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SPPADE = Inflammation

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If you are a cancer survivor, I’m guessing that  you are familiar with SPPADE side effects. Most of us are. According to the research linked below, most cancer survivors live with some or all of these six side effects of cancer treatment yet they are probably under diagnosed or overlooked.

A clarification-

The research considers SPPADE issues to be “symptoms.” Implying that these health challenges result from the survivor’s cancer somehow. I disagree. I consider SPPADE issues to be side effects of chemotherapy and/or radiation. All are well-documented side effects by themselves and all have inflammation in common.

  • sleep disturbance,
  • pain,
  • physical function impairment,
  • anxiety,
  • depression,
  • and low energy /fatigue

As we know, chemotherapy and radiation cause inflammation- both chronic and acute (see below).

As the fifth link below states “”Importantly, it has become apparent that these symptom clusters are associated with presence of a systemic inflammatory response in the patient with cancer.

All to say I believe that SPPADE side effects are a cluster of examples of chronic inflammation in cancer survivors. Since my own cancer cancer diagnosis and conventional therapies, I have lived through all SPPADE side effects- both by itself as well as all together.

I believe Dr. Kroenke is correct when he says that these side effects are often overlooked due to bigger, more serious side effects such as CIPN or mucositis appears. In can care, the squeaky wheel gets the grease, as the saying goes.


Further, I believe there are inexpensive, evidence-based non-conventional therapies that can calm chronic inflammation such as chamomile, CBD oil, yoga, others that can help cancer survivors manage SPPADE side effects.

Are you a cancer survivor? Do you experience any/all SPPADE side effects? Scroll down the page, post a question or comment and I will reply to you ASAP.

Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Majority of Patients With Cancer Have SPPADE Symptoms

“Many patients with cancer have a cluster of common symptoms, which should be acknowledged and addressed, as they can help improve quality of life, say researchers reporting a new study…

The study involved 31,866 patients who were asked to complete questionnaires about these SPPADE symptoms before, during, or soon after an outpatient medical oncology encounter.

The study found that over half of patients experienced three or more SPAADE symptoms.

“The high prevalence and co-occurrence rates of the six SPPADE symptoms may warrant multi-symptom rather than single-symptom screening in patients with cancer as well as management strategies that acknowledge more than one symptom may require attention,” the team concludes…

There were some modest differences among types of cancers, but most of the cancers had a pretty consistent level of symptoms,” Kroenke said. “And so the take-home message is [that] regardless of cancer type or regardless of age or sex, these SPPADE symptoms are as important…it’s not particularly important to just one group of cancer type of patient, but to all…”

Prevalence, Severity, and Co-Occurrence of SPPADE Symptoms in 31,866 Patients With Cancer

“The SPPADE symptoms (sleep disturbance, pain, physical function impairment, anxiety, depression, and low energy /fatigue) are prevalent, co-occurring, and undertreated in oncology and other clinical populations…”

Study assesses prevalence, severity, co-occurrence of common symptoms undertreated in cancer patients

“The study authors note, “Because SPPADE symptoms are highly prevalent and their effects relate more to morbidity and than mortality, it is important to minimize overdiagnosis while at the same time optimizing treatment in patients most needing or desiring treatment…”

What is an inflammation?

“Inflammations can cause chronic diseases too

Inflammations don’t always help the body. In some diseases the immune system fights against the body’s own cells by mistake, causing harmful inflammations. These include, for example:

  • Rheumatoid arthritis, where many joints throughout the body are permanently inflamed
  • Psoriasis – a chronic skin disease
  • Inflammatory bowel diseases like or ulcerative colitis

Collectively known as chronic inflammatory diseases, these diseases can last for years or even a lifetime. Their severity and level of activity varies…”

Cancer and systemic inflammation: treat the tumour and treat the host

“Importantly, it has become apparent that these symptom clusters are associated with presence of a systemic inflammatory response in the patient with cancer. Given the understanding of the above, there is now a need to intervene to moderate systemic inflammatory responses, where present. In this context the rationale for therapeutic intervention using nonselective anti-inflammatory agents is clear and compelling and likely to become a part of routine clinical practice in the near future…”




Leave a Comment:

Shirley Hahs says 11 months ago

Onc recommended husband to go on Hospice since chemo is not working. Hubby still e joys light work such as mowing, taking out trash, picking up sticks from yard and did some welding for friend 2 weeks ago.

    David Emerson says 11 months ago

    Hi Shirley-

    Can’t say much about your husband’s MM situation without knowing more. However, I interpret your onc. as saying that he does not have FDA approved therapies to suggest. Consider therapies such as low dose options or re-challenging your n=husband’s MM with integrative therapies. Consider a palliative approach. Lot’s to consider.

    David Emerson

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