Symptomlast unheilbar an Krebs erkrankter Patienten zum Diagnosezeitpunkt - eine systematische Übersichtsarbeit

Symptom burden in patients with incurable cancer at the time of diagnosis - a systematic review

by Lukas Harzheim
Doctoral thesis
Date of Examination:2021-07-08
Date of issue:2021-06-25
Advisor:Prof. Dr. Bernd Alt-Epping
Referee:Prof. Dr. Bernd Alt-Epping
Referee:Prof. Dr. Eva Hummers
Referee:Prof. Dr. Thomas Meyer
Persistent Address: http://dx.doi.org/10.53846/goediss-8682

 

 

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Abstract

English

Introduction: The beneficial effect of early integration of palliative care in cancer patients on quality of life and course of disease has been proven in several interventional studies. Despite this knowledge and increasing demand for early integration of palliative care, symptom prevalence studies mainly address symptoms and burdens of patients in the later course of disease. Lack of clarity exists however regarding the symptom burden at the time of diagnosis of the incurable disease. The aim of this systematic review is to identify and evaluate symptom prevalence studies at the time of diagnosis of an incurable cancer disease. Methods: We conducted a systematic review using a search string in the medical database MEDLINE from 1969 to 2020. Two reviewers screened the search results. In a second step all references from included studies were hand-searched. We included studies of patients with an initial diagnosis of an incurable solid or metastatic cancer and early recording of symptoms after the diagnosis. Studies with hematological and pediatric patients or patients already receiving cancer therapy were excluded. Results: A total of 3110 studies were reviewed and just 15 studies matched all criteria for inclusion: six for ovarian cancer, eight for lung cancer and one for pleural mesothelioma. The results show that most patients were symptomatic and burdened already at the time of diagnosis of their incurable cancer disease and there was a variety of relevant symptoms and physical disabilities. Conclusions: Most patients with a newly diagnosed incurable cancer have physical symptoms and psychosocial stress. It can be assumed that there is a need for an interdisciplinary cooperation and palliative care treatment in addition to their primary care and oncological treatment. However, due to the small number of studies, further and more specific clinical research is required in order to determine the needs and treatment approaches for this special patient group.
Keywords: palliative care; early integration; systematic review; quality of life; incurable cancer; symptom burden
 
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