Distinct Symptom Profiles in Younger and Older Patients With Cancer Receiving Chemotherapy

Compared to younger patients, older patients report differences in the occurrence, severity, and distress of common symptoms associated with cancer and its treatment.

Identify subgroups of younger and older patients with distinct symptom burden profiles and evaluate for risk factors associated with these profiles.

Oncology outpatients (n = 1329) were dichotomized into younger (< 60 years) and older (≥ 60 years) groups. Data included demographic and clinical questionnaires and measures of global, cancer-specific, and cumulative life stress, resilience, and coping. Memorial Symptom Assessment Scale evaluated the occurrence of 38 common symptoms. Separate latent class analyses were done within each age group to identify distinct symptom profiles. Differences among latent classes in demographic and clinical characteristics, stress, resilience, and coping were evaluated.

In younger group (n = 730), four profiles were identified (i.e., All Low (28.8%), Moderate Physical and Lower Psychological (21.9%), Moderate Physical and Higher Psychological (34.6%), All High (14.7%)). Compared to All Low class, All High class was younger, more likely to be female, had a higher comorbidity burden, and a lower functional status, as well as higher stress and lower resilience scores. In the older group (n = 599), three profiles were identified (i.e., Low (34.4%), Moderate (47.9%), High (17.7%)). Compared to Low class, High class was more likely to be female, had a higher comorbidity burden and lower functional status, and received a more toxic chemotherapy regimen, as well as higher stress and lower resilience scores.

Study is the first to use latent class analysis to identify distinct symptom burden profiles in younger versus older oncology patients. In the younger group, differences in the occurrence of psychological symptoms differentiated among the symptom burden profiles. While some of the risk factors were similar, within the older group, patients in the High symptom burden class used a higher number of disengagement coping strategies.