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Advanced Cancer Patients’ Physical and Emotional Burdens Linked to Lengthy Hospital Stays, Readmissions

New research indicates that hospitalized patients with advanced cancer experience many physical and psychological symptoms, and that patients dealing with a higher burden of these symptoms have longer hospital stays and a greater risk for unplanned hospital readmissions.


The Relationship between Physical and Psychological Symptoms and Healthcare Utilization in Hospitalized Patients with Advanced Cancer.

Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings highlight the critical need to develop and test interventions to lessen these patients’ symptoms.

Patients with advanced cancer often experience frequent and prolonged hospitalizations for reasons that have not been fully explored. To investigate, Ryan Nipp, MD, MPH, of Massachusetts General Hospital and his colleagues collected self-reported physical and psychological symptoms from 1036 patients with advanced cancer as they were being admitted for an unplanned hospitalization. The researchers examined the relationship between patients’ symptom burden, the duration of their hospital stay, and risk for later readmission.

More than half of patients reported moderate or severe fatigue, poor well-being, drowsiness, pain, and lack of appetite. Also, 29 percent and 28 percent of patients had depression and anxiety symptoms, respectively. Average hospital stay was 6.3 days and the readmission rate within 90 days of discharge was 43.1 percent. Physical symptoms, psychological distress, and depression symptoms were linked with longer hospital stays. Physical and anxiety symptoms were linked with a higher likelihood of readmission.

“We demonstrated that many hospitalized patients with advanced cancer experience an immense physical and psychological symptom burden,” said Dr. Nipp. “Interventions to identify and treat symptomatic patients hold great potential for improving patients’ experience with their illness, enhancing their quality of life, and reducing their health care utilization.”

Additional Information

Full Citation: “The Relationship between Physical and Psychological Symptoms and Healthcare Utilization in Hospitalized Patients with Advanced Cancer.” Ryan D. Nipp, Areej El-Jawahri, Samantha M. Moran, Sara M. D’Arpino, P. Connor Johnson, Daniel E. Lage, Risa L. Wong, William F. Pirl, Lara Traeger, Inga T. Lennes, Barbara J. Cashavelly, Vicki A. Jackson, Joseph A. Greer, David P. Ryan, Ephraim P. Hochberg, and Jennifer S. Temel. CANCER; Published Online: October 23, 2017 (DOI: 10.1002/cncr.30912).

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About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online at

About Wiley
Wiley, a global company, helps people and organizations develop the skills and knowledge they need to succeed. Our online scientific, technical, medical, and scholarly journals, combined with our digital learning, assessment and certification solutions help universities, learned societies, businesses, governments and individuals increase the academic and professional impact of their work. For more than 200 years, we have delivered consistent performance to our stakeholders. The company’s website can be accessed at

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