Symptoms in Pediatric Cancer Do Not Coincide with Proxy Reports

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Symptoms are common among children diagnosed with cancer; however, children’s reports of these symptoms do not coincide with proxy reports, according to an article published online in the journal Cancer.

In this study, 60 pediatric patients with cancer and their family caregivers completed the pediatric Memorial Symptom Assessment Scale (pMSAS), which was translated into Spanish.

The median age of the children was 10 years (range, 7 to 18 years) and 62% were male. Approximately 33% of the patients were Spanish-speaking, but the English- and Spanish-speaking participants yielded similar results.

Results showed nine patients (15%) reported no symptoms, while 38 (63%) had greater than or equal to 2 symptoms. Among the younger patients who reported symptoms, fatigue (12 patients; 40%) and itch (9 patients; 30%) were the most common; whereas, pain (15 patients; 50%) and lack of energy (13 patients; 45%) were the most common symptoms among the older children.

The authors noted 14 oncologists completed 25 patients’ pMSAS.

Furthermore, the range of agreement for individual symptoms between the patient and proxy was from a kappa of -0.30 (95% CI: -0.43, -0.01) to 0.91 (95% CI: 0.75, 1.00).

Out of 51 patients with demonstrated symptoms, 3 (6%) had documented treatment recommendations in their electronic health records.

Childhood cancer survivors exposed to therapies that cause pulmonary dysfunction are associated with
Symptoms are common among children diagnosed with cancer; however, children’s reports of these symptoms do not match proxy reports.
Zhukovsky, D. S., Rozmus, C. L., Robert, R. S., Bruera, E., Wells, R. J., Chisholm, G. B., Allo, J. A. and Cohen, M. Z. (2015), Symptom profiles in children with advanced cancer: Patient, family caregiver, and oncologist ratings. Cancer. doi: 10.1002/cncr.29597
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