Study Reveals Surprising Positive Impacts of Symptom Control for Late-Stage Cancer Patients

The vast majority of oncology research is dedicated to finding medications that either cure or more effectively manage the disease. But what about cancer patients in later life or those who are suffering from late-stage cancer, for whom a cure is unlikely? A study recently published in the Journal of Pain and Symptom Management provides several interesting insights into patient attitudes toward symptom control for late-stage cancer and the potential impacts of such treatment.

Pain—along with fatigue and nausea—is among symptoms usually experienced by late-stage cancer patients. Conducting research in such patients is a challenge for a number of reasons, not least of which is what the study authors call “an intrinsic resistance from health professionals, including those in palliative care, to encourage patients to participate in palliative care research, especially clinical trials, with paternalistic assumptions regarding vulnerability and cause of undue patient distress as common themes.” Yet, there are a host of previous studies that suggest patients with advanced cancer often would like to participate in palliative care research. The goal of the Journal of Pain and Symptom Managementstudy was to take a closer look at both the mindset and the experiences of cancer patients who took part in symptom control research.

Patients were recruited from two regional cancer centers in Scotland. Those eligible for the study had a diagnosis of advanced cancer (defined as metastatic and/or incurable), aged 18 years or over, able to give written informed consent, and have participated previously in a symptom control trial. Patients in the “dying phase” were excluded from the research, though the study authors note that such patients may very well benefit from symptom control as well.

In general, participants viewed taking part in a clinical trial as a positive experience. Importantly, this view was independent of any amelioration of pain suffering or other side effects associated with late-stage cancer.

This study was among the first to examine the experiences of patients with advanced cancer who have participated in symptom control trials. While relief of pain was a primary incentive for many of the trial participants, the researchers noted that “trial participation improved well-being, making the trial a therapeutic opportunity in and of itself. These findings suggest that conducting symptom control research in patients with advanced cancer is appropriate and may be beneficial, regardless of the effect of the trial intervention.”

Two other interesting aspects of the research were the “decision tree” that began to form while discussing the trial with participants and the reasons that the trial design was appealing to participants. While many were primarily focuses on symptom relief, participants described other potential benefits, including those to future patients, and in some cases, even the researchers conducting the trials. “In the eyes of the participant,” the authors wrote, “the benefit from the trial did not have to be solely for them.”

The key take-home from the study is an echo of other research suggesting that simply being in a clinical trial has the potential to improve well-being—even when there is no apparent improvement in physical symptoms.