title: Prevalence and severity of suffering among patients with advanced cancer.
abstract: BACKGROUND
  Suffering is an expression commonly used to describe distressing experience of cancer patients. Suffering experience among patients with advanced cancer has not been studied before in Saudi Arabia.
  
  
  OBJECTIVE
  The objective of this study is to determine the pattern of suffering and the feasibility of measuring its severity on a numerical scale for cancer patients attending a palliative care outpatient clinic.
  
  
  METHODS
  This is part of a larger survey studying the pattern of symptomatology in an outpatient palliative care clinic. Over a 5-month period, cancer patients attending an outpatient palliative care clinic were requested to rate their suffering as well as 11 listed symptoms on a 0-10 numerical scale.
  
  
  RESULTS
  Of the 124 patients interviewed, 73 (59 %) were females. Only 15 patients (12 %) reported no suffering. For those who were suffering (88 %), the median score is 5. Suffering scores did not differ based on sex, age, or type of cancer. Patients with a Palliative Performance Scale of ≤50 % had significantly higher mean suffering score (6.8) compared to those with better performance status (4.8; P = 0.003). Multivariate analysis resulted in three independent variables showing a significant relationship to suffering score, namely pain (P = 0.018), tiredness (P = 0.022), and depression (P = 0.022).
  
  
  CONCLUSIONS
  Patients with advanced cancer were able to easily rate their suffering on a numerical scale. Pain, tiredness, and depression were associated with the suffering scores. Suffering scores might help in tracing the trend of suffering in the individual patient over time.
authors.affiliation: Palliative Care Medicine, Oncology Centre, King Faisal Specialist Hospital and Research Center, P O Box 365636, Riyadh 11393, Saudi Arabia. alshahri_m@yahoo.com
authors.forename: Mohammad Zafir
authors.initials: MZ
authors.lastname: Al-Shahri
authors.forename: Abdelmoneim M
authors.initials: AM
authors.lastname: Eldali
authors.forename: Omar
authors.initials: O
authors.lastname: Al-Zahrani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D010146:Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D010166:Palliative Care / Q000523:psychology*; D015995:Prevalence; D012529:Saudi Arabia / Q000453:epidemiology; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology