Symptom management is a core concern of oncology practice, with clinicians trying to alleviate suffering and avoid complications for advanced cancer patients. However, up to half of symptoms go missed between visits, seriously challenging clinicians' symptom management efforts and impacting patient survival.
A potential solution: Systemic symptom monitoring via web-based interface. According to a randomized trial, patients' use of a digital tool was associated with improved quality of life and longer overall survival – by almost half a year. “This approach should be considered for inclusion as a part of standard symptom management,”said Dr. Ethan Basch, principal investigator.
The study data were announced June 4 at the ASCO Annual Meeting. Ethan M. Basch, MD, MSc, FASCO, of The University of North Carolina at Chapel Hill, led the study with investigators at Memorial Sloan Kettering Cancer Center.
The standard reactive model for reporting symptoms relies on patients to remember and report their symptoms to their care teams. Dr. Basch and team hypothesized that symptom management and clinical outcomes would improve if patients could self-report their symptoms through an online portal, thus alerting physicians to intervene earlier.
In this proactive model, e-reminders were sent periodically to patients prompting them to report recent symptoms, which then alerted health professionals to the patient-reported symptom data for prompt follow-up. The proactive, tech-enabled model improved overall survival by 5 months and quality of life benefits for 31% more patients.
Dr. Basch named 3 possible reasons for the improvements in outcomes:
- Proactive monitoring prompts clinicians to intervene early, before symptoms worsen and cause downstream complications.
- Symptom control helps patients stay more functional, which is associated with better survival.
- Symptom monitoring enhances control of chemotherapy side effects, enabling more intensive and longer duration therapy.
The study recruited 777 patients receiving chemotherapy for metastatic breast, lung, genitourinary, or gynecologic cancers. These single-center results are being further evaluated in a national multicenter implementation trial.
Access the full announcement from the American Society of Clinical Oncology here.
Photo Credit: American Society of Clinical Oncology