Symptom prevalence and burden, and the risk of depression among patients with advanced cancer attending two South African oncology units

Lindsay Farrant; Richard Harding; David Anderson; Linda Greeff; Reshma Kassanjee; R Krause; Zainab Mohamed; Jeannette Parkes; Liz Gwyther

doi:10.3332/ecancer.2022.1349

Symptom prevalence and burden, and the risk of depression among patients with advanced cancer attending two South African oncology units

Ecancermedicalscience. 2022 Jan 27:16:1349. doi: 10.3332/ecancer.2022.1349. eCollection 2022.

Authors

Lindsay Farrant¹, Richard Harding², David Anderson³, Linda Greeff⁴, Reshma Kassanjee⁵, R Krause¹, Zainab Mohamed⁶, Jeannette Parkes⁶, Liz Gwyther¹

Affiliations

¹ Division of Interdisciplinary Palliative Care and Medicine, Department Public Health and Family Medicine, Faculty of Health Science, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa.
² Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London SE5 9PJ, UK.
³ Radiation Oncology, Dunedin Hospital, Southern DHB, 201 Great King Street, Dunedin 9016, New Zealand.
⁴ Social Worker in Private Practice, Andrag Street, Welgemoed 7530, Cape Town, South Africa.
⁵ Centre for Infectious Disease Epidemiology and Research (CIDER), Department Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa.
⁶ Division of Radiation Oncology, Department of Radiation Medicine, Faculty of Health Science, University of Cape Town, L-Block D-Floor, Room D-8, Groote Schuur Hospital, Observatory 7925, Cape Town, South Africa.

Abstract

Background: The incidence of cancer is predicted to increase globally by 47% between 2020 and 2040, largely in low and middle-income countries. The World Health Organisation and World Health Assembly recognise palliative care as an essential component of cancer care. The evidence of palliative care needs among South African oncology patients is sparse. This study aimed to describe the prevalence and burden of symptoms and the risk of depression amongst oncology patients with stage 3 or 4 cancer.

Methods: Demographic and clinical data were collected and the Memorial Symptom Assessment Scale Short Form was used to measure the 7-day period prevalence of 28 physical and 4 psychological symptoms of patients receiving oncology care. The Centre for Epidemiological Studies Depression Scale was used to measure the risk of depression.

Results: A total of N = 343 patients were recruited, of which n = 229 (66.8%) had stage 4 cancer. The mean number of symptoms was 11.56 (SD = 5.86). Pain and feeling drowsy/tired were the two most prevalent symptoms. N = 66 (19.3%) were at risk of mild depression and n = 27 (7.9%) for major depression.

Discussion: Pain and depression persist in advanced cancer care despite the advances in policy and clinical education. Health services research must now focus on how to enact this in routine practice.

Keywords: cancer; depression; pain; palliative care; symptoms.