Symptom severity and distress in advanced cancer

Jordanka Kirkova, Declan Walsh, Lisa Rybicki, Mellar P. Davis, Aynur Aktas, Jin Tao Jin, Jade Homsi

Research output: Contribution to journalArticle

57 Scopus citations


We determined the relationship between symptom severity and distress for multiple cancer symptoms, and examined patient demographic influences on severity and distress in advanced cancer. A Cochran-Armitage trend test determined whether symptom distress increased with severity. Chi-square, Fishers exact test and logistic regression analysis examined moderate/severe (clinically important) and distressful symptoms by age (ĝ‰Currency sign65 versus >65), gender, primary site group, and ECOG performance status. Forty-six symptoms were analyzed in 181 individuals. More than 50% of individuals with clinically important symptoms rated them as distressful. The median percentage of individuals with mild but still distressful symptoms was 25%, with a range of 0% (bad dreams) to 73% (sore mouth). In both univariate and multivariate analysis, younger (ĝ‰Currency sign65 years) patients, females, and those with poor performance status had more clinically important and a higher prevalence of distressful symptoms (only anxiety was more frequently distressful to older individuals). Clinically important symptoms and two of those considered distressful varied by primary site group. After control for severity, symptom distress did not differ by primary site group. The prevalence of distress increased with greater symptom severity. Younger individuals, those with poor performance status, and females had greater symptom severity and distress. Mild symptoms were often distressful. After adjustment for severity, age, gender, and performance status all influenced symptom distress.

Original languageEnglish (US)
Pages (from-to)330-339
Number of pages10
JournalPalliative Medicine
Issue number3
StatePublished - Apr 1 2010


  • Age
  • Distress
  • Gender
  • Performance status
  • Severity
  • Symptom

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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  • Cite this

    Kirkova, J., Walsh, D., Rybicki, L., Davis, M. P., Aktas, A., Tao Jin, J., & Homsi, J. (2010). Symptom severity and distress in advanced cancer. Palliative Medicine, 24(3), 330-339.