Background and Aim
Cancer symptoms, from disease or treatment, are common. Our aim was to reach consensus on the most troublesome cancer symptoms in Australian / New Zealand adults, to inform the direction of future clinical research and improve quality of life.
Methods
We conducted a modified Delphi study comprising two online surveys and consensus-building meetings for participants who included consumers and healthcare professionals (HCPs). Consensus was defined a priori as ≥70% participant agreement. Responses were summarised descriptively.
Round 1: HCPs were asked about prevalence/severity/management of 31 cancer symptoms in their patients; consumers were asked whether they experienced these symptoms, and to rate their impact. Participants were asked to nominate interventions for future symptom management research.
Round 2: Participants were asked if there were symptoms missing from the list of the top 10 ranked symptoms from Round 1, and to rate the importance of researching each intervention nominated in Round 1 (4-point Likert scale).
Round 3: Consumer meetings aimed to reach consensus on symptoms that had previously been agreed on by HCPs. All participants voted on symptoms reinstated in Round 2, and interventions that had not previously reached consensus.
Results
Participation peaked in Round 1 (consumers=332; HCPs=51). Consumers reached consensus that fatigue, bowel/bladder problems were troublesome. HCPs reached consensus on these and agreed that depression/mood, memory, cachexia, drowsiness, anorexia, sensory neuropathy, neuropathic pain, breathlessness, anxiety, insomnia were also poorly managed.
Both groups agreed that medicinal cannabis, physical activity, psychological therapies, non-opioid interventions for pain and opioids for breathlessness were important foci for future research.
Conclusion
This study identified clear priority areas for future cancer symptom research, including intervention strategies nominated by consumers and HCPs. We will collaborate with investigators, industry, and consumers to target clinical trial research into these priority areas, starting with the online 'Facing Fatigue Seminar Series' (Jul2023-Jun2024).