Symptom experiences in patients with advanced pancreatic cancer as reported during healthcare encounters.

Symptom management is one of the primary goals of care for advanced pancreatic cancer (APC) patients. The purpose of this study was to examine recorded healthcare encounters to better understand the symptom experiences of APC patients as told to healthcare providers (HCP). In this qualitative descriptive study, content analysis was used to analyze 37 transcripts of audio-recorded, naturally occurring encounters among APC patients, caregivers, and HCP. Transcripts were drawn from a larger randomized controlled study, which recruited advanced cancer patients and caregivers across the United States. Findings revealed that APC patients and caregivers experienced multiple troubling symptoms. Thirty-seven APC patients and 34 caregivers discussed 10 types of symptoms: pain, fatigue, abnormal bowel movements, decreased appetite, nausea and vomiting, sleeping problems, neurological problems, skin problems, psychological distress, and taste changes. The patients and caregivers discussed various aspects of the symptoms, including the nature of the symptoms, how the symptoms affected their lives, and the way they managed symptoms. Some symptoms were described as severe, life-changing, and highly distressing. HCP should be attuned to the wide variety of ways in which APC patients experience, manage, and live with symptoms. A systematic approach to address symptoms during encounters may improve care and efficiency.