TRAJECTORY OF SYMPTOMS THROUGHOUT CHEMOTHERAPY: SCREENING ROUTINE USING PALLIATIVE CARE SCALE

Background: The best strategy for maintaining quality of life is the combination of supportive care with chemotherapy in all stages of treatment. In this study we used a specific scale for palliative care seeking to describe longitudinal symptoms of patients in neoadjuvant, adjuvant and palliative chemotherapy. Methods: Observational study conducted in 2017 with patients on outpatient chemotherapy in a Cancer Center of Brasília (Cettro). For data collection we applied the ESAS scale (Edmonton Symptom Assessment System) in four stages throughout the treatment. We performed descriptive statistics and calculated the score from 4 to 10 (moderate/severe) in reporting ESAS symptoms. Results: We included 200 reviews, the mean age was 59 years, 58% were female. At the beginning of neoadjuvant chemotherapy, the highest mean of symptoms was: anxiety (36%), depression (29%), inappetence, fatigue, felling unwell and somnolence (21%). There was a decrease in emotional symptoms during the treatment, but increased fatigue, inappetence and somnolence (25%). In the finishing stages all symptoms increased considerably except pain. At the beginning of adjuvant chemotherapy, the highest symptoms were: anxiety (60%), fatigue (44%), somnolence, felling unwell (33%) and inappetence (25%). During the study there was an increase in depression (20%), pain (20%) and nausea (15%); in the end, the highest symptoms were inappetence (33%), fatigue (56%), somnolence (56%) and depression (15%). For palliative chemotherapy the highest mean was anxiety (41%) subsequently, inappetence (30%), fatigue (34%), depression (11%), pain (7%), nausea (7%), feeling unwell (19%) and somnolence (15%), meanwhile increased shortness of breath (from 7% to 11%). In the final stages, symptoms of anxiety (42%), fatigue (33%), pain (25%) and somnolence (33%) increased and shortness of breath decreased (8%). Conclusions: It is observed that the discomfort is related to the characteristics of the treatment, but the moderate/high level of anxiety was a standard at the beginning of the 3 types of treatment. These preliminary results favor early palliative care because they help to understand the moments of greater vulnerability and thus determine when to increase palliative care.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019