title: Does age influence the symptom experience of lung cancer patients prior to surgery?
abstract: OBJECTIVE
  Older patients with lung cancer are less likely to be offered surgery then younger patients. Although higher preoperative symptom burden is associated with poorer postoperative outcomes, few studies have examined age-related differences in symptom experience of lung cancer patients prior to surgery. This study evaluated for differences in symptom occurrence, severity, and distress between older (≥65 years) and younger (<65 years) patients prior to surgery.
  
  
  METHODS
  Data were collected through chart review and a symptom assessment scale (i.e., Memorial Symptom Assessment Scale (MSAS)) that evaluated multiple dimensions of 32 symptoms. Descriptive statistics were used to present demographic and clinical characteristics of the sample. Logistic regression analyses were used to evaluate for age-related differences in each dimension of the symptom experience.
  
  
  RESULTS
  A total of 270 patients completed the MSAS prior to surgery (113 younger and 157 older patients). Few age-related differences were found. When age differences were identified, older patients reported lower occurrence rates and lower severity and distress ratings. Cough, lack of energy, feeling drowsy and worrying was the four most common symptoms in both age groups. In the younger patients, feeling nervous was ranked fourth. Shortness of breath was ranked third by the older patients. The study confirmed the high occurrence rates for cough, pain, fatigue, shortness of breath, and sleep disturbance found in previous studies. However, "new" symptoms were identified including feeling nervous, worrying, sweats, feeling bloated, and problems with sexual interest. These "new" symptoms were reported by over 40% of the patients.
  
  
  CONCLUSIONS
  Measurement of symptoms in lung cancer patients before surgery is important, because patients reported an average of 10 symptoms. Few age-related differences in the patients' symptom experience were identified. Psychological symptoms were common and warrant consideration.
authors.affiliation: Centre for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: trine.oksholm@rr-research.no.
authors.forename: Trine
authors.initials: T
authors.lastname: Oksholm
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
authors.forename: Johny Steinar
authors.initials: JS
authors.lastname: Kongerud
authors.forename: Bruce
authors.initials: B
authors.lastname: Cooper
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
authors.forename: Line
authors.initials: L
authors.lastname: Laerum
authors.forename: Tone
authors.initials: T
authors.lastname: Rustoen
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D012720:Severity of Illness Index; D063189:Symptom Assessment
keywords: Age differences; Elderly; Lung cancer; Preoperative; Surgery; Symptoms