• Angela Steineck, Miranda C Bradford, Alison O'Daffer, Kaitlyn M Fladeboe, Maeve B O'Donnell, Samantha Scott, Joyce P Yi-Frazier, and Abby R Rosenberg.
• Seattle Children's Hospital (A.S.), Cancer and Blood Disorders Center, Seattle, Washington, USA; Seattle Children's Research Institute (A.S., A.O., K.M.F., M.B.O., J.P.Y-F., A.R.R.), Center for Clinical and Translational Research, Seattle, Washington, USA; University of Washington School of Medicine (A.S.), Department of Pediatrics, Seattle, Washington, USA; University of Washington (A.S., K.M.F., M.B.O., A.R.R.), Cambia Palliative Care Center of Excellence, Seattle, Washington, USA; MACC Fund Center for Cancer and Blood Disorders (A.S.), Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
• J Pain Symptom Manage. 2022 Sep 1; 64 (3): 244253.e2244-253.e2.

ContextAdolescents and young adults (AYAs) with cancer report worse health-related quality of life (HRQOL) than other age groups. Symptom burden is a modifiable predictor of HRQOL.ObjectivesThe objective of this study was to identify which symptoms are most burdensome to AYAs with advanced cancer.MethodsIn this observational study, English-speaking individuals aged 12-25 years undergoing treatment for advanced cancer completed assessments of symptom burden (Memorial Symptom Assessment Scale) and HRQOL (Pediatric Quality of Life Inventory Generic Form and Cancer Module; minimal clinically important difference 4.4). We dichotomized participants as having low (<7) or high (≥7) symptom prevalence. Mixed regression models estimated HRQOL differences between groups. For individual symptoms, unadjusted mixed models estimated HRQOL reductions.ResultsN = 58 AYAs completed baseline surveys. The median age was 17 years (IQR 15-19), 58% were male, 59% identified as white, and 44% were diagnosed with leukemia/lymphoma. High symptom prevalence was associated with a mean generic HRQOL 7 points lower (95% CI: -11, -3; P < 0.01) and cancer-specific HRQOL score 12 points lower (95% CI: -17, -7; P < 0.01) than low symptom prevalence. The most prevalent symptoms were fatigue (71%), pain (58%), and difficulty sleeping (58%). Fatigue (-8), difficulty concentrating (-7), and mouth sores (-6) were associated with the greatest generic HRQOL score reductions. Dysphagia (-12), difficulty concentrating (-12), and sadness (-11) were associated with the greatest cancer-specific HRQOL score reductions.ConclusionThe symptom experience among AYAs with advanced cancer is unique. Separate evaluation of AYA's symptoms may optimize management and improve HRQOL.Copyright © 2022. Published by Elsevier Inc.

19 keywords...

hide…