Symptom Management

​​​Many people living with advanced disease struggle with the physical and emotional effects of their illness and treatment. Regardless of where they are in their journey, patients sometimes need help to manage their pain, nausea, anxiety or other symptoms.

Assessment Tools

  • ESAS (Edmonton Symptom Assessment Score) is a valid and reliable patient self-assessment tool that can be used to screen for the intensity of nine common symptoms experienced by patients: pain, tiredness, nausea, depression, anxiety, drowsiness, lack of appetite, well-being and shortness of breath. ESAS has been translated into many languages. At cancer centres across the province, symptom severity is routinely screened using the ESAS.
  • Palliative Performance Scale (PPS)
  • Ken Rockwood 9 point Frailty Tool (Dalhousie University)

Symptom Management Guides

The Ontario Cancer Symptom Management Collaborative was established to improve the quality and consistency of managing cancer patient's symptoms.  This collaborative has developed numerous symptom management guides to help healthcare professionals and patients assess and appropriately manage cancer-related symptoms.

Access the Symptom Management Guides via the following web link:

SymptomClinician GuidePatient Guides



Nausea & Vomiting



Loss of Appetite

Bowel Care

Oral Care

Anxiety **

Depression **

Fatigue **

Sleep Disturbances**

** Developed by the Cancer Journey Advisory Group and the Canadian Association of Psychosocial Oncology, with support from the Canadian Partnership Against Cancer, in collaboration with the Ontario Cancer Symptom Management Collaborative.

Prostate Cancer Guides

Bowel Function

Hormonal Symptoms/Vitality

Sexual Function

Urinary Incontinence

Urinary Obstruction


These tools represent current evidence and best practice and replace previously published guidelines distributed through Ontario Health (Cancer Care Ontario)​, including the Telephone Nursing Practice and Symptom Management Guidelines and KFL&A Palliative Care Integration Project Symptom Management Guidelines.