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Cancer patients who systematically reported their symptoms lived longer

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Credit: Brian Strickland/UNC Lineberger

CHICAGO-Cancer patients who reported their symptoms to their cancer care providers using a web-based survey lived longer than those patients who did not, according to a study led by a University of North Carolina Lineberger Comprehensive Cancer Center researcher.

Ethan Basch, MD, MSc, director of the UNC Lineberger Cancer Outcomes Research Program and professor in the UNC School of Medicine, will present findings (abstract LBA 2) at the American Society of Clinical Oncology Annual Meeting 2017 on Sunday, June 4, that showed patients who used the symptom-reporting Internet tool lived five months longer than patients who reported their symptoms using standard methods. The median overall survival benefit data are from a Memorial Sloan Kettering Cancer Center study that examined the impact of using computer surveys to communicate symptoms for patients with metastatic cancer.

The study's findings also will be published concurrently in the Journal of the American Medical Association.

"Symptom management is a cornerstone of high quality cancer care, and if we can control patients' symptoms better, that's a win, and it is meaningful in and of itself," said Ethan Basch, MD, MSc, director of the UNC Lineberger Cancer Outcomes Research Program and professor in the UNC School of Medicine. "However, we have demonstrated that systematic monitoring of patient-reported outcomes is linked to quality of life improvements and fewer ER admissions, and people are actually living longer."

The study tracked outcomes for patients with solid tumors who were being treated at MSK with outpatient chemotherapy between 2007 and 2011. Basch led the study at MSK, where he still holds an appointment, before his move to UNC-Chapel Hill in 2012.

Patients were randomly assigned to self-report 12 common symptoms using a survey on a tablet computer or to use standard symptom-reporting methods, such as calling the doctor's office. Patients in the Internet-based reporting group were sent weekly email reminders about the need to report symptoms between visits. Automatic email alerts were sent to nurses when a patient reported severe or worsening symptoms. Doctors received print-outs of the patient's symptom reports at visits.

The researchers had previously reported that patients who used the computer survey, on average, remained on chemotherapy longer and that a larger share of patients saw improvements in quality of life scores. In the new analysis, patients who used the computer surveys experienced an overall median survival of 31 months, compared to 26 months for patients who did not use the surveys. The five-month benefit was a 20 percent improvement.

"This study demonstrates that if we can change one of the simple processes in how we administer care, we can potentially benefit more patients by identifying and responding more quickly to health issues before they worsen over time can alleviate suffering, potentially lower health care costs, and help people live longer," said Basch.

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In addition to Basch, other authors include: Allison M. Deal, MS; Amylou C. Dueck, PhD; Antonioa V. Bennett, PhD; Thomas M. Atkinson, PhD; Howard I. Scher, MD; Mark G. Kris, MD; Clifford Hudis; Paul Sabbatini, MD; Dorothy Dulko, RN, PhD; Lauren J. Rogak, MA; Allison Barz, MD, and Deborah Schrag, MD.

The study was supported by the Conquer Cancer Foundation.

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