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Patients’ self-reported overall wellbeing correlates with concurrent reported symptoms: analysis of the Edmonton Symptom Assessment System
- Catherine B. McKenna, Ernest Osei, Brooklynn Fleury, Stephanie Swanson, Christabel Oghinan, Johnson Darko
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- Journal:
- Journal of Radiotherapy in Practice / Volume 22 / 2023
- Published online by Cambridge University Press:
- 16 October 2023, e110
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Background:
The primary intent of cancer treatment is either curative, prolongation of patient life, or to improve patient quality of life; however, treatments are associated with various side effects that may impact patient wellbeing. Thus, understanding the patients’ wellbeing from the patient’s perspective is essential as it could help enable the provision of the necessary support for patients throughout their cancer journey.
Materials and Method:We analysed Edmonton Symptom Assessment System (ESAS) questionnaire responses completed by 19,288 patients over 201,839 visits to our Cancer Centre. As part of their routine and standard of care, patients completing the questionnaire are asked to score 6 physical and 2 psychological symptoms as well as overall wellbeing using an 11-point numerical rating scale ranging from 0 to 10, where 0 means complete absence of the symptom or best overall wellbeing and 10 means worst possible symptom or worst overall wellbeing. We used the ESAS responses to characterise the relationship between the overall wellbeing score and concurrent symptoms scored by cancer patients.
Results:Patients reported tiredness and nausea as the physical symptom causing the most and least distress respectively. Patients that reported severe (7–10) wellbeing also scored high mean scores for tiredness (6·2 ± 2·7), drowsiness (4·7 ± 3·1) and lack of appetite (4·4 ± 3·4). Univariate and multivariable logistic regression analysis suggests higher odds for patients to report moderate-to-severe (4–10) wellbeing when they report moderate-to-severe concurrent symptoms compared to none-to-mild concurrent symptoms.
Conclusions:Our findings suggest that patients’ overall wellbeing as reported by the ESAS system is influenced by a number of concurrent symptoms. Tiredness was found to impact patients’ overall wellbeing to a greater extent than other concurrent symptoms. The sum of physical or psychological symptom scores was stronger indicators of a patient’s overall wellbeing compared to the scores of individual symptoms.
Review of novel liquid-based biomarkers for prostate cancer: towards personalised and targeted medicine
- Ernest Osei, Stephanie Swanson, Ruth Francis
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- Journal:
- Journal of Radiotherapy in Practice / Volume 22 / 2023
- Published online by Cambridge University Press:
- 06 April 2021, e1
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Background:
Prostate cancer is the most commonly diagnosed cancer in men and it is responsible for about 10% of all cancer mortalities in both American and Canadian men. At present, serum prostate-specific antigen levels remain the most commonly used test to detect prostate cancer, and the standard and definitive diagnosis of the disease is via prostate biopsy. Conventional tissue biopsies are usually invasive, expensive, painful, time-consuming, and unsuitable for screening and need to be consistently evaluated by expert pathologists and have limited repeatability. Consequently, liquid biopsies are emerging as a favourable alternative to conventional tissue biopsies, providing a non-invasive and cost-effective approach for screening, diagnosis, treatment and monitoring of prostate cancer patients.
Materials and methods:We searched several databases from August to December 2020 for relevant studies published in English between 2000 and 2020 and reporting on liquid-based biomarkers available in detectable quantities in patient bodily fluid samples. In this narrative review paper, we describe seven novel and promising liquid-based biomarkers that potentially account for individual patient variability as well as used in disease risk assessment, screening for early disease detection and diagnosis, identification of patients’ risk for metastatic disease and subsequent relapse, monitoring patient response to specific treatment and providing clinicians the potential to stratify patients likely to benefit from a particular treatment.
Conclusions:The concept of precision medicine from prevention to treatment techniques that take individual patient variability into account will depend on the development of effective clinical biomarkers that interrogate key aberrant pathways potentially targetable with molecular targets or immunologic therapies. Liquid-based biomarkers with high sensitivity and specificity for prostate cancer are emerging as minimally invasive, lower risk, readily obtainable and easily repeatable technique for screening for early disease detection and diagnosis, patient stratification at diagnosis into different risk categories, identification of patients’ risk for metastatic disease and subsequent relapse, and real-time monitoring of patient response to specific treatment. Thus, effective liquid-based biomarkers will potentially shift the treatment paradigm of prostate cancer towards more personalised and targeted medicine.
Review of novel tissue-based biomarkers for prostate cancer: towards personalised and targeted medicine
- Ernest Osei, Stephanie Swanson, Lyba Sheraz, Nada Khaled Fouad Ibrahim
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- Journal:
- Journal of Radiotherapy in Practice / Volume 21 / Issue 4 / December 2022
- Published online by Cambridge University Press:
- 06 April 2021, pp. 566-575
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Background:
Prostate cancer is the most commonly diagnosed cancer in men and responsible for about 10% of all cancer mortality in both Canadian and American men. Currently, serum PSA level is the most commonly used test for the detection of prostate cancer, though the levels can also be elevated in benign conditions, has limited specificity and has a high rate of overdiagnosis and treatment of indolent disease. Consequently, in recent years, several investigations have been conducted to identify novel cancer biomarkers capable of both effective screening and diagnosis, as well as assisting to shift the diagnostic and treatment paradigm of prostate cancer towards more patient-specific and targeted medicine. The goal of this narrative review paper is to describe eleven novel and promising tissue-based biomarkers for prostate cancer capable to account for individual patient variabilities and have the potential for risk assessment, early detection and diagnosis, identification of patients who will benefit from a particular treatment and monitoring patient response to treatment.
Materials and methods:We searched several databases from August to December 2020 for relevant studies published in English between 2000 and 2020 and reporting on tissue-based biomarkers for screening and early diagnosis, treatment and monitoring of prostate cancer.
Conclusions:Emerging prostate cancer biomarkers have the potential to guide clinical decision-making since they have the potential to detect the disease early, measure the risk of developing the disease and the risk of progression, provide accurate information of patient response to a specific treatment and are capable of informing clinicians about the likely outcome of a cancer diagnosis independent of the treatment received. Therefore, the future holds promise for personalised and targeted medicine from prevention to diagnosis and treatment that considers the individual patient’s variabilities in the management of prostate cancer.
Contributors
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- By Charles E. Argoff, Gerard A. Banez, Samantha Boris-Karpel, Barbara K. Bruce, Alexandra S. Bullough, Annmarie Cano, Victor T. Chang, Elizabeth A. Clark, Daniel J. Clauw, June L. Dahl, Tam K. Dao, Amber M. Davis, Courtney L. Dixon, Michael H. Ebert, Robin M. Gallagher, Gerald W. Grass, Carmen R. Green, Jay Gunkelman, Bradford D. Hare, Jennifer A. Haythornthwaite, Jaclyn Heller Issner, W. Michael Hooten, Mark P. Jensen, Mark E. Jones, Robert D. Kerns, Raphael J. Leo, Morris Maizels, Mary E. Murawski, Brooke Myers-Sorger, Akiko Okifuji, Renata Okonkwo, John D. Otis, Stacy C. Parenteau, Laura E. Pence, Donald B. Penzien, Donna B. Pincus, Ellyn Poltrock Stein, Wendy J. Quinton, Jeanetta C. Rains, M. Carrington Reid, Thomas J. Romano, Jeffrey D. Rome, Robert L. Ruff, Suzanne S. Ruff, Steven H. Sanders, Ingra Schellenberg, John J. Sellinger, Howard S. Smith, Brenda Stoelb, Jon Streltzer, Mark D. Sullivan, Kimberly S. Swanson, Gabriel Tan, Stephen Thielke, Beverly E. Thorn, Cynthia O. Townsend, Dennis C. Turk, Stephanie C. Wallio, Lawrence J. Weinberger, David A. Williams, Hilary Wilson
- Edited by Michael H. Ebert, Yale University, Connecticut, Robert D. Kerns, Yale University, Connecticut
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- Book:
- Behavioral and Psychopharmacologic Pain Management
- Published online:
- 10 January 2011
- Print publication:
- 25 November 2010, pp ix-xii
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