Prevalence and severity of symptoms and signs in patients with advanced cancer in the last days of life: the East Asian collaborative cross-cultural study to elucidate the dying process (EASED)

Yusuke Hiratsuka, Sang Yeon Suh, Seon Hye Won, Sun Hyun Kim, Seok Joon Yoon, Su Jin Koh, Jung Hye Kwon, Jeanno Park, Hong Yup Ahn, Shao Yi Cheng, Ping Jen Chen, Takashi Yamaguchi, Tatsuya Morita, Satoru Tsuneto, Masanori Mori, Akira Inoue

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Purpose: Few large-scale studies have focused on the prevalence of symptoms and signs during the last days of patients diagnosed with advanced cancer. Identifying the patterns of specific symptoms according to cancer type is helpful to provide end-of-life care for patients with advanced cancer. We investigated the prevalence and severity of symptoms and signs associated with impending death in patients with advanced cancer. Methods: In this secondary analysis of an international multicenter cohort study conducted in three East Asian countries, we compared the severity of symptoms and signs among dying patients in the last 3 days of life according to the type of primary cancer using one-way analysis of variance (ANOVA). Post hoc analysis was conducted for multiple comparisons of each symptom according to the type of primary cancer. Results: We analyzed 2131 patients from Japan, Korea, and Taiwan. The prevalence of most symptoms and signs were relatively stable from 1 week after admission to the last 3 days of life. According to cancer type, edema of the lower extremities was the most common symptom and fatigue/ ascites were the most severe symptoms in digestive tract cancer. For lung cancer, respiratory secretion was the most prevalent and dyspnea/respiratory secretion were the most severe symptoms. Conclusion: We demonstrated the prevalence and severity of symptoms and signs associated with the impending death of patients with advanced cancer in East Asia. Our study can enable clinicians to recognize the specific symptoms and signs at the very end of life.

Original languageEnglish
Pages (from-to)5499-5508
Number of pages10
JournalSupportive Care in Cancer
Volume30
Issue number6
DOIs
StatePublished - Jun 2022

Keywords

  • Advanced cancer
  • East Asia
  • End of life
  • Palliative care
  • Signs and symptoms

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