Azza Adel Hassan
National Center for Cancer Care and Research, Qatar
Azza Adel Hassan has completed her MBBCh from Alexandria University, Egypt. She has also done her Master’s and Doctorate degree in Clinical Oncology from Alexandria University. In 2003, she got the Certification of Hospice and Palliative Medicine (ABHPM). Currently, she is a Program Director of the Supportive and Palliative Care Unit at National Center for Cancer Care and Research, Hamad Medical Corporation in Doha, Qatar. She has several publications in the field of Clinical Oncology and Palliative Medicine in reputed journals.
Patients admitted in a palliative care are usually highly symptomatic and in poor performance status. The aim of this study is to report on the most frequently encountered symptoms among palliative care patients, the associated comorbidities and the palliative perform score from a single institution in Qatar, dealing with the management of patients with advanced cancer diagnosis. A retrospective cohort study that included 262 patients admitted to the Palliative Care Unit, National Center for Cancer Care and Research (NCCCR) in Qatar over the period of 1-1-2012 till 31-12-2014. The initial palliative care assessment forms were reviewed for the presenting symptoms, PPS and associated comorbidities. Further, analysis of pain in terms of quality and severity was also reported. A total of 262 patients were reviewed over a 3 years period from 01-01-2012 till 31-12-2014 using the initial palliative care assessment form. Pain was the most common symptom encountered (70% of cases), followed by fatigue (52%), weakness (44%), anorexia (36%) and dyspnea (23%). Anxiety and depression was reported in 17% of patients. Further analysis of pain quality revealed that, dull aching pain was the most common (53%) type of pain, followed by sharp pain (15%) and colicky cramping in 9% of cases. The median score of pain on NRS was 3 with a range from 0-9. Most patients had more than 3 symptoms at initial presentation (74%) of cases. The most common associated comorbidities were diabetes and hypertension (44% and 49%, respectively). Around 50% of patients presented with poor palliative performance score (PPS 30% or less). Patients with advanced incurable cancer diagnosis admitted to our Palliative Care Unit present with a high burden of symptoms including mainly pain, fatigue, anorexia and dyspnea. The majority of those patients have a poor PPS at initial presentation. This entails daily assessment and management of their symptoms.