Symptom clusters in oncology patients and implications for symptom research in people with primary brain tumors

Purpose: To provide a critical analysis of the state of the science of research on symptom clusters in the general oncology population, compared to symptom research in the primary brain tumor population. Organizing Construct: Symptoms are a multidimensional experience that include perceptions of the frequency, intensity, distress, and meaning as symptoms occur and are expressed. A symptom can influence the occurrence and meaning of other symptoms. Methods: Literature pertaining to symptom presentation in people with primary brain tumors and the occurrence of multiple symptoms and symptom clusters in patients with cancer was reviewed and analyzed. Findings: Symptoms occur in clusters in general oncology patients, and these clusters have been shown to influence functional status. The potential effect of tumor biology on symptom clusters is shown by the cluster of symptoms theorized to be associated with proinflammatory cytokine production. In patients with primary brain tumors, few researchers have examined the occurrence of symptoms at the time of diagnosis. Studies to date are retrospective and descriptive and were conducted before the use of modern imaging techniques. Studies of symptom clusters have not been reported for patients with primary brain tumors. Conclusions: Symptom clusters have recently been identified in the general oncology population and might provide a new strategy for assessment and intervention. Neurologic symptoms in patients with. primary brain tumors are those related to increased intracranial pressure and those that are location-dependent within the brain. Therefore, application of the symptom cluster paradigm to guide research is warranted.