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By Paul Ossi

M.D. on 06/27/2017

Closely Monitoring Symptoms Shown to Improve Health Outcomes for Cancer Patients

An online reporting tool for cancer treatment side effects not only improved quality of life for participants, but also extended survival, according to a study conducted by researchers at Memorial Sloan Kettering.

The large scale, randomized study included 766 participants – some as old as 91 – who were undergoing treatment for various types of advanced cancers. Each was asked to use Symptom Tracking and Recording (STAR), an online interface that asked questions about 12 side effects associated with chemotherapy: breathing difficulty, constipation, cough, diarrhea, difficulty urinating, fatigue, hot flashes, loss of appetite, nausea, neuropathy, pain and vomiting.

Weekly reminders were sent to encourage participants to complete their assessments and nurses were notified about any symptom reported as grade three or higher, as well as any that had increased in severity by two or more points since the previous assessment. Nurses were able to act on 77 percent of email notifications by providing medications, referrals, chemo dosage changes, etc. Reports were also viewed by physicians at each office visit.

The study analysis showed that after six months users of the online tool reported better health-related quality of life and fewer emergency room visits. Study participants were also able to remain on chemo longer – an average of 8 months as compared to 6 months – and median survival for the group increased from 26 months to 31 months.

Previous studies have revealed that approximately half of cancer treatment related side effects go unreported or are not reported in a timely manner. When patients simply tolerate new symptoms that develop between appointments or delay reporting them until their next exam, it can potentially cause serious cancer treatment delays. 

Whether this lack of reporting is due to patients’ belief that side effects are just part of cancer treatment, reluctance to bother their doctor, or challenges in the reporting process, delays in addressing symptoms is problematic. I always encourage patients to speak openly and honestly with me and their cancer care team about any symptoms they may be experiencing, even when it is not clear the symptoms are related to their cancer treatment.

As technology advances, it is likely we will continue to find new ways to utilize it to improve cancer care and treatment. Patients can benefit immensely from tools such as STAR – which is currently being tested in a nationwide study – but even without the system, prompt reporting of symptoms is needed. When patients share symptoms in a timely manner, it allows those symptoms to be expediently evaluated and managed.


All my best,

Paul Ossi, M.D.

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