State of the Science: Symptoms and Quality of Life in Individuals with Pancreatic Cancer Undergoing Surgery

Thursday, 2 August 2012: 9:10 AM

Sherry A. Burrell, MSN, RN, ACNS-BC, CNE
School of Nursing-Camden, Rutgers, The State University of New Jersey, Camden, NJ
Suzanne C. Smeltzer, EdD, RN, MS, FAAN
College of Nursing, Villanova University, Villanova, PA
Theresa Pluth Yeo, PhD, MPH, MSN
Department of Surgery, Thomas Jefferson University, Philadelphia, PA

Learning Objective 1: The learner will be able to discuss three symptoms that may negatively affect quality of life in individuals undergoing surgery for pancreatic cancer.

Learning Objective 2: The learner will be able to describe two ways that future research can advance the science of symptoms and quality of life in this population.

Purpose:   The purpose of this integrative review was to examine the science regarding symptoms and quality of life (QoL) in individuals with pancreatic cancer (PC) undergoing surgery with or without adjuvant therapy.

Methods: The integrative review method was used to conduct this review of the literature. Whittemore and Knafl’s (2005) updated integrative review guidelines were followed.  Fourteen studies were included for review as a result of a search in Medline, PubMED, and CINAHL databases from 1995 to 2012.

Results: Several studies had methodological issues including poor response rates, small sample sizes, and heterogeneous samples that limited the generalizability of results and failed to provide a full picture of symptoms and QoL in individuals with PC after surgery with or without adjuvant therapy.   Nonetheless, studies revealed the occurrence of foul stools, flatus, thirst, frequent urination, diabetes mellitus, heartburn, nausea, vomiting, weight loss, abdominal pain, fatigue, and muscle weakness were major symptom concerns in this population.  In several studies, individuals with PC were found to experience significantly higher symptom severity when compared to individuals with benign pancreas conditions.  More than 70% of studies that concurrently examined symptoms revealed that overall QoL or one or more domains of QoL were significantly impaired.  Thus, suggesting that multiple symptoms may have a negative impact on QoL in this population.

Conclusions:   Individuals with PC undergoing surgery with or without adjuvant therapy experience multiple symptoms that may have a negative impact on QoL.  Methodological concerns were apparent in the previous research; thus, future research should include homogenous samples to improve the generalizability of findings and be conducted longitudinally to capture changes in symptoms and QoL over time. It is clear that additional research is needed to fully understand symptoms, the factors that influence symptoms, and the direct impact that symptoms have on QoL in this population.