On psychological assessment, the levels of anxiety and depression in Group 6 were found to be higher than those of other groups, suggesting that subjective symptoms are associated with psychological distress.37 Although LE and depression are associated,38 the depression levels of patients in Group 5 with prominent LE were lower than those of patients in Groups 1 and 6, which means that the associated factors of depression are multiple,39 and more active pain control is indicated for the patients with depression.40 Subjective symptoms are correlated with organ failure, indicating that symptoms of advanced cancer patients result mainly from physical deterioration, and psychological distress is secondary.41 Therefore, aggressive symptom management is very important for advanced cancer patients.