Symptoms in the lives of terminal cancer patients: Which is the most important?

Objectives: Symptoms other than their primary disease can interfere in the lives of terminal cancer patients. We sought to identify which of these symptoms is most important. Methods: We administered a questionnaire, including the M.D. Anderson Symptom Inventory (MDASI), to 142 terminal cancer patients at the National Cancer Center, Korea. The validity of the MDASI was tested by principal-axis factor analysis and Cronbach's α coefficient. Stepwise multiple regression analysis was used to determine the symptoms that interfered most in terminal cancer patients' lives. Results: Factor analysis showed that it was composed of two factors (symptom and interference scales). Cronbach's α coefficients of symptom and interference scales were each >0.70. The patients had an average of 11 of 13 symptoms of the MDASI. Pain was the most common and severe, followed by feelings of distress and fatigue. Fatigue was the most highly correlated with interference sum. In stepwise multiple regression analysis, the most interfering symptom was fatigue. Conclusions: Although pain was the most common and severe symptom, fatigue was the most important symptom interfering in the lives of terminal cancer patients. In treating terminal cancer patients, healthcare providers should actively intervene to reduce both fatigue and pain.