Palliative care needs assessment in patients with metastatic and locally advanced oesophageal cancer

Abstract

Background Palliative care plays an important role in improving symptom burden and quality of life for patients with incurable oesophageal cancers. There is a dearth of studies regarding palliative care needs in advanced oesophageal cancer patients. Aim To understand the unmet palliative care needs and the associated factors in advanced oesophageal cancer patients. Design We conducted a cross-sectional observational study. Study/Participants We recruited 50 patients in the Thoracic Oncology OPD in a tertiary cancer centre in Mumbai, India, who were newly diagnosed with locally advanced, unresectable, or metastatic Oesophageal Cancer. The recruited patients’ concerns were assessed using Needs Assessment Tool-Progressive Disease Cancer (NAT-PDC) and symptom burden was assessed using Edmonton Symptom Assessment Score (ESAS). A Chi-square test was performed for correlating different factors with some or significant concerns, considering p ≤ 0.05 as statistically significant. Results Oesophageal cancer patients had concerns in physical (94%), financial (94%), psychological (82%), sociocultural (76%), activities of daily living (70%) and spiritual (58%) domains. They had a high symptom burden, most common symptoms being dysphagia, pain and tiredness. Anxiety and depression were associated with higher psychological and spiritual concerns. Older age, female gender and low financial income were associated with higher levels of concerns. Caregivers were most concerned about their patients’ physical symptoms (94%) and financial issues (92%). Conclusion Patients with advanced oesophageal cancer have significant burden of unmet palliative care needs. This should trigger referrals to specialist palliative care for comprehensive care of patients and their caregivers.