Symptom burden among young adults with breast or colorectal cancer

Authors

  • Stacy D. Sanford PhD,

    Corresponding author
    1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    • Corresponding author: Stacy D. Sanford, PhD, Department of Medical Social Sciences, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, 675 N. St. Clair St, Suite 21-100, Chicago, IL 60611; Fax: (312) 695-1106; ssanford@nmff.org

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  • Fengmin Zhao PhD,

    1. Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
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  • John M. Salsman PhD,

    1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • Victor T. Chang MD,

    1. Department of Medicine, Veterans Affairs New Jersey Health Care System, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
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  • Lynne I. Wagner PhD,

    1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • Michael J. Fisch MD

    1. Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Abstract

BACKGROUND

Cancer incidence has increased among young adults (YAs) and survival rates have not improved compared with other age groups. Patient-reported outcomes may enhance our understanding of this vulnerable population.

METHODS

In a multisite prospective study, patients completed a cancer symptom inventory at the time of enrollment (T1) and 4 weeks to 5 weeks later (T2). YAs (those aged ≤ 39 years) with breast or colorectal cancer were compared with older adults (those aged ≥ 40 years) with breast or colorectal cancer with regard to symptom severity, symptom interference, changes over time, and medical care.

RESULTS

Participants included 1544 patients with breast cancer (96 of whom were YAs) and 718 patients with colorectal cancer (37 of whom were YAs). Compared with older adults, YAs with breast cancer were more likely to report moderate/severe drowsiness, hair loss, and symptom interference with relationships at T1. YAs with colorectal cancer were more likely to report moderate/severe pain, fatigue, nausea, distress, drowsiness, shortness of breath, and rash plus interference in general activity, mood, work, relationships, and life enjoyment compared with older adults. Compared with older adults, shortness of breath, appetite, and sore mouth were more likely to improve in YAs with breast cancer; vomiting was less likely to improve in YAs with colorectal cancer. Referrals for supportive care were few, especially among patients with colorectal cancer. YAs with breast cancer were somewhat more likely to be referred to nutrition and psychiatry services than older patients.

CONCLUSIONS

YAs reported symptom severity, symptom interference, and variations over time that were distinct from older patients. Distinctions were found to differ by diagnostic group. These findings enhance the understanding of symptom burden in YAs and inform the development of targeted interventions and future research. Cancer 2014;120:2255–2263. © 2014 American Cancer Society.

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