The symptom experience of patients with cancer

Laurie L. Stark, Cindy Tofthagen, Constance Visovsky, Susan C. McMillan

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


There is little doubt that despite advances in supportive cancer care, unrelieved symptoms continue to be prevalent and persistent in the cancer patient population. The purpose of this study was to describe the symptom experience of patients with cancer and pain. Secondary analysis of data gathered for a larger ongoing National Institutes of Health-funded study of medication-induced constipation was conducted to determine the following: the mean number of symptoms reported, the most commonly occurring symptoms, symptoms with the highest severity, and the symptoms causing the most distress. The sample consisted of 393 outpatients at an National Cancer Institute-designated cancer center in west-central Florida, 70% with advanced disease. The sample was predominantly female (57.7%); had either breast or lung cancer or lymphoma (53.7%); and had stage III or IV disease (51.3%). Two hundred ninety-eight of the 393 (75.8%) patients for whom data were available reported pain and were included in this analysis. Patients reported between two and 30 symptoms, each with a mean of 14.1 (SD, 5.5). As in earlier symptom studies of cancer patients, fatigue was the most commonly reported, occurring in more than 91% of the patients. The next most frequently reported symptoms were feeling drowsy (66.8%, n = 199), difficulty sleeping 65.8%, n = 196), and worrying (n = 193, 64.8%). Symptoms with the greatest severity were hair loss and impaired sexual activity, which were reported to be severe or very severe by more than 50% of the patients who had these symptoms. However, lack of energy/fatigue, pain, and difficulty sleeping were the most distressing problems and were reported to be quite a bit or very bothersome by at least 50% of patients with each symptom. Pain, fatigue, and difficulty sleeping continue to be among the most frequently reported and distressing symptoms for persons with cancer. In addition to asking about the presence of symptoms patients may be experiencing, nurses must also inquire about the associated distress. Knowing which symptoms are causing the most distress for patients will assist nurses in prioritizing their care and providing the much needed support and education for this population. Continued attention on treating these symptoms should be the focus of ongoing research as well as nursing education both in service areas and in schools of nursing.

Original languageEnglish (US)
Pages (from-to)61-70
Number of pages10
JournalJournal of Hospice and Palliative Nursing
Issue number1
StatePublished - Jan 2012


  • Cancer
  • Hospice
  • Palliative care
  • Symptom distress

ASJC Scopus subject areas

  • Community and Home Care
  • Advanced and Specialized Nursing


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