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Monday, 05 June 2017

Webwatch: Symptom app helps cancer patients live longer, trial suggests

Written by Jane Kirby

An app that tracks cancer patients' symptoms can boost their survival by five months, according to a new study.

Research presented at the world's biggest cancer conference found that patients who told their doctors of their symptoms via an app or telephone helpline lived far longer than those who did not.

Experts think part of the reason is that people who receive help in managing their symptoms are far more likely to stick with chemotherapy or remain well enough for further treatment.

The study also found that recording and acting upon symptoms reduced complications and kept people out of hospital, cutting their risk of infection.

The new research, presented at the American Society of Clinical Oncology (ASCO) conference in Chicago, saw 766 patients with all types of advanced cancer split into two groups.

Both groups were evenly matched for cancer type and the sorts of treatment people were already on.

Those in the app group were asked to record their symptoms - including from their cancer or the side-effects of treatment - in real time, such as whether they were in pain, had nausea or diarrhoea.

Other symptoms recorded included loss of appetite, difficulty breathing and hot sweats.

Clinicians monitored the reporting and offered help to those with worsening or severe symptoms, such as by giving more pain medication or anti-sickness drugs.

The results of the study showed that, compared to patients in the group receiving usual care, patients in the app group lived five months longer on average (31.2 months versus 26 months).

Ethan Basch (pictured), professor of medicine at the Lineberger Comprehensive Cancer Centre of the University of North Carolina, said the effect seen was greater than for many cancer drugs for advanced cancer.

He said the tool should be used alongside drugs to help extend life.

Prof Basch said people using the app were living longer for three reasons.

The first was that, on average, these patients were able to tolerate two months longer of chemotherapy, because their side-effects were better managed.

Physical functioning was also better.

He said: "We kept people out of bed, we kept people up and going. Patient's ability to function was substantially improved. We know from many studies that people who are up and around live longer when they have cancer."

The third reason was that early intervention from medical staff meant complications were prevented.

"Keeping people out of hospital is a major benefit," he added.

He said patients in the app group also did not make more visits to doctors or nurses, and did not take up more time.

He said that traditionally, despite best efforts, doctors tended to miss half of symptoms in their patients.

"I think there's a basic communication gap that exists between clinicians and patients," he said.

"Between visits people are often reluctant to pick up the phone. They may not realise something has become a problem until it is too severe.

"People want to please their doctors. We as doctors want to believe our patients are doing wonderfully well. There is a collusion, a shared denial, of the difficulties people are having.

"This causes people to miss problems until they become really severe."

Leeds University is running a similar study using the same tool.

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