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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 2010

The American Society of Clinical Oncology, or ASCO, held its 2010 annual meeting from June 4 to 8 in Chicago. The features below highlight some of the news emerging from the meeting. » A New Screening Strategy for Ovarian Cancer » Yoga Improves Sleep in Cancer Survivors » Genetics, Heart Disease, & Dosing of Chemotherapy » Maintenance Therapy May Cut Risk of Lymphoma Recurrence A New Screening Strategy for Ovarian Cancer [back to top] The Particulars: More than 70% of ovarian cancers are diagnosed when they have already grown to an advanced stage. There are currently no effective screening tools for the early detection of ovarian cancer in women at average risk. A screening strategy that incorporated change of CA-125 levels over time and age of the participant was assessed to estimate the risk of ovarian cancer using the Risk of Ovarian Cancer Algorithm (ROCA), followed by transvaginal sonography (TVS). Data Breakdown: : In an analysis of 3,238 women who participated in the 8-year study, researchers found that the combined specificity of ROCA followed by TVS for referral to surgery was 99.7%. The average annual rate of referral to 3 monthly CA-125 screenings was 6.8%, and the average annual rate of TVS and gynecologic oncology referral was 0.9%. Cumulatively, 85 women received TVS and referral to a gynecologic oncologist. Eight women subsequently underwent surgery based on the TVS and referral, with three invasive ovarian cancers, two borderline ovarian tumors, and three benign ovarian tumors, providing a positive predictive value of 37.5%. Less than 1% of participants annually required a TVS. The invasive high-grade ovarian cancers that were detected were...
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