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The Burden of Pain & Depression in Cancer Patients

The role of somatic symptoms has been investigated in many studies and in various clinical settings because of its impact on patients. Studies have shown that somatic symptoms are frequently persistent, accounting for more than half of all general medical visits. Physical and psychological factors also appear to contribute to somatic symptom reporting. “Somatic symptoms are associated with substantial functional impairment, disability, and healthcare use, even after controlling for medical and psychiatric comorbidities,” says Kurt Kroenke, MD. In investigations on the prevalence of symptoms in cancer, research has often focused on patients with advanced cancer or with certain types of cancer. Data demonstrate that symptoms like fatigue, pain, weakness, appetite loss, dry mouth, depressed mood, constipation, insomnia, dyspnea, nausea, and anxiety occur in at least 30% of patients with cancer. “These symptoms can have a substantial effect on functional status and quality of life,” explains Dr. Kroenke. “In some circumstances, they can hasten the desire of patients to die.” The relationship between psychological distress and somatic symptoms—somatization—has not been studied extensively in cancer, but Dr. Kroenke and colleagues recently addressed this knowledge gap. In a study published in the October 11, 2010 Archives of Internal Medicine, they examined the impact of somatic symptom burden on disability and healthcare use in patients with cancer experiencing pain, depression, or both. “Pain and depression are two of the most common and potentially treatable symptoms in patients with cancer,” Dr. Kroenke says. “We measured somatic symptom burden using a 22-item scale. We also sought to determine the association of somatic symptom burden with disability and healthcare use.” Analyzing Prevalence of Somatic Symptoms According to...

American Society of Clinical Oncology GI Symposium

New research presented at the Gastrointestinal (GI) Cancers Symposium from the American Society of Clinical Oncology, or ASCO, from January 22-24, 2010 in Orlando addressed key issues on the prevention, screening, and treatment of GI cancers. The features below highlight just some of the studies that emerged from the symposium. Comparing Treatments for True Cardia & Sub-Cardia Cancer The Particulars: Different surgical treatments are available for the treatment of true cardia and sub-cardia cancer. In left thoracoabdominal (LT) approaches, surgeons make a large incision from the left side of the chest to the middle of the abdomen. In abdominal and transhiatal (AT) approaches, the incision is smaller in the upper abdomen. The AT approach does not provide as much space to remove lymph nodes for analysis as the LT approach, but it is less invasive. Data Breakdown: Researchers randomly assigned 167 patients to undergo surgery with AT or LT between 1995 and 2003. After a medium follow-up of 7.7 years, 5-year survival rates were higher in the AT group than the LT group (51% vs 37%). AT recipients experienced significantly less deterioration in respiratory function, body weight, and other symptoms. Take Home Pearl: When surgical treatment is indicated in true cardia or sub-cardia cancer, AT approaches appear to be superior to LT approaches. Predicting Survival in Gastric Cancer The Particulars: Peritoneal cytology is often used to determine the presence of cancer spread in gastric cancer patients that is not visible to the naked eye. It is performed by microscopic examination of cell samples collected during surgery. Data Breakdown: A study was conducted to analyze poor disease-specific survival (DSS) among...
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