Comparing the Palliative Care Needs of Patients With Hematologic and Solid Malignancies

Area of Science:

• Oncology
• Palliative Care
• Symptom Management

Background:

• Hematologic cancer patients access palliative care less frequently than solid tumor patients.
• Existing research indicates a substantial symptom burden in hematologic malignancies.
• Limited comparative data exists on end-of-life symptom burden between hematologic and solid tumors.

Purpose of the Study:

• To compare unmet symptom needs between hematologic and solid tumor patients referred to specialty palliative care.
• To identify specific symptom burdens unique to hematologic cancer patients.

Main Methods:

• Cross-sectional analysis of initial palliative care encounters from a novel data registry.
• Inclusion of 1235 cancer patients across 17 Global Palliative Care Quality Alliance sites.
• Comparison of clinically significant symptoms (severity rating ≥4) and multivariate logistic regression analysis.

Main Results:

• Pain, dyspnea, nausea, and anorexia burden were comparable between hematologic and solid tumor patients.
• Hematologic cancer patients showed higher rates of clinically significant tiredness (51% vs. 42%, P=0.03).
• Blood cancer patients had increased odds of tiredness (OR 2.19) and drowsiness (OR 1.81) independent of covariates.

Conclusions:

• Both hematologic and solid tumor patients present with significant symptom burden upon palliative care referral.
• Hematologic cancer patients may have distinct symptom concerns, notably tiredness and drowsiness.
• Findings suggest a need to enhance palliative care utilization among hematologic cancer patients.