Background

Multiple symptoms are experienced as a result of cancer, its treatment and in advanced disease. Following cancer treatment, the problems caused by unrelieved symptoms and their effect on quality of life/return to normal activity are well documented. In advanced cancer unrelieved symptoms can result in suffering for patients and families, long term disability, costly hospital admissions, financial hardship and social isolation. Numbers affected will increase as cancer incidence rises over coming decades and as people survive longer. This has led to interest in how people can be best supported to 'live with cancer' which is consistent with a broader shift in health care towards patients being more active participants.

1. Self management of problems associated with cancer. People generally manage problems associated with their cancer as part of their daily lives and many people want to have an active role in tackling such problems. The evidence base is currently very limited.
2. Non-pharmacological approaches to symptom management. There is some evidence for the effectiveness of non-pharmacological interventions in SuPaC (e.g. in the management of breathlessness in lung cancer) but the evidence base is very limited, particularly for those symptoms identified as requiring further research.

Aims of the 'symptoms' theme:

1. To gain insight into how patients and carers self manage the symptoms and problems of cancer and its treatment
2. To test non-pharmacological interventions, focusing on nausea and vomiting, depression, sleep disturbances and nutritional problems.

Theme objectives

1. To develop an evidence base about the actions taken by people affected by cancer to avoid/control the symptoms of the disease and treatment side effects.
2. To use the evidence base along with existing theoretical models outside cancer to develop a theoretical basis for self management interventions in cancer
3. To develop innovative non-pharmacological and self management interventions for symptoms, drawing on appropriate theoretical models and to assess their effectiveness via multi-centre RCTs
4. To develop programmatic research, which makes maximum use of the collaborative culture of CECo
5. To underpin all developments with strong involvement from research partners

Overall, the aim is to maintain significant and substantive progress in research capacity and the quality of research in innovative approaches to complex symptoms over the 5 years of the collaborative and beyond.

Expected outcomes/policy implications:

This work will provide effective non-pharmacological interventions; test the applicability to cancer of self management and patient-led care strategies; and develop theoretical and methodological insights that will be widely relevant in this growing but underdeveloped field of inquiry.

Symptom Management Team

Dr Claire Foster - University of Southampton - C.L.Foster@soton.ac.uk
Prof Mari Lloyd-Williams - University of Liverpool - mlw@liv.ac.uk
Prof Alex Molassiotis - University of Manchester - Alex.Molassiotis@manchester.ac.uk

Theme Research Fellows

Dr Sarah Brearley - Sarah.brearley@christie.nhs.uk
Dr John Hughes - John.Hughes@liv.ac.uk