Clinical questions on rehabilitation in cancer patients with skeletal metastasis: a content analysis of the multidisciplinary tumor board records

Purpose Cancer rehabilitation addresses the functional needs of patients who have various impairments. Disease control is a critical oncological consideration, while physical intervention increased weights of importance in several situations. To identify the clinical status that necessitates active...

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Bibliographic Details
Published in:Supportive care in cancer 2021-04, Vol.29 (4), p.2015-2020
Main Authors: Yamanaka, Nobuki, Tsukamoto, Shinji, Ishida, Yukako, Shigematsu, Hideki, Hasegawa, Masatoshi, Sajiki, Marina, Mano, Tomoo, Tanaka, Yasuhito, Kido, Akira
Format: Article
Language:English
Subjects:
Bone cancer
Cancer
Cancer patients
Care and treatment
Content analysis
Female
Humans
Male
Medicine
Medicine & Public Health
Metastasis
Muscle Neoplasms - secondary
Neoplasm Metastasis
Neoplasms - rehabilitation
Nursing
Nursing Research
Oncology
Original Article
Pain Medicine
Qualitative research
Rehabilitation
Rehabilitation Medicine
Tumors
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Summary:Purpose Cancer rehabilitation addresses the functional needs of patients who have various impairments. Disease control is a critical oncological consideration, while physical intervention increased weights of importance in several situations. To identify the clinical status that necessitates active physical intervention in cancer patients with skeletal metastasis, we performed a content analysis in the multidisciplinary tumor board (MDTB) records. Methods From January 2017 to September 2019, the MDTB discussed 168 consecutive patients with skeletal metastasis. We reviewed the MDTB records and asked responsible physicians to frame clinical questions. Based on these data, we identified the predictor valuables with the association to rehabilitation-related clinical questions using univariate and multivariate analyses. Moreover, we investigated a predictor of the change in Barthel index (BI) scores using univariate analyses. Results Rehabilitation-related questions arose more frequently in older patients ( p  = 0.011), in patients with slow-growth vs. rapid-growth tumor ( p  = 0.002), and in patients with skeletal-related events ( p  = 0.001) at MDTB. The tumor growth speed was associated with the change in BI scores, as slower-growth tumors had the benefit of BI gains ( p  = 0.017). Conclusions Regarding rehabilitation in patients with skeletal metastasis, we should pay attention to three parameters: occurrence of skeletal events, patient age, and growth speed of tumors. Rehabilitation-related questions may reflect patients’ functional needs that occur more frequently in patients with pathological fractures or neurological symptoms, older patients, and patients with slow-growth tumors.
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-020-05696-3