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Many cancer patients experience a variety of distressing symptoms, adversely affecting their functional status and quality of life (QOL). Subjective symptoms such as pain, fatigue and depression are common among cancer patients, with approximately 33-55% of cancer patients experiencing pain during the course of their illness. Previous literature commonly examined a single symptom and its effect on patients'functional status and QOL, but patients often experience multiple symptoms simultaneously. Since individual symptoms are often associated with decreased QOL, the assumption that symptom clusters might have a greater effect on QOL is logical. The coexistence of symptoms provides an insight into the importance of assessing clusters of symptoms rather than focusing on individual symptoms. Although the focus of single symptoms has advanced the understanding of those particular symptoms, it may not be as helpful to health care professionals in guiding practice when patients present several concurrent symptoms. It is important for clinicians to address and ultimately treat all concurrent symptoms. Symptom cluster research will help our understanding and treatment of multiple symptoms.

In early stages of cancer, patients are often presented with treatment options and encouraged to have shared treatment decisions with their oncologists. Shared decision making becomes particularly important, as several treatment options with different possible outcomes and adverse events exist. For example, women with early breast cancer are counseled on the options of mastectomy versus lumpectomy and radiation. The same principle should also apply in late stages of cancer, where cure is usually not possible in patients with widespread metastases. In these cases, the aim of treatment should be to relieve symptoms and suffering. Improving quality of life (QOL) rather than tumor control takes priority in palliative care. QOL has also been identified as an important endpoint for new cancer drugs, as determined by the Food and Drug Administration (FDA); as such, cancer drug approval can be based on improvement of QOL. The use of patient-reported QOL instrument tools help clinicians determine if certain treatments improve QOL. The research of palliative interventions should have QOL assessment to assist clinicians, patients and their family members in shared decision making.