title: The Symptom Experience in Rectal Cancer Survivors.
abstract: As the number of rectal cancer survivors grows, it is important to understand the symptom experience after treatment. Although data show that rectal cancer survivors experience a variety of symptoms after diagnosis, little has been done to study the way these symptoms are grouped and associated.
  
  
  
  To determine symptom prevalence and intensity in rectal cancer survivors and if clusters of survivors exist, who share similar symptom-defined survivor subgroups that may vary based on antecedent variables.
  
  
  
  A secondary analysis of the Cancer Care and Outcomes Research and Surveillance database was undertaken. Cluster analysis was performed on 15-month postdiagnosis data to form post-treatment survivor subgroups, and these were examined for differences in demographic and clinical characteristics. Data were analyzed using cluster analysis, chi-square, and analysis of variance.
  
  
  
  A total of 275 rectal cancer survivors were included who had undergone chemotherapy, radiation therapy, and surgery. Most frequently reported symptoms included feeling "worn out" (87%), feeling "tired" (85%), and "trouble sleeping" (66%). Four symptom-defined survivor subgroups (minimally symptomatic n = 40, tired and trouble sleeping n = 138, moderate symptoms n = 42, and highly symptomatic n = 55) were identified with symptom differences existing among each subgroup. Age and being married/partnered were the only two antecedents found to differ across subgroups.
  
  
  
  This study documents differences in the symptom experience after treatment. The identification of survivor subgroups allows researchers to further investigate tailored, supportive care strategies to minimize ongoing symptoms in those with the greatest symptom burden.
authors.affiliation: Duke University Health System, Duke Cancer Institute, Durham, North Carolina, USA. Electronic address: gosse001@mc.duke.edu.
authors.forename: Tracy K
authors.initials: TK
authors.lastname: Gosselin
authors.affiliation: University of Utah, College of Nursing, Salt Lake City, Utah, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Beck
authors.affiliation: Durham Veterans Affairs Epidemiologic Research and Information Center, Durham, North Carolina, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Abbott
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Grambow
authors.affiliation: Durham Veterans Affairs Epidemiologic Research and Information Center, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA.
authors.forename: Dawn
authors.initials: D
authors.lastname: Provenzale
authors.affiliation: School of Nursing, Oregon Health and Science University, Portland, Oregon, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Berry
authors.affiliation: Division of General Internal Medicine, University of California, Los Angeles, Los Angeles, California, USA; RAND Corporation, Santa Monica, California, USA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Kahn
authors.affiliation: Division of General Internal Medicine, University of California, Los Angeles, Los Angeles, California, USA; Anthem, Thousand Oaks, California, USA; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Malin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000073116:Cancer Survivors / Q000523:psychology; D016000:Cluster Analysis; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D012893:Sleep Wake Disorders / Q000453:epidemiology; D055815:Young Adult
keywords: Rectal cancer; cluster analysis; subgroups; survivors; symptoms