurement scales: a practical guide to their development and use, 4th edn. Oxford University Press, Oxford

    Book  Google Scholar 

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Acknowledgements

The authors would like to thank the patients, clinical staff, and research staff at the study sites: Royal Surrey County Hospital (Guildford), Princess Alice Hospice (Esher), St. Catherine’s Hospice (Crawley), Frimley Park Hospital (Camberley), Hospice in the Weald (Pembury), Pilgrims Hospice (Margate), Wisdom Hospice (Rochester), EllenorLions Hospice (Gravesend), East Sussex Healthcare NHS Trust (Eastbourne), East Surrey Hospital (Redhill), St. Wilfrid’s Hospice (Chichester), and Royal Sussex County Hospital (Brighton). We would especially like to acknowledge Dr Nicholas Dando, Dr Georgina Parker, Dr Andrew Thorns, Dr David Oliver, Dr Siva Subramanium, Dr Farida Malik, Dr Naomi Collins, and Dr Louise Mason.

Funding

The study was sponsored by the Royal Surrey County Hospital and was financed by the Palliative Care Research Fund at the Royal Surrey County Hospital.

Author information

Authors and Affiliations

  1. Trinity College Dublin, University College Dublin, Our Lady’s Hospice Dublin, Dublin, Ireland

    Andrew Davies

  2. Royal Marsden Hospital, Sutton, UK

    Alison Buchanan & Kabir Mohammed Batsari

  3. Princess Alice Hospice, Esher, UK

    Jennifer Todd

  4. St. Catherine’s Hospice, Crawley, UK

    Amanda Gregory

Authors
  1. Andrew Davies
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  2. Alison Buchanan
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  3. Jennifer Todd
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  4. Amanda Gregory
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  5. Kabir Mohammed Batsari
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Corresponding author

Correspondence to Andrew Davies.

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The authors declare that they have no conflict of interest.

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Davies, A., Buchanan, A., Todd, J. et al. Oral symptoms in patients with advanced cancer: an observational study using a novel oral symptom assessment scale. Support Care Cancer 29, 4357–4364 (2021). https://doi.org/10.1007/s00520-020-05903-1

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  • DOI: https://doi.org/10.1007/s00520-020-05903-1

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