• Tracy K Gosselin, Susan Beck, David H Abbott, Steven C Grambow, Dawn Provenzale, Patricia Berry, Katherine L Kahn, and Jennifer L Malin.
• Duke University Health System, Duke Cancer Institute, Durham, North Carolina, USA. Electronic address: gosse001@mc.duke.edu.
• J Pain Symptom Manage. 2016 Nov 1; 52 (5): 709-718.

ContextAs the number of rectal cancer survivors grows, it is important to understand the symptom experience after treatment. Although data show that rectal cancer survivors experience a variety of symptoms after diagnosis, little has been done to study the way these symptoms are grouped and associated.ObjectivesTo determine symptom prevalence and intensity in rectal cancer survivors and if clusters of survivors exist, who share similar symptom-defined survivor subgroups that may vary based on antecedent variables.MethodsA secondary analysis of the Cancer Care and Outcomes Research and Surveillance database was undertaken. Cluster analysis was performed on 15-month postdiagnosis data to form post-treatment survivor subgroups, and these were examined for differences in demographic and clinical characteristics. Data were analyzed using cluster analysis, chi-square, and analysis of variance.ResultsA total of 275 rectal cancer survivors were included who had undergone chemotherapy, radiation therapy, and surgery. Most frequently reported symptoms included feeling "worn out" (87%), feeling "tired" (85%), and "trouble sleeping" (66%). Four symptom-defined survivor subgroups (minimally symptomatic n = 40, tired and trouble sleeping n = 138, moderate symptoms n = 42, and highly symptomatic n = 55) were identified with symptom differences existing among each subgroup. Age and being married/partnered were the only two antecedents found to differ across subgroups.ConclusionThis study documents differences in the symptom experience after treatment. The identification of survivor subgroups allows researchers to further investigate tailored, supportive care strategies to minimize ongoing symptoms in those with the greatest symptom burden.Copyright © 2016 American Academy of Hospice and Palliative Medicine. All rights reserved.

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