Early Satiety in Individuals With Cancer: A Scoping Review of an Orphan Symptom

Background: A common, underrecognized symptom in cancer is early satiety (ES), which is classified as an orphan symptom. No systematic or scoping review focusing on ES has been published previously. Objective: This scoping review aimed to detail the available evidence and knowledge gaps surrounding ES in individuals with cancer. Methods: Five databases (Cochrane, EBSCOhost, Embase, PubMed, and Web of Science) were searched from inception until August 9, 2023. Inclusion criteria were original data on ES in cancer, human studies, peer-reviewed, and full text in English. Extracted data included characteristics, tools used, and results on ES. Results: Seventy-eight reports were included. All but 1 was quantitative. A quarter used validated tools to screen for ES. Where a description of ES was given (n = 40), 20 were unique. Median prevalence in mixed cancer cohorts was 44%. ES was the most common symptom postesophagectomy. ES was associated with cachexia, malnutrition, lower handgrip strength, lower quality of life, and reduced survival in cancer compared with those without ES. No clear pathophysiology was identified. No 2 studies investigated the same intervention, and none investigated nonpharmacologic interventions. Healthcare professionals reported lacking knowledge regarding the identification and management of ES. It was therefore among the least treated symptoms in practice. Conclusions: ES is a highly prevalent symptom, with multiple potentially negative associations with health. Despite this, there are large knowledge deficits in identification practices, influence, pathophysiology, and appropriate treatment because no specific pathophysiology or treatment was identified. Future work should form a consensus definition, investigate pathophysiology, and trial both pharmaceutical and nonpharmaceutical interventions.