Structured Symptom Assessment in Dermato-Oncology Patients-A Prospective Observational Study of the Usability of a Symptom Questionnaire.

BACKGROUND

A focused anamnesis of symptoms is essential in medical practice, especially in oncology, where new or increasing symptoms often indicate disease progression or therapy side effects. However, there are only a few studies in dermato-oncology that address the question of how symptoms should ideally be recorded. There are no validated questionnaires specifically tailored to the needs of dermato-oncology.

PATIENTS AND

METHODS

Over a one-year period, all patients at the skin cancer centre were given a standardised questionnaire to record relevant symptoms before consultation. This was followed by the attending dermato-oncologist completing an additional section regarding therapeutic measures based on the reported symptoms.

RESULTS

809 patients with 1879 consultations were included. In most patient contacts, patients did not report an increase in symptoms (n = 840; 44.7%). Fatigue, restlessness/anxiety, pruritus, and pain were the most recorded distressing symptoms. The chi-square test revealed that increased symptoms led to significantly more frequent interventions. Overall, symptom relief was observed at follow-up. Analysis using Generalised Estimating Equations showed patients benefited significantly from interventions for sleep disorders. Subgroup analysis showed that patients in ongoing therapy benefitted significantly from interventions for pain and nausea. Those in advanced disease stages benefitted significantly from interventions for pain. In those groups, if symptoms were explicitly stated as having worsened using the questionnaire, measures taken by physicians also showed significant benefit for obstipation and nausea along with pruritus.

CONCLUSIONS

Targeted symptom screening is feasible and provides valuable insights for guiding diagnostic or therapeutic interventions. However, the questionnaire is most useful at higher tumour stages, as it is only effective when distressing symptoms are present.