Symptom burden in mesothelioma patients admitted to home palliative care

Alessandra Casuccio, Daniela Degiovanni, Sebastiano Mercadante

Risultato della ricerca: Article

4 Citazioni (Scopus)

Abstract

Context: Mesothelioma is a very aggressive cancer that is brought on by asbestos exposure. Because there is a long latency period between exposure to asbestos and symptoms of disease, most patients with mesothelioma present with advanced disease and survive an average of 8–12 months. Thus, best supportive care should be considered critical to optimally manage these patients. Aim: The aim of this study was to examine the epidemiological characteristics and symptom burden of mesothelioma patients when admitted to home palliative care. Methods: The charts of a consecutive sample of patients admitted to the home palliative care program with a diagnosis of mesothelioma in an endemic industrialized area were reviewed. The estimated survival time was about two months from admission. Epidemiological characteristics were collected. Karnofsky status, characteristics of pain and analgesic treatment at time of admission were recorded. ESAS (Edmonton Symptom Assessment System) and other clinical problems reported in the charts at admission time were also recorded. Results: Of the 674 charts reviewed, 56 patients (8.3%) had a diagnosis of mesothelioma. About three quarters of those had pain, with 18 and 2 patients with moderate and severe pain, respectively, despite receiving medium to high doses of opioids. The principal pain site was the chest. Pain was significantly associated with opioid consumption (p <.0005) and dyspnea (p =.049). Symptom burden was relevant, with a global ESAS of about 40. Pain, weakness, poor appetite, poor well-being, and dyspnea were the most frequent symptoms with the highest intensity; cough and pleural effusion were more frequently present as clinical problems. Conclusion: This study shows that mesothelioma is a devastating cancer with a relevant symptom burden, and that patients were referred to palliative care late in the course of their disease, suggesting that earlier integration of palliative care should be considered to relieve suffering in all disease stages–not only at the end of life.
Lingua originaleEnglish
pagine (da-a)1985-1988
Numero di pagine4
RivistaCurrent Medical Research and Opinion
Volume32
Stato di pubblicazionePublished - 2016

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Mesothelioma
Home Care Services
Palliative Care
Pain
Symptom Assessment
Asbestos
Dyspnea
Opioid Analgesics
Appetite
Pleural Effusion
Cough
Analgesics
Neoplasms
Thorax
Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Symptom burden in mesothelioma patients admitted to home palliative care. / Casuccio, Alessandra; Degiovanni, Daniela; Mercadante, Sebastiano.

In: Current Medical Research and Opinion, Vol. 32, 2016, pag. 1985-1988.

Risultato della ricerca: Article

Casuccio, Alessandra ; Degiovanni, Daniela ; Mercadante, Sebastiano. / Symptom burden in mesothelioma patients admitted to home palliative care. In: Current Medical Research and Opinion. 2016 ; Vol. 32. pagg. 1985-1988.
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title = "Symptom burden in mesothelioma patients admitted to home palliative care",
abstract = "Context: Mesothelioma is a very aggressive cancer that is brought on by asbestos exposure. Because there is a long latency period between exposure to asbestos and symptoms of disease, most patients with mesothelioma present with advanced disease and survive an average of 8{\^a}€“12 months. Thus, best supportive care should be considered critical to optimally manage these patients. Aim: The aim of this study was to examine the epidemiological characteristics and symptom burden of mesothelioma patients when admitted to home palliative care. Methods: The charts of a consecutive sample of patients admitted to the home palliative care program with a diagnosis of mesothelioma in an endemic industrialized area were reviewed. The estimated survival time was about two months from admission. Epidemiological characteristics were collected. Karnofsky status, characteristics of pain and analgesic treatment at time of admission were recorded. ESAS (Edmonton Symptom Assessment System) and other clinical problems reported in the charts at admission time were also recorded. Results: Of the 674 charts reviewed, 56 patients (8.3{\%}) had a diagnosis of mesothelioma. About three quarters of those had pain, with 18 and 2 patients with moderate and severe pain, respectively, despite receiving medium to high doses of opioids. The principal pain site was the chest. Pain was significantly associated with opioid consumption (p <.0005) and dyspnea (p =.049). Symptom burden was relevant, with a global ESAS of about 40. Pain, weakness, poor appetite, poor well-being, and dyspnea were the most frequent symptoms with the highest intensity; cough and pleural effusion were more frequently present as clinical problems. Conclusion: This study shows that mesothelioma is a devastating cancer with a relevant symptom burden, and that patients were referred to palliative care late in the course of their disease, suggesting that earlier integration of palliative care should be considered to relieve suffering in all disease stages{\^a}€“not only at the end of life.",
keywords = "Cancer pain; Dyspnea; Mesothelioma; Palliative care; Aged; Aged, 80 and over; Analgesics, Opioid; Cancer Pain; Dyspnea; Female; Home Care Services; Humans; Male; Middle Aged; Retrospective Studies; Mesothelioma; Palliative Care; Medicine (all)",
author = "Alessandra Casuccio and Daniela Degiovanni and Sebastiano Mercadante",
year = "2016",
language = "English",
volume = "32",
pages = "1985--1988",
journal = "Current Medical Research and Opinion",
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TY - JOUR

T1 - Symptom burden in mesothelioma patients admitted to home palliative care

AU - Casuccio, Alessandra

AU - Degiovanni, Daniela

AU - Mercadante, Sebastiano

PY - 2016

Y1 - 2016

N2 - Context: Mesothelioma is a very aggressive cancer that is brought on by asbestos exposure. Because there is a long latency period between exposure to asbestos and symptoms of disease, most patients with mesothelioma present with advanced disease and survive an average of 8–12 months. Thus, best supportive care should be considered critical to optimally manage these patients. Aim: The aim of this study was to examine the epidemiological characteristics and symptom burden of mesothelioma patients when admitted to home palliative care. Methods: The charts of a consecutive sample of patients admitted to the home palliative care program with a diagnosis of mesothelioma in an endemic industrialized area were reviewed. The estimated survival time was about two months from admission. Epidemiological characteristics were collected. Karnofsky status, characteristics of pain and analgesic treatment at time of admission were recorded. ESAS (Edmonton Symptom Assessment System) and other clinical problems reported in the charts at admission time were also recorded. Results: Of the 674 charts reviewed, 56 patients (8.3%) had a diagnosis of mesothelioma. About three quarters of those had pain, with 18 and 2 patients with moderate and severe pain, respectively, despite receiving medium to high doses of opioids. The principal pain site was the chest. Pain was significantly associated with opioid consumption (p <.0005) and dyspnea (p =.049). Symptom burden was relevant, with a global ESAS of about 40. Pain, weakness, poor appetite, poor well-being, and dyspnea were the most frequent symptoms with the highest intensity; cough and pleural effusion were more frequently present as clinical problems. Conclusion: This study shows that mesothelioma is a devastating cancer with a relevant symptom burden, and that patients were referred to palliative care late in the course of their disease, suggesting that earlier integration of palliative care should be considered to relieve suffering in all disease stages–not only at the end of life.

AB - Context: Mesothelioma is a very aggressive cancer that is brought on by asbestos exposure. Because there is a long latency period between exposure to asbestos and symptoms of disease, most patients with mesothelioma present with advanced disease and survive an average of 8–12 months. Thus, best supportive care should be considered critical to optimally manage these patients. Aim: The aim of this study was to examine the epidemiological characteristics and symptom burden of mesothelioma patients when admitted to home palliative care. Methods: The charts of a consecutive sample of patients admitted to the home palliative care program with a diagnosis of mesothelioma in an endemic industrialized area were reviewed. The estimated survival time was about two months from admission. Epidemiological characteristics were collected. Karnofsky status, characteristics of pain and analgesic treatment at time of admission were recorded. ESAS (Edmonton Symptom Assessment System) and other clinical problems reported in the charts at admission time were also recorded. Results: Of the 674 charts reviewed, 56 patients (8.3%) had a diagnosis of mesothelioma. About three quarters of those had pain, with 18 and 2 patients with moderate and severe pain, respectively, despite receiving medium to high doses of opioids. The principal pain site was the chest. Pain was significantly associated with opioid consumption (p <.0005) and dyspnea (p =.049). Symptom burden was relevant, with a global ESAS of about 40. Pain, weakness, poor appetite, poor well-being, and dyspnea were the most frequent symptoms with the highest intensity; cough and pleural effusion were more frequently present as clinical problems. Conclusion: This study shows that mesothelioma is a devastating cancer with a relevant symptom burden, and that patients were referred to palliative care late in the course of their disease, suggesting that earlier integration of palliative care should be considered to relieve suffering in all disease stages–not only at the end of life.

KW - Cancer pain; Dyspnea; Mesothelioma; Palliative care; Aged; Aged, 80 and over; Analgesics, Opioid; Cancer Pain; Dyspnea; Female; Home Care Services; Humans; Male; Middle Aged; Retrospective Studies; Mesothelioma; Palliative Care; Medicine (all)

UR - http://hdl.handle.net/10447/244303

M3 - Article

VL - 32

SP - 1985

EP - 1988

JO - Current Medical Research and Opinion

JF - Current Medical Research and Opinion

SN - 0300-7995

ER -