Paying Attention to Cancer Symptoms

86496585Getting involved in your own care may help you live longer if you have cancer, a research letter Rick and I discuss on PodMed this week and published in JAMA shows. The letter reports outcomes from a strategy developed by oncologists at Memorial Sloan Kettering to allow patients to report their own symptoms - so called 'patient reported outcomes' or PROs - and record them into their electronic record. When the patient identified a severe or worsening symptom, an email alert was sent to the nurse who was involved in the person's care, and the nurse was then empowered to make changes to the chemotherapy dose or to supportive medications, provide counseling for symptom management, or make appropriate referrals. Nurses did so 77% of the time they received an alert in this study.

Benefits to patients who reported their symptoms over a median of seven years of follow up included longer median survival: 31.2 months for the PRO group versus 25 months for the usual care group, and longer duration of chemotherapy: 6.3 months in the usual care group versus 8.2 months in the PRO group, which the authors speculate may be the mechanism by which the PRO group survived longer. They also recommend that such a strategy could be integrated broadly into cancer care for almost all, since one in eight of the patients in this study were non-white and almost a quarter had a high school education or less.

Other topics this week include Growth and Rupture Risk of Small Unruptured Intracranial Aneurysms in Annals of Internal Medicine, Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline in the BMJ, and Completion Lymph-Node Dissection in Melanoma in NEJM. Until next week,y'all live well.

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