Biological Basis for the Clustering of Symptoms.
Debra Lynch Kelly, Kristin Dickinson, Chao-Pin Hsiao and 4 others
PMID 27776832WHAT IT FOUND
Pain, depression, and fatigue were the most commonly studied cancer symptom cluster, but blood markers fit individual symptoms more than whole clusters.
Nurses can assess these symptoms together; the biomarker evidence is inconsistent.
Key findings
01The symptom cluster most frequently examined was pain, depression, and fatigue, but specific cytokines correlated with individual symptoms rather than clusters.
02The immune/inflammation pathway was the most explored biologic pathway, and IL-6 and TNF-alpha were the most measured cytokines, but their associations were inconsistent.
03The review concludes that current understanding is limited and further investigation is needed to identify and validate potential pharmacodynamic targets.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The included studies used different ways to measure cytokines and symptoms, so the findings do not line up. There was no agreed definition of what counts as a symptom cluster. Many studies were small, making it hard to generalise. All biologic samples were peripheral blood, so central mechanisms were not tested. The search was limited to English articles published 2005 to 2015 in adults at least 21 years of age.
Declared interests
Funding was from the Division of Intramural Research, National Institute of Nursing Research, NIH.
The easy way to misread this
Do not read this as evidence that a blood marker can diagnose or guide treatment of cancer symptom clusters. The review found inconsistent associations, with specific cytokines linked to individual symptoms rather than clusters, and says further investigation is needed.