Symptom Experience Following Lung Cancer Surgery

Background: Annually over 225,000 individuals are diagnosed with lung cancer and over 80,000 undergo surgery with many experiencing concurrent post-operative symptoms. Objectives: The purposes of this study were to: 1) describe the symptom experience during the first year following lung cancer surgery, 2) explore relationships between symptoms, influencing factors and functional performance, and 3) compare responses in patients with and without PTPS. Methods: This descriptive, cross-sectional, correlational study was guided by the Theory of Unpleasant Symptoms (TOUS). Patients were recruited over 28 months from a university medical center and subsequently completed the following six self-report instruments: the Symptom Distress Scale, McGill Pain Questionnaire, Neuropathic Symptom Questionnaire, Hospital Anxiety and Depression Scale, the Health History Survey and Functional Assessment of Cancer Therapy-Lung; medical record reviews were conducted to corroborate responses. Spearman’s rho was used to measure relationships among variables. Comparisons between participants with and without PTPS were made using Chi-Square or Fisher’s exact test. Significance was set at p < .05. Results: Patients were assessed on average 6 months after surgery, and were predominantly diagnosed at cancer Stage I, elderly, female, Caucasian, educated at the high school level with mild to moderate psychiatric distress, and at least five comorbid conditions. The majority reported distress associated with concurrent symptoms. Patients with more psychiatric distress reported more symptom distress and patients with higher symptom distress reported lower functional performance. Patients who were younger, had some mood disorder and decreased functionality were significantly more likely to report PTPS. Conclusions: Patients reported distress associated with a wide range of concurrent post-operative symptoms, including PTPS. The TOUS may assist clinicians to explore relationships that are important for the assessment and management of symptoms after surgery for lung cancer.