Supportive care needs of patients with advanced disease undergoing radiotherapy for symptom control

Margaret I. Fitch


Many patients with advanced cancer have numerous medical complications and multiple sites involving metastases that cause distressing symptoms. Radiotherapy is often used for the palliative treatment of these patients, especially those with bone metastases. There is a lack of information about the types of supportive care needs these patients experience, the services that are available for them, and whether people want help with their needs.

The main purpose of this cross-sectional, descriptive study was to identify the supportive care needs (physical, emotional, social, spiritual, psychological, and practical) of patients with advanced cancer who attended the Palliative Radiation Therapy Rapid Response Clinic (PRTRRC) at a comprehensive, ambulatory cancer centre. A second purpose was to determine if patients wanted assistance in meeting those needs.

A total of 69 patients participated in this study by completing a self-report questionnaire. The data provided a clear indication that a range of supportive care needs remained unmet for this patient group. Lack of energy, pain, and concerns about the worries of those close to them were the most frequently reported needs. Additionally, patients expressed a range of difficulty managing needs and many of these patients desired help to manage the identified needs. However, despite this reality, significant numbers of patients indicated they did not wish to have assistance with some needs. Suggestions for practice and future research are offered to assist oncology nurses in providing supportive care to these patients.

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Accreditation Canada (2010). Standards: Cancer care and oncology

services. Ottawa: Author.

Andersson. L., & Sousa, P. (1998). An innovative way of caring:

Palliative radiation therapy rapid response clinic. Canadian

Oncology Nursing Journal, 8(2), 146–147.

Ashbury, F.D., Findley, H., Reynolds, B., & McKerracher, K. (1998). A

Canadian survey of cancer patients’ experiences: Are their needs

being met? Journal of Pain and Symptom Management, 16(5),


Body, J. (1992). Metastatic bone cancer: Clinical and therapeutic

aspects. Bone, 13, 1350–1354.

Bonevski, B., Sanson-Fisher, R., Girgis, A., Burton, L., Cook, P., Boyes,

A., & the Supportive Care Review Group. (2000). Evaluation of an

instrument to assess the needs of patients with cancer. Cancer,

(1), 217–225.

Bradley, N., Davis, L., & Chow, E. (2005). Symptom distress in

patients attending an outpatient palliative radiotherapy clinic.

Journal of Pain and Symptom Management, 30(2), 123–131.

Bruera, E., Michaud, M., Vigano, A., Neumann, C., Watanabe, S., &

Hanson, J. (2001). Multidisciplinary symptom control clinic in

a cancer centre: A retrospective study. Support Care Cancer, 9,


Charles, K., Sellick, S.M., Montesanto, B., & Mohide, E.A. (1996).

Priorities for cancer survivors regarding psychosocial needs.

Journal of Psychosocial Oncology, 14(2), 57–72.

Chow, E., Tsao, M., & Harth, T. (2004). Does psychosocial intervention

improve survival in cancer? A meta-analysis. Palliative Medicine,

, 25–31.

Chow, E., Wong, R., Connolly, R., Hruby, G., Franssen, E., Fung, K.,

et al. (2001). Prospective assessment of symptom palliation

for patients attending a rapid response radiotherapy program:

Feasibility of telephone follow-up. Journal of Pain and Symptom

Management, 22(2), 649–656.

Ciezki, J., Komurcu, S., & Macklis, R. (2000). Palliative radiotherapy.

Seminars in Oncology, 27(1), 90–93.

Edmonds, P., Karlsen, S., Khan, S., & Addington-Hall, J. (2001). A

comparison of the palliative care needs of patients dying from

chronic respiratory diseases and lung cancer. Palliative Medicine,

(4), 287–295.

Fitch, M.I., Mings, D., & Lee, A. (2008). Exploring patient initiated

strategies for living with treatment-related fatigue. Canadian

Oncology Nursing Journal, 18(3),124–140.

Fitch, M.I., & Bultz, B. (2009). Symptom patterns in patients with

advanced cancer. Oncology Exchange, 8(4),11–13.

Fitch, M.I., Porter, H.B., & Page, B.D. (2008). Supportive Care

Framework: A Foundation for Person-Centered Care. Pembroke,

ON: Pappin Communications.

Fitch, M.I., & Steele, R. (2010a). Identifying supportive care needs of

women with ovarian cancer. Canadian Oncology Nursing Journal,

(2), 66–74.

Fitch, M.I., & Steele, R. (2010b). Supportive care needs of individuals

with lung cancer. Canadian Oncology Nursing Journal, 20(1), 15–

Hutton, J., Martin, L., Field, C.J., Wismer, W.V., Bruera, E.D., Watanabe,

S.M., et al. (2006). Dietary patterns in patients with advanced

cancer: Implications for anorexia-cachexia therapy. American

Journal of Clinical Nutrition, 84(5), 1163–1170.

Kennett, C., & Payne, M. (2005). Understanding why palliative care

patients ‘like day care’ and ‘getting out’. Journal of Palliative

Care, 21(4), 292–298.

Kirkbride, P. (1995). The role of radiation therapy in palliative care.

Journal of Palliative Care, 11(1), 19–26.

Sarna, L., Evangelista, L., Tashkin, D., Padilla, G., Holmes, C., Brecht,

M., et al. (2004). Impact of respiratory symptoms and pulmonary

function on quality of life of long-term survivors of non-small

cell lung cancer. Chest, 125(2), 439–445.

Sarna, L., Lindsey, A.M., Dean, H., Brecht, M.L., & McCorkle, R. (1994).

Weight change and lung cancer: Relationships with symptom

distress, functional status and smoking. Research in Nursing &

Health, 17(5), 371–379.

Solano, J., & Higginson, I. (2006). A comparison of symptom

prevalence in far advanced cancer, AIDS, heart disease, chronic

obstructive pulmonary disease and renal disease. Journal of Pain

and Symptom Management, 31(1), 58–68.

Steele, R., Fitch, M.I., Alderson, D., Barrow, K., Hurst, N., & Doyle,

C. (2004). Measuring supportive care needs of women with

gynecological cancer. Supportive Care in Cancer, 12(6), 411.

Steele, R., & Fitch, M.I. (2008). Why patients with lung cancer do not

want help with some needs. Supportive Care in Cancer, 16(3),


Voogt, E., van der Heide, A., van Leeuwen, A.F., Visser, A.P.,

Cleiren, M.P., Passchier, J., et al (2005). Positive and negative

affect after diagnosis of advanced cancer. Psychooncology,

(4), 262–273.

Whelan, T.J., Mohide, E.S., Willan, A.R., Arnold, A., Tew, A., Sellick,

S., et al. (1997). The supportive care needs of newly diagnosed

cancer patients attending a regional cancer centre. Cancer, 80(8),



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