JAMA Logo Living with a dreadful disease like cancer may be no child’s play. A recent study suggests that cancer patients going through pain or depression have high rate of physical symptoms like fatigue, dry mouth and nausea. It is known that experiencing many physical, or somatic, symptoms significantly affects patients in primary care settings and those with chronic medical conditions other than cancer.

During the investigation data from 405 cancer patients with no pain or depression was scrutinized. Presence and burden of 22 different somatic symptoms with number of days spent in disability within the previous three-month period and health care use was mentioned by the subjects. While at least one somatic symptom was reported by all the participants, more than half had 15 of the 22 symptoms. 97.5 percent were feeling tired, 78.8 percent had difficulty in sleeping and 78 percent went through pain in the limbs or joints. On the other hand, 74.8 percent suffered from back pain and 72.1 percent were facing difficulty in remembering things.

Experts quote, “Somatic symptoms account for more than half of all general medical visits, lack a definitive medical explanation one-third to half of the time and are frequently persistent. Physical and psychological factors seem to contribute to somatic symptom reporting, even in patients with chronic medical disorders. These symptoms are associated with substantial functional impairment, disability and health care use, even after controlling for medical and psychiatric comorbidity.”

An average of 16.9 disability days were registered in the previous four weeks, during which 5.7 days were in bed and for 11.2 days activities were reduced by 50 percent or more. In health care usage, 32 percent had three to five outpatient visits in the previous three months, 28 percent went through 10 visits and 26 percent with more than 10 visits. While 38 percent were hospitalized at least once, one-third visited the emergency department one or more times. On the basis of a scale from zero to 44, participants revealed an average somatic symptom burden score of 18.3.

Investigators allege, “This study strengthens the case for improving the recognition and treatment of somatic symptoms in patients with cancer. Given the strong association with disability and the high prevalence of many types of symptoms, recognizing and managing somatic symptoms may be important in improving quality of life and functional status regardless of type or phase of cancer.”

Kurt Kroenke, M.D., of the Richard Roudebush VA Medical Center, Indiana University, and Regenstrief Institute Inc., Indianapolis, and colleagues noted that a higher score was linked with education, employment status, income and an emergency department or mental health visit in the previous three months. Elevation in score may not be correlated with sex, race or marital status. For every five-unit rise in somatic symptom burden score, the ability of having at least 14 days of disability in the previous 28 days seemingly heightened by 50 percent.

The study was published in the October 11 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.