Symptoms and symptom clusters in adolescents receiving cancer treatment: A review of the literature

Objectives: The purpose of this literature review is to document what is known about the most common symptoms and symptom clusters in adolescents receiving cancer treatment in order to advance the science of symptom management for this unique group of patients. Design: This review identified primary research reports focused on cancer-related symptoms in adolescents using methodology that included objective measurement of the symptom(s) or self-report from the adolescents. Data sources: We searched the literature using Medline, PubMed, and CINAHL from 2000 to 2011. Review methods: The first step of the review was to synthesize evidence to identify the most common symptoms experienced by adolescents during the cancer treatment period. The second step located findings from additional research about these specific symptoms individually or as clusters. Results: From 12 reports, we identified 6 common symptoms in adolescents during the treatment period: fatigue, sleep-wake disturbances, nausea/eating problems, pain, mood disturbances, and appearance changes. Findings from 51 studies provided a foundation of evidence about symptom trajectories, contributing factors, and associations between symptoms. Conclusions: This review of the literature identified a relatively small body of research related to symptoms in adolescents during the cancer treatment period. Most of the studies were of low quality evidence and described individual symptoms rather than associations or clusters. A few longitudinal studies described symptoms during a cycle of chemotherapy and across months of chemotherapy treatment. With the exception of nausea, no studies tested any interventions to relieve these common symptoms in adolescents. To ensure that adolescents complete the challenging period of cancer treatment and emerge capable of achieving the developmental milestones of young adulthood, important work remains to be done in this field of symptom management. (C) 2012 Elsevier Ltd. All rights reserved.