Katherine Webber

Validity of the Memorial Symptom Assessment Scale-Short Form Psychological Subscales in Advanced Cancer Patients

CONTEXT The Memorial Symptom Assessment Scale-Short Form (MSAS-SF) is designed to evaluate physical and psychological symptom burden in advanced cancer patients. There are no current data assessing the validity of the MSAS-SF psychological symptom scores when compared with anxiety and depression. OBJECTIVES This observational cross-sectional study was designed to determine the relationship between the MSAS-SF subscales and the presence of anxiety and depression. METHODS Advanced cancer patients attending a U.K. oncology center completed the MSAS-SF and the Hospital Anxiety and Depression Scale. RESULTS One hundred twenty patients participated in the study. There was an association between the presence of anxiety and depression and the MSAS-SF global distress index. There was no association between the presence of anxiety and depression and the MSAS-SF physical symptom subscale. The MSAS-SF psychological symptom subscale was more closely correlated with anxiety than depression. CONCLUSION These results support the validity of the MSAS-SF global distress index and psychological subscales in the assessment of patients with anxiety and depressive disorders.

An observational study to determine the prevalence of alcohol use disorders in advanced cancer patients

Context: observational studies in North America suggest alcohol dependence is a common problem in advanced cancer patients and is associated with a high burden of physical and psychological symptoms. The prevalence of all types of alcohol use disorders, and the relationship between alcohol use disorders and symptoms, has not been studied. Objectives: this observational, cross-sectional study was designed to determine the prevalence of alcohol use disorders in patients with advanced cancer and establish if such patients have a higher symptom burden. Methods: sequential patients referred to the palliative medicine team at a United Kingdom cancer centre completed the Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale (HADS) and Memorial Symptom Assessment Scale-Short Form (MSAS-SF). Results: 120 patients participated in the study. Twenty-two (18%) patients screened positively for the presence of an alcohol use disorder. This study found no significant association between alcohol use disorders and the presence of anxiety (P = 0.38) or depression (P = 0.81) on the HADS or the global distress index subscale (P = 0.142), physical symptom distress index subscale (P = 0.734), or the psychological distress index subscale (P = 0.154) on the MSAS-SF. Current smoking status was the only independent predictor for the presence of an alcohol use disorder (P < 0.001). Seven (6%) patients screened positively for high-risk alcohol use disorders. Current smoking status (P < 0.001) and male gender (p < 0.001) were independent predictors of this problem. Conclusions: alcohol use disorders in this cohort of patients were not associated with a higher symptom burden, and the prevalence was lower than the general United Kingdom population.

Stercoral Perforation of the Colon: A Potentially Fatal Complication of Opioid-Induced Constipation.

Stercoral perforation of the colon is a rare complication of constipation, and there have only been a few reported cases of stercoral perforation of the colon secondary to opioid-induced constipation. This article describes such a case in a cancer survivor with chronic cancer-related pain and reviews the medical/surgical literature on stercoral perforation of the colon.

Letter to the Editor re ‘Characteristics of breakthrough cancer pain and its influence on quality of life in an international cohort of patients with cancer (BMJ Support Palliat Care 2016;6:344–52)’

Hjermstad et al 1 report an association between ‘high’ background pain intensity and breakthrough cancer pain. However, we would suggest that their results demonstrate that patients with uncontrolled background have more flares of pain than patients with well-controlled background pain. Thus, we would question the criteria used to identify patients with breakthrough cancer pain in their study. We acknowledge the lack of consensus regarding the definition of breakthrough cancer pain, although this group has previously stated that …