Prevalence and severity of suffering among patients with advanced cancer.

Background: Suffering is an expression commonly used to describe distressing experience of cancer patients. Suffering experience among patients with advanced cancer has not been studied before in Saudi Arabia.

Objective: The objective of this study is to determine the pattern of suffering and the feasibility of measuring its severity on a numerical scale for cancer patients attending a palliative care outpatient clinic.

Methods: This is part of a larger survey studying the pattern of symptomatology in an outpatient palliative care clinic. Over a 5-month period, cancer patients attending an outpatient palliative care clinic were requested to rate their suffering as well as 11 listed symptoms on a 0-10 numerical scale.

Results: Of the 124 patients interviewed, 73 (59 %) were females. Only 15 patients (12 %) reported no suffering. For those who were suffering (88 %), the median score is 5. Suffering scores did not differ based on sex, age, or type of cancer. Patients with a Palliative Performance Scale of ≤50 % had significantly higher mean suffering score (6.8) compared to those with better performance status (4.8; P = 0.003). Multivariate analysis resulted in three independent variables showing a significant relationship to suffering score, namely pain (P = 0.018), tiredness (P = 0.022), and depression (P = 0.022).

Conclusion: Patients with advanced cancer were able to easily rate their suffering on a numerical scale. Pain, tiredness, and depression were associated with the suffering scores. Suffering scores might help in tracing the trend of suffering in the individual patient over time.