The Symptom Experience While Taking Oral Anti-Cancer Medication (Chemotherapy or Targeted Agents)Midwest Nursing Research Society (2014)
Background: Over 50-oral agents are on the market, and within three years, 25% of treatment will be in pill form, shifting the responsibility for symptom management to the patients. Symptoms need to be managed so they do not become so severe that it leads to reducing or stopping the medication, potentially rendering the cancer treatment ineffective. A gap in the literature exists, with no studies reporting the symptom experience of patients taking oral agents. Prior to developing interventions for patients at home setting on oral agents, we need to determine if symptoms are similar to those treated with IV chemotherapy.
Purpose: This study describes symptom experience of patients prescribe oral agents.
Conceptual Framework: A synthesized model from the Health Belief Model, the Theory of Reasoned Action, and Social Cognitive Theory guided this study.
Methods: Phone interviews with structured and open-ended questions for 30-cancer patients taking oral agents from 6-centers were conducted 5-times over 8-weeks. Cancer site, stage, treatment, comorbidities, symptom experience were obtained.
Findings: Mean age was 65; 50% (N=15) female/male; 83% (N=25) Caucasian and 17% (N=5) African American; 77% (N=23) had comorbidities. Nine types of oral agents were taken. Symptoms were experienced in 146 of 148 assessments: 83% (N=25) fatigue, 83% (N=25) pain, 63% (N=19) numbness/tingling, 53% (N=16) sleep disturbance, 40% (N=12) diarrhea, 37% (N=11) distress, 37% (N=11) swelling of hands and feet, 33% (N=10) lack of appetite, 33% (N=10) shortness-of-breath, 30% (N=9) redness/swelling/pain in hands/feet, 23% (N=7) constipation, 21% (N=6) skin rash/sores, 21% (N=6) nausea/vomiting, 17% (N=5) sores in mouth, and 7% (N=2) fever. Other symptoms reported included: fluid retention (N=4), dizziness (N=3), chemo brain (N=3), weakness (N=3), Lymphadema (N=2), blood clots (N=2), weight gain (N=2), plugged ears (N=2), and one patient reported a fall, chills, coughing, acid reflux, restless legs, thinning hair, elevated blood pressure, and facial muscles locked. Patients had a mean of 5.3 of the 15 symptoms; and mean summed symptom severity score decreased from 25.3 at assessment 1 to 22.3 at assessment 5; not significant (paired t-test, t = 0.98, p = 0.3348).
Implications: Symptoms experienced in those prescribed oral agents are similar to those on IV chemotherapy. Clinicians can utilize evidence-based symptom management strategies developed for IV chemotherapy with patients prescribed oral agents.
Publication DateSpring 2014
Citation InformationSandra Spoelstra. "The Symptom Experience While Taking Oral Anti-Cancer Medication (Chemotherapy or Targeted Agents)" Midwest Nursing Research Society (2014)
Available at: http://works.bepress.com/sandra-spoelstra/32/