Symptom research in gynecologic oncology: A review of available measurement tools

Objective: Cancer and its treatment produce multiple symptoms that significantly distress patients and impair function. Effective symptom management requires effective symptom assessment. A variety of measurement instruments have been created to identify symptoms in oncology practice. Here we review symptom assessment measures available for gynecologic cancers. Methods: A systematic literature search was performed to identify articles on symptom assessment and quality-of-life instruments in gynecologic oncology. Articles were accessed through searches performed in PubMed, MEDLINE, CINAHL Plus, and the Cochrane Library. Studies were selected if they described development of symptom assessment tools for diagnosis and measurement of symptoms of gynecologic cancers and treatments. We also included studies using quality-of-life measurement tools that contained symptom items. Results: Nine studies examined symptom assessment, quality-of-life assessment, or symptom indexes for various gynecologic cancers. Studies varied in design, patient profiles, symptoms assessed, and outcomes measured. Meta-analysis was not performed due to heterogeneity in the studies. Conclusion: Although pain is well-studied and well-characterized, other disease-specific and general systemic symptoms of gynecologic cancers need better understanding and assessment. Accordingly, assessment of symptoms throughout the course of disease is crucial for treatment decisions and outcomes monitoring for patients with gynecologic cancer. This is especially true for survivors of gynecologic cancer, for patients whose treatment was unsuccessful, or for choosing between treatments with comparable survival outcomes. However, measurement and assessment of cancer-related symptoms is challenging because of the complex interaction between disease progression, multi-modality treatments, and symptoms. In this review, we evaluate the currently available symptom assessment tools for gynecologic cancers, along with quality-of-life assessment tools that include symptom items, and we give recommendations for further research.