title: The impact of an outpatient palliative care consultation on symptom burden in advanced prostate cancer patients.
abstract: OBJECTIVE
  There are limited studies characterizing cancer-related symptoms in outpatient advanced prostate cancer patients. The aim of this retrospective study was to describe the impact of an outpatient palliative care (PC) consultation on symptoms in patients with advanced prostate cancer.
  
  
  METHODS
  We retrospectively reviewed the medical records of 55 consecutive patients with advanced prostate cancer seen in our institution's outpatient PC center. Information regarding demographics, disease status, Edmonton Symptom Assessment System (ESAS) scores, Eastern Cooperative Oncology Group (ECOG) Performance Status, laboratory data, and pharmacological interventions were analyzed.
  
  
  RESULTS
  The median age of the study's patients was 66 years old, with 73% Caucasian ethnicity. All patients had metastatic disease and 96% had received prior cytotoxic chemotherapy. The most frequently occurring symptoms upon presentation were pain, fatigue, and drowsiness (>50%). Pain and fatigue were also the most severe symptoms, each having median ESAS scores of 7 (on a 0-10 scale). We instituted a median of 3 pharmacological interventions per patient, with a median of 15 days to follow-up assessment. At follow-up, patients reported significant symptom improvements in pain, drowsiness, fatigue, depression, sleep, sense of well-being, and anxiety.
  
  
  CONCLUSIONS
  Based on our preliminary data, we conclude that patients with advanced prostate cancer referred to PC experience severe and clinically significant symptoms. An outpatient PCconsultation is associated with significant symptom improvement in this subset of a distressed population. Future prospective studies are warranted to further describe symptom burden and the role for outpatient PC for advanced prostate cancer patients.
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. syennu@mdanderson.org
authors.forename: Sriram
authors.initials: S
authors.lastname: Yennurajalingam
authors.forename: Bradley
authors.initials: B
authors.lastname: Atkinson
authors.forename: Jessica
authors.initials: J
authors.lastname: Masterson
authors.forename: David
authors.initials: D
authors.lastname: Hui
authors.forename: Diana
authors.initials: D
authors.lastname: Urbauer
authors.forename: Shi-Ming
authors.initials: SM
authors.lastname: Tu
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D017281:Cost of Illness; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010166:Palliative Care; D011471:Prostatic Neoplasms / Q000503:physiopathology* / Q000628:therapy*; D012017:Referral and Consultation; D012189:Retrospective Studies; D013781:Texas