Web-Based Symptom Monitoring Contributes to Cancer Patients’ Survival

One noteworthy study at ASCO 2017 concerned an internet-based e-health application through which patients reported their symptoms themselves in real time and warning signs were immediately communicated to clinicians.

People diagnosed with cancer have many questions. Some concern how their illness will progress and whether they can contact healthcare professionals at any time if problems such as treatment side effects arise. Until recently, this did not seem possible. But an e-health application based on patients reporting their own symptoms, among its many benefits, also helps patients live longer.

In a study of stage 4 metastatic cancer involving 766 patients, those using a web-based symptom-reporting application lived an average of 5 months longer than those not using the system. This result is meaningful in many respects. First, any intervention improving cancer survival is valuable. Second, what prolongs life here is an e-health application representing better patient care rather than a new cancer drug, which is often very expensive.

You May Be Interested In:

• Listening to patients’ voices - Patients recording their own condition and symptoms through smartphone applications

Since its beginnings, healthcare has operated through patients visiting physicians, describing their symptoms at that moment, and physicians managing disease according to their findings. In this limited time, the physician must both make accurate assessments and choose the most appropriate treatment for the patient and disease. Much of medical education is based on making the best use of these patient-physician encounters, called visits.

In chronic diseases, led by cancer, patients, relatives and clinicians have always felt the need for closer monitoring. Many attentive physicians have offered what might be called manual solutions, such as giving their phone number and saying “you can call us 7/24,” or providing instructions on emergencies. Advancing online communication technologies, however, have now reached a point where they can meet this need.

Study Details

This study included advanced cancer patients receiving outpatient chemotherapy for breast, lung, bladder and gynecological cancers (uterine, ovarian and cervical), totaling 766. It was presented at the American Cancer Congress ASCO 2017. Patients were divided into two groups: some regularly reported symptoms through tablet computers (once weekly), while the usual-care group reported symptoms during oncologist visits. Usual-care patients were also encouraged to seek telephone advice between visits if symptoms occurred.

The web-based e-health application asked patients weekly to rate 12 common symptoms (loss of appetite, shortness of breath, fatigue, hot flashes, nausea and pain, for example) on a 5-point scale. If a symptom was rated highly or was worsening, the oncology nurse received an email notification. This enabled early intervention before symptoms worsened. Ultimately, this approach, with patients regularly reporting symptoms online, reduced emergency visits and improved their quality of life while also contributing to longer survival (31.2 versus 26 months).

In the Future

Symptom and side-effect management are central to oncology care and as important as cancer treatment. In the future, better healthcare appears possible through real-time, continuous electronic health records integrating patient-reported outcomes via mobile phone applications.