Patient-reported treatment-related symptom burden for patients with advanced melanoma in Canada

• Published in: Supportive care in cancer Vol. 27; no. 1; pp. 219 - 227
• Main Authors: Cheung, Winson Y., White, Michelle K., Bayliss, Martha S., Stroupe, Angela, Lovley, Andrew, King-Kallimanis, Bellinda L., Lasch, Kathryn
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2019; Springer; Springer Nature B.V
• Subjects: Activities of Daily Living - psychology; Adult; Aged; Canada - epidemiology; Chemotherapy; Constipation; Cost of Illness; Dermatitis; Diarrhea; Disease Progression; Drug-Related Side Effects and Adverse Reactions - epidemiology; Drug-Related Side Effects and Adverse Reactions - psychology; Fatigue; Fatigue - epidemiology; Fatigue - etiology; Female; Humans; Immunotherapy - adverse effects; Inhibitor drugs; Interviews as Topic; Ipilimumab - adverse effects; Ipilimumab - therapeutic use; Male; Medicine; Medicine & Public Health; Melanoma; Melanoma - epidemiology; Melanoma - pathology; Melanoma - psychology; Melanoma - therapy; Middle Aged; Nausea; Nursing; Nursing Research; Oncology; Original; Original Article; Pain Medicine; Patients; Qualitative research; Quality of Life; Rehabilitation Medicine; Self Report; Side effects; Surveys and Questionnaires; Treatment Outcome; Canada; Patient-reported; Health-related quality of life; Treatment-related symptoms; Burden of treatment; Melanoma; Patient interviews; Qualitative; Cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-018-4316-9

Background Little is known on the impact of emerging treatments for advanced melanoma (stages III and IV) on patients’ functioning and well-being. The objective of this study was to describe the patient-reported treatment-related symptom (TRS) burden in advanced melanoma. Method Twenty-nine in-depth, qualitative interviews were conducted among adult patients with advanced melanoma in Canada using a semi-structured interview method. Interviews were transcribed verbatim, and key concepts were identified using a grounded theory analytic approach. Results The 29 patients reported 13 unique treatment journeys involving the following drug therapy categories: cytotoxic chemotherapies, CTLA-4 inhibitors, BRAF or MEK inhibitors, and PD-1 inhibitors. Patients typically underwent multiple treatment episodes over time. Common TRSs included nausea, fatigue, diarrhea or constipation, and skin rashes. Patients described these as impacting their physical functioning, ability to perform activities of daily living, social functioning, and overall quality of life. Conclusion Our findings provide a description of the patient’s experience with treatment for advanced melanoma. Our sample included patients typically diagnosed in mid-life, facing an urgent sequence of medical procedures and a pharmacological treatment journey that was burdensome. There is a need for less toxic and more efficacious treatments earlier in the patient journey to alleviate the impact of advanced melanoma treatment on patients’ health-related quality of life.