Sarcoma patients keeping mum about less severe symptoms: Study
SINGAPORE — Patients diagnosed with sarcoma — a rare form of cancer that usually presents itself in large soft tissue tumours — have been keeping mum about many symptoms bothering them, possibly out of fear that these are side-effects from their medication or that their medical bills will rise, a new study has shown.
For instance, although one-third of patients studied experience difficulty sleeping, only 6.3 per cent sought help. Similarly, for the 30 per cent of patients who lose their appetite, only one sought pharmacological treatment.
The study, done by the National University of Singapore (NUS) and National Cancer Centre Singapore (NCCS), hopes to make clinicians more aware of such behaviour — which patients of other cancers may have — so they can offer help.
“Through this study ... we will certainly be on the lookout and actively ask about these symptoms,” co-researcher Richard Quek said, adding that treatment will include medication, where available, or non-pharmacological treatment such as counselling and sleep advice.
The researchers, who polled 79 sarcoma patients at the NCCS from October 2013 to February last year, found that many patients do not report relatively less severe symptoms even though these bothered them the most. Examples included tiredness, difficulty sleeping, irritability, worrying and anxiety.
It could be because patients are unsure if their medication is causing these side-effects and thus fear that doctors will stop prescribing them these drugs, or a bid to keep medication costs low, the researchers said.
Alternatively, there could be more complaints of symptoms such as tiredness and insomnia — compared with nausea, headache or pain — because there is a lack of effective drug therapies, said lead researcher Alexandre Chan from the NUS Department of Pharmacy.
Better control of these physiological and psychological symptoms can significantly improve the quality of life for sarcoma patients, the study found. This is especially important for patients who may experience treatment-related symptoms for years, it added.
“Symptoms, even though they can be mild, can be very persistent and therefore very irritating. And worse, if (symptoms) are moderate to severe ... that will affect their perception of their cancer and well-being,” said Dr Quek, deputy head of the medical oncology division at NCCS. “The psychological symptoms reported in this study can be shared with caregivers so that they can appreciate what the patient is going through psychologically ... which may translate to better care and understanding of the patient.”
Associate Professor Chan said caregivers can help track and document side-effects and symptoms patients have, since most receive outpatient treatment.
Given the limited effective drug therapies available in managing some symptoms, he said his team intends to trial a group-based psycho-social programme in April for younger adult patients to offer non-pharmacological intervention instead.
“(It would be) more like a patient orientation programme, so we tell them what are some things to expect while undergoing treatment,” he said. “From there, we’ll try to identify patients who are at higher risk (and) need more personalised types of intervention from the multidisciplinary team.”
