title: Neuropathic symptoms, quality of life, and clinician perception of patient care in medical oncology outpatients with colorectal, breast, lung, and prostate cancer.
abstract: OBJECTIVE
  We investigated how treatment-induced neuropathic symptoms are associated with patients' quality of life (QOL) and clinician-reported difficulty in caring for patients.
  
  
  METHODS
  Data were obtained from 3,106 outpatients with colorectal, breast, lung, or prostate cancer on numbness/tingling (N/T), neuropathic pain, and QOL. Clinicians reported the degree of difficulty in caring for patients' physical and psychological symptoms.
  
  
  RESULTS
  For all patients, moderate to severe N/T was associated with poor QOL (OR = 1.82, 95% CI = 1.47-2.26, P < 0.001) but neuropathic pain was not (OR = 1.31, 95% CI = 0.94-1.83, P = 0.114). Moderate to severe N/T and neuropathic pain were associated with increased care difficulty (OR = 1.49, 95% CI = 1.27-1.74, P < 0.001 for N/T, and OR = 1.46, 95% CI = 1.15-1.84, P = 0.002 for neuropathic pain). The association of neuropathic pain with care difficulty was most significant in patients with colorectal cancer (CRC) (OR = 2.32, 95% CI = 1.41-3.83, P = 0.001). Baseline neuropathic pain was associated with declining QOL in CRC patients (OR = 2.08, 95% CI = 1.21-3.58, P = 0.008).
  
  
  CONCLUSIONS
  Clinicians may experience increased care difficulty for patients of all cancer types with moderate to severe N/T or neuropathic pain; care difficulty due to neuropathic pain may be higher for CRC patients. Nearly half the patients of all cancer types with moderate to severe N/T may expect poor short-term QOL; CRC-but not other-patients with baseline neuropathic pain are likely to experience declining QOL.
  
  
  CONCLUSIONS
  About half of patients with moderate to severe N/T (any cancer type) may expect poor QOL in the short term; CRC patients with baseline neuropathic pain in particular may experience declining QOL.
authors.affiliation: Department of General Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 410, Houston, TX, 77030, USA, djones1@mdanderson.org.
authors.forename: Desiree
authors.initials: D
authors.lastname: Jones
authors.forename: Fengmin
authors.initials: F
authors.lastname: Zhao
authors.forename: Joanna
authors.initials: J
authors.lastname: Brell
authors.forename: Mark A
authors.initials: MA
authors.lastname: Lewis
authors.forename: Charles L
authors.initials: CL
authors.lastname: Loprinzi
authors.forename: Matthias
authors.initials: M
authors.lastname: Weiss
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fisch
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000473:pathology*; D010045:Outpatients; D010146:Pain / Q000523:psychology; D011788:Quality of Life; D017741:Survivors