Influence of Pain Symptom Cluster in Advanced Breast Cancer Patients to Reduce Performance Status

in pain
In pain (Source: Pixabay)

Main Point:

Pain, vomiting, constipation, nausea, anxiety, sleep disturbance, fatigue are highly co-related symptoms that occur commonly in cancer patients. These are known as symptom clusters (SCs), which affect the quality of a patient’s life and are much more challenging to manage. Constipation and pain clusters lead to devastating outcomes in metastatic and advanced cancer patients. Women diagnosed with breast cancer suffer from high-intensity pain and depression. At different stages of breast cancer, multiple symptoms start appearing in the patient, which can aggravate if left untreated or ignored.

Published in:

Pain Management Nursing

Study Further:

By managing symptom clusters, patients are less likely to suffer from psychoneurological symptoms and are better able to function. In northeast Ohio, the palliative care center was selected to conduct the research study. Eighty-six participants were enrolled in the research study who were diagnosed with breast cancer. The quantitative cross-sectional study was designed to determine the medication effect of psychoneurological symptoms on oncology patients’ performance. The assessment of relief of symptom clusters must be assessed in patients of different age groups to determine the prognosis and need for intervention, when required. The framework of the research study was provided by the theory of unpleasant symptoms (TOUS), which included performance status, symptoms, and influencing factors. The deregulation of norepinephrine and serotonin is observed in breast cancer patients, which ultimately leads to depression and pain. Psychoneurological symptoms were more common in patients with pain cluster symptoms. The post-hoc analysis revealed the significant effect of the pain symptom cluster on the psychoneurological symptom cluster. The odd ratio and confidence interval, respectively, were found to be 3 and 1.18–7.62. Hamash et al. (2018) concluded that in advanced cancer patients, cluster symptoms need to be treated instead of single symptoms. Nevertheless, a number of factors contribute to the severity and prevalence of SC in oncology patients, including situational factors, physiological factors, and psychological factors that need to be considered in an intervention.


Hamash, K. I., Umberger, W., Aktas, A., Walsh, D., & Cheruvu, V. K. (2018). The effect of the pain symptom cluster on performance in women diagnosed with advanced breast cancer: the mediating role of the psychoneurological symptom cluster. Pain Management Nursing19(6), 627-636.

Nagina Anwar

Nagina Anwar is Medical and Business graduate (Pharm. D - gold medalist, MPhil, MBA exec., B.Sc.). She is pursuing her career in the field of education and freelancing as a lecturer and content writer, respectively. Writing is her passion, which she is pursuing for the last 6 years. She is continuously unlocking new horizons with national and international projects.