Re-analysis of symptom clusters in advanced cancer patients attending a palliative outpatient radiotherapy clinic

A diagnosis of incurable metastatic cancer may lead to significant psychological distress for patients as well as a high symptom burden, with patients experiencing an average of 11–13 concurrent symptoms (1,2). Proper palliative care is necessary to manage presenting symptoms and improve the quality of life (QOL) of patients (3). Symptoms can result from treatment, the disease itself, or other comorbidities (4,5). Multiple symptoms also have the ability to independently predict changes in functional status and overall patient outcomes (6,7). Historically, symptom management has focused on treating one symptom at a time, which has led to increased knowledge of individual symptoms, but may not reflect the entirety of the patient experience as symptoms rarely present alone (1,2,5). This rationalizes the need for the treatment of multiple symptoms at once. Identifying symptoms that often cluster together endeavors to better characterize the symptom experience of advanced cancer patients and increase the effectiveness of palliative care