From Cure Today:
Patients receiving treatment for metastatic cancer who used a web-based tool to report their symptoms either while at home or during clinic visits lived on average five months longer than their counterparts who had standard symptom monitoring, according to findings of a randomized trial reported at the 2017 ASCO Annual Meeting and published simultaneously online in JAMA.1,2
Those who used the tool also were able to stay on their chemotherapy longer, had fewer visits to the emergency department (ED), and experienced better quality of life and physical function, reported lead author Ethan M. Basch, M.D., M.Sc., F.A.S.C.O., at an ASCO press conference June 4.
“Compared to standard care, patients who self-reported symptoms experienced multiple, statistically significant, clinical benefits,” said Basch, MD, MSc, FASCO, professor of medicine at the Lineberger Comprehensive Cancer Center of the University of North Carolina, who was practicing at Memorial Sloan Kettering Cancer Center (MSK) when the study was conducted.
Providing a rationale for the study, Basch said that between visits, patients are often hesitant to call the office, until problems become severe. Even at clinic visits, with many competing topics and limited time, symptoms are often not fully communicated between patients and their doctors and nurses.
“We hypothesized that having patients report their own symptoms—using an online system with the information conveyed to their clinicians—would prompt clinicians to intervene earlier, therefore, improving symptom control and downstream outcomes.”
The trial enrolled 766 patients between September 2007 and January 2011 who were being treated with chemotherapy for metastatic solid tumors (breast, lung, genitourinary, or gynecologic) at MSK. Patients in the intervention arm reported on 12 common symptoms, including appetite loss, dyspnea, fatigue, hot flashes, nausea, and pain, and were asked to grade each on a five-point grading scale based on the Common Terminology Criteria for Adverse Events. Each symptom could be reported either as “none,” or graded from 1 (mild) to 4 (disabling). Short descriptions were included alongside each of the choices to help patients accurately rate their symptoms.