Cancer Survivors Experience Low Health-Related Quality of Life

Cancer has a major impact on mental, physical, social and behavioral well-being of patients and survivors. More than four in five cancer survivors suffer from anxiety and depression following a year after diagnosis.

"We urgently need new ways of supporting cancer survivors and addressing wider aspects of well-being. Instead of just focusing on clinical outcome, doctors must focus equally on quality of life for cancer patients especially psychologically, financially and socially." says lead author Shridevi Subramaniam, a research officer at the National Clinical Research Center, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.

Survey Among Breast Cancer Patients

The most frequently diagnosed cancer among women is breast cancer. About half of the breast cancer cases and 60% of the deaths occur in developing countries. The incidence of breast cancer has increased during last three decades in Malaysia.

It is estimated that one in 19 women in Malaysia is at lifetime risk, compared to one in 8 in Europe and the United States.

Among the Malaysian patients from the ACTION study (ASEAN Cost in Oncology Study, a third or 33% had breast cancer.

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They were asked to complete questionnaires in order to assess health-related quality of life (HRQoL). Anxiety and depression levels were also included in the survey.

HRQoL may be defined as a patient's satisfaction with their physical health and mental well-being. It is an important end result in cancer care.

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The results showed that twelve months post-diagnosis, patients' mental and physical well-being was low.

Survey Among Young Adults

The group of young adults and adolescents do not expect to develop the disease at a young age. In a separate on-going study, researchers focused on a group of young adults and adolescents.

The study included 56 patients with an average age of 28 years who were newly diagnosed with cancer.

They completed questionnaires on occupation and lifestyle, problems around physical symptoms, mental well-being and financial issues.

Results showed more than 37% of patients in this group were suffering distress at diagnosis of cancer. The top causes for distress were identified as treatment decisions, followed by family health issues, sleep and worry.

The young adults diagnosed with cancer are at a higher risk of suicide and so conducting studies like this will help in finding new ways to address this issue effectively.

Senior author Associate Professor Alexandre Chan, Department of Pharmacy, National University of Singapore and Specialist Pharmacist, National Cancer Center, Singapore said, "The young differ from older people because they don't expect to be ill, and certainly not with cancer. They're also at a stage when they're facing many social responsibilities and family burdens. That's why they need effective supportive care and help in managing the physical, psychological and emotional side-effects that come with both cancer diagnosis and treatment."

Factors that Influence Health-Related Quality of Life

Stage of cancer- The more advanced the cancer is, the lower the HRQoL.

Type of cancer Women with cancer in reproductive organs like cervix of uterus had higher sense of well-being compared to patients suffering from lymphoma. This is because of the difference in severity. Cancer of uterus and cervix tend to spread slowly over many years in comparison to lymphoma. The more aggressive the cancer is, the lower the quality of life.

Age at cancer diagnosis - Cancer also has a significant impact on the lives and well-being of adolescents and young adults.

Factors That May Help Improve Quality of Life

• Psychotherapy sessions and counseling improve quality of life in patients.
• Emotional support - It can help cancer patients manage symptoms better.
• Maintain the right attitude - It may not be easy to stay positive all the time. It is advisable to deal with symptoms of depression, anxiety, fear and grief. Ignoring these symptoms and not sharing feelings with another person may increase the loneliness among cancer patients.

Conclusion

Ravindran Kanesvaran, assistant professor, Duke-NUS Medical School, and Consultant Medical Oncologist, National Cancer Center, Singapore, said “There is a critical need to find ways of addressing the high levels of distress among cancer survivors in general as highlighted by the Malaysian study.”

"The key message is to focus more on supporting patients throughout their whole cancer 'journey' especially in their lives after treatment," added Subramanian.

Researchers feel that the psycho-social impact of cancer clearly needs further evaluation. This is to assess the impact on quality of life at the time of diagnosis as well as throughout and after treatment.

Researchers reported their findings at the European Society for Medical Oncology (ESMO) Asia 2016 Congress in Singapore.

References:

1. Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4762172/)
2. Attitudes and Cancer - (http://www.cancer.org/treatment/treatmentsandsideeffects/emotionalsideeffects/attitudes-and-cancer)

Source-Medindia