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Neuropathic symptoms, quality of life, and clinician perception of patient care in medical oncology outpatients with colorectal, breast, lung, and prostate cancer

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Abstract

Purpose

We investigated how treatment-induced neuropathic symptoms are associated with patients’ quality of life (QOL) and clinician-reported difficulty in caring for patients.

Methods

Data were obtained from 3,106 outpatients with colorectal, breast, lung, or prostate cancer on numbness/tingling (N/T), neuropathic pain, and QOL. Clinicians reported the degree of difficulty in caring for patients’ physical and psychological symptoms.

Results

For all patients, moderate to severe N/T was associated with poor QOL (OR = 1.82, 95 % CI = 1.47–2.26, P < 0.001) but neuropathic pain was not (OR = 1.31, 95 % CI = 0.94–1.83, P = 0.114). Moderate to severe N/T and neuropathic pain were associated with increased care difficulty (OR = 1.49, 95 % CI = 1.27–1.74, P < 0.001 for N/T, and OR = 1.46, 95 % CI = 1.15–1.84, P = 0.002 for neuropathic pain). The association of neuropathic pain with care difficulty was most significant in patients with colorectal cancer (CRC) (OR = 2.32, 95 % CI = 1.41–3.83, P = 0.001). Baseline neuropathic pain was associated with declining QOL in CRC patients (OR = 2.08, 95 % CI = 1.21–3.58, P = 0.008).

Conclusions

Clinicians may experience increased care difficulty for patients of all cancer types with moderate to severe N/T or neuropathic pain; care difficulty due to neuropathic pain may be higher for CRC patients. Nearly half the patients of all cancer types with moderate to severe N/T may expect poor short-term QOL; CRC—but not other—patients with baseline neuropathic pain are likely to experience declining QOL.

Implications for Cancer Survivors

About half of patients with moderate to severe N/T (any cancer type) may expect poor QOL in the short term; CRC patients with baseline neuropathic pain in particular may experience declining QOL.

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Acknowledgments

This study was supported in part by Public Health Service Grants CA37604, CA17145, and grants from the National Cancer Institute, National Institutes of Health and the Department of Health and Human Services. Drs. Fisch and Zhao had full access to the data.

Conflict of interest

The authors reported no disclosures or conflicts of interest.

Author information

Authors and Affiliations

  1. Department of General Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 410, Houston, TX, 77030, USA

    Desiree Jones, Mark A. Lewis & Michael J. Fisch

  2. Department of Biostatistics and Computational Biology, Dana Farber Cancer Institute, Boston, MA, USA

    Fengmin Zhao

  3. MetroHealth Medical Center, Cleveland, OH, USA

    Joanna Brell

  4. Breast and Oncology Departments, Mayo Clinic, Rochester, MN, USA

    Charles L. Loprinzi

  5. Marshfield Clinic, Marshfield, WI, USA

    Matthias Weiss

Authors
  1. Desiree Jones
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  2. Fengmin Zhao
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  3. Joanna Brell
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  4. Mark A. Lewis
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  5. Charles L. Loprinzi
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  6. Matthias Weiss
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  7. Michael J. Fisch
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Correspondence to Desiree Jones.

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Jones, D., Zhao, F., Brell, J. et al. Neuropathic symptoms, quality of life, and clinician perception of patient care in medical oncology outpatients with colorectal, breast, lung, and prostate cancer. J Cancer Surviv 9, 1–10 (2015). https://doi.org/10.1007/s11764-014-0379-x

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  • DOI: https://doi.org/10.1007/s11764-014-0379-x

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