Background: Throughout and after treatment, cancer patients often face a high symptom burden (e.g. fatigue, pain, cognitive difficulties, etc.). A high symptom burden can reduce QOL and treatment adherence, potentially reducing survival. However, predicting the symptom burden in cancer patients remains challenging. Methods: Cancer patients scheduled to receive chemotherapy and/or radiation therapy were prospectively surveyed at pre-treatment (n=972), during treatment (n=748), and 6-month follow-up (n=652). At pre-treatment, patients indicated symptom concern (Low, Moderate, or High) and the desire for additional information (Yes, No) on relieving symptoms. During treatment and at 6-month follow-up, patients reported on the severity (an 11-point scale: 0 “None” to 10 = “Worst”) of 12 symptoms (fatigue, hair loss, memory, nausea, depression, sleep, pain, concentration, hot flashes, weight loss, skin problems, and dyspnea). Total Symptom Score (TSS) is the sum of all 12 symptoms. Mean symptom severity by symptom concern and additional information desire were determined by ANCOVA analysis. Results: Symptom concern at pre-treatment predicted symptom severity during treatment (Table). Patients who wanted more information on symptoms management before also had a significantly greater TSS (Yes = 46.7 vs No = 39.4; p=0.02) during treatment. Patients with high concern at pre-treatment also had a significantly higher TSS 6 months after treatment (High = 24.5 vs Low = 21.1; p<0.05). Conclusions: Pre-treatment patient symptom concern and wanting more symptom management information predicted symptom burden during treatment and 6 months after treatment. Clinicians should consider using these questions as indicator to which patients may require additional symptom management care.

*Adjusted for severity of the respective symptom at pre-treatment.