Symptom Clusters in Head and Neck Cancer: A Systematic Review and Conceptual Model.
Asha Mathew, Amit Jiwan Tirkey, Hongjin Li and 4 others
PMID 34483015WHAT IT FOUND
Studies found head and neck cancer patients often had symptom clusters: pain with fatigue and appetite loss, dry mouth with swallowing and mouth sores, and nausea with vomiting.
Names varied, but these patterns can guide assessment.
Key findings
01Three main symptom clusters were discernible across studies: general or systemic, head and neck cancer specific, and gastrointestinal.
02A cluster of fatigue, pain and lack of appetite was reported in 50% of studies, and a cluster of dry mouth, difficulty swallowing or chewing and mouth or throat sores was reported in 25% of studies.
03Cluster names and composition varied across studies, even when the same symptom measure was used.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPsWhat it means for RNs
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What it does not show
No meta-analysis was possible because symptom measures, clustering methods, and findings were too heterogeneous. Cluster names and composition varied even when studies used the same symptom measure. Stability of clusters over time was reported in only two studies. Predictors of clusters were examined in only two studies, and subgroup predictors in five studies. Most findings came from cross-sectional studies, and power analysis was often not described. Only studies available in English were included.
Declared interests
The authors declared no conflicts of interest. The article is listed as supported by NIH extramural research funding.
The easy way to misread this
Do not conclude that treating one symptom in a cluster will improve the others. The review grouped symptoms from observational studies and found naming and composition varied. It did not test symptom management interventions.