Biological Basis for the Clustering of Symptoms

Debra Lynch Kelly, Kristin Dickinson, Chao Pin Hsiao, Nada Lukkahatai, Velda Gonzalez-Marrero, Margaret McCabe, Leorey N. Saligan

Research output: Contribution to journalReview articlepeer-review


Objectives Identification of biologic pathways of symptom clusters is necessary to develop precision therapies for distressing symptoms. This review examined extant literature evaluating relationships between biomarkers and symptom clusters in cancer survivors. Data Sources PubMed, CINAHL, Web of Science and Cochrane Library were searched using terms “biological markers” or “biomarkers” and “symptom cluster” or “symptom complex” or “multiple symptoms.” Conclusion Biomarkers related to inflammation (eg, cytokines) were the most studied and showed the most significant relationships with clusters of symptoms. This review suggests that clustering of symptoms related to cancer or cancer therapy is linked to immune/inflammatory pathways. Implications for Nursing Practice Understanding the etiology of symptom clusters may guide future nursing interventions for symptom management.

Original languageEnglish (US)
Pages (from-to)351-360
Number of pages10
JournalSeminars in Oncology Nursing
Issue number4
StatePublished - Nov 1 2016


  • biological
  • cancer-related symptoms
  • inflammation
  • pathways
  • symptom cluster
  • symptom complex

ASJC Scopus subject areas

  • Oncology(nursing)


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