Symptom Clusters Related to Treatment for Prostate Cancer

Published in: Oncology Nursing Forum, v. 35, no. 5, Sep. 2008, p. 786-793

Posted on RAND.org on January 01, 2008

by Sally L. Maliski, Lorna Kwan, David Elashoff, Mark Litwin

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PURPOSE/OBJECTIVES: To identify symptom clusters that include urinary and erectile dysfunction among men treated for prostate cancer. DESIGN: Secondary data analysis. SETTING: University-affiliated urology clinic. SAMPLE: Data collected on 402 men for a longitudinal prostate cancer quality-of-life study. METHODS: Data were collected from an eight-month time point. Four analytic approaches were applied to determine whether consistent clusters of symptoms were identifiable. MAIN RESEARCH VARIABLES: Pain, fatigue, emotional distress, and urinary, sexual, and bowel dysfunction. FINDINGS: Thirty-three percent of patients reported scores on three or more quality-of-life measures falling in the lowest quartile for that measure. Although composition of the clusters was not consistent, poor mental health or poor energy was a component of any cluster made up of three or more symptoms. CONCLUSIONS: Using a four-way analytic approach enabled the authors to explore how symptom clusters measuring general and diseasespecific quality of life occurred in patients who have been treated for prostate cancer. When clusters occur, fatigue and emotional distress often are included. IMPLICATIONS FOR NURSING: Fatigue and emotional distress may be seen together or in combination with prostate cancer-specific symptoms. Nurses should be more alert to the possibility of additional treatmentrelated symptoms when fatigue or emotional distress is present.

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