Alison C Zucca1, Allison W Boyes, Wolfgang Linden, Afaf Girgis. 1. Centre for Health Research & Psycho-oncology (CHeRP), Cancer Council NSW, University of Newcastle, Callaghan, New South Wales, Australia. Alison.Zucca@newcastle.edu.au
Abstract
CONTEXT: Little is known about the presentation of multiple concurrent symptoms (symptom clusters) in long-term cancer survivors, with few studies adequately powered to compare quality of life (QoL) and symptom presentation by cancer type. OBJECTIVES: This research aimed to 1) assess patient-reported QoL and 2) identify clusters of cancer-related physical symptoms by cancer type among long-term breast, prostate, colorectal, and melanoma cancer survivors. METHODS: A population-based cross-sectional sample of 863 adult cancer survivors five to six years post-diagnosis completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), assessing global QoL and frequency of presentation of cancer-related physical symptoms. RESULTS: Long-term survivors reported higher levels of global QoL than 1) the general population (age-adjusted mean=79.4 vs. 71.1, small clinical difference) and 2) cancer patients early in the care trajectory (age-adjusted mean=77.1 vs. 61.3, moderate clinical difference). The majority (71%) did not report any cancer-related physical symptoms; 18% reported multiple (two or more) symptoms in the past month. Factor analysis found that cognitive functioning, fatigue, insomnia, pain, dyspnea, appetite loss, constipation, diarrhea, nausea, and vomiting formed a cluster (α=0.48). No symptom clusters were identified that were specific to just one cancer type. However, individual symptoms (including diarrhea, pain, constipation, and insomnia) modestly discriminated between cancer types. CONCLUSION: Contrary to expectations, no symptom clusters specific to one type of cancer were identified and survivors reported few cancer-related symptoms and high QoL. These results convey a strong "good news" message, providing health professionals with a sound foundation for making encouraging predictions about their patients' long-term physical recovery after cancer. Cancer patients also will welcome the news that only a minority of five-year survivors experience long-term and late effects.
CONTEXT: Little is known about the presentation of multiple concurrent symptoms (symptom clusters) in long-term cancer survivors, with few studies adequately powered to compare quality of life (QoL) and symptom presentation by cancer type. OBJECTIVES: This research aimed to 1) assess patient-reported QoL and 2) identify clusters of cancer-related physical symptoms by cancer type among long-term breast, prostate, colorectal, and melanoma cancer survivors. METHODS: A population-based cross-sectional sample of 863 adult cancer survivors five to six years post-diagnosis completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), assessing global QoL and frequency of presentation of cancer-related physical symptoms. RESULTS: Long-term survivors reported higher levels of global QoL than 1) the general population (age-adjusted mean=79.4 vs. 71.1, small clinical difference) and 2) cancerpatients early in the care trajectory (age-adjusted mean=77.1 vs. 61.3, moderate clinical difference). The majority (71%) did not report any cancer-related physical symptoms; 18% reported multiple (two or more) symptoms in the past month. Factor analysis found that cognitive functioning, fatigue, insomnia, pain, dyspnea, appetite loss, constipation, diarrhea, nausea, and vomiting formed a cluster (α=0.48). No symptom clusters were identified that were specific to just one cancer type. However, individual symptoms (including diarrhea, pain, constipation, and insomnia) modestly discriminated between cancer types. CONCLUSION: Contrary to expectations, no symptom clusters specific to one type of cancer were identified and survivors reported few cancer-related symptoms and high QoL. These results convey a strong "good news" message, providing health professionals with a sound foundation for making encouraging predictions about their patients' long-term physical recovery after cancer. Cancerpatients also will welcome the news that only a minority of five-year survivors experience long-term and late effects.
Authors: Crystal S Denlinger; Robert W Carlson; Madhuri Are; K Scott Baker; Elizabeth Davis; Stephen B Edge; Debra L Friedman; Mindy Goldman; Lee Jones; Allison King; Elizabeth Kvale; Terry S Langbaum; Jennifer A Ligibel; Mary S McCabe; Kevin T McVary; Michelle Melisko; Jose G Montoya; Kathi Mooney; Mary Ann Morgan; Tracey O'Connor; Electra D Paskett; Muhammad Raza; Karen L Syrjala; Susan G Urba; Mark T Wakabayashi; Phyllis Zee; Nicole McMillian; Deborah Freedman-Cass Journal: J Natl Compr Canc Netw Date: 2014-01 Impact factor: 11.908
Authors: Laurence Leysen; Astrid Lahousse; Jo Nijs; Nele Adriaenssens; Olivier Mairesse; Sergei Ivakhnov; Thomas Bilterys; Eveline Van Looveren; Roselien Pas; David Beckwée Journal: Support Care Cancer Date: 2019-07-25 Impact factor: 3.603
Authors: Paul A Glare; Pamela S Davies; Esmé Finlay; Amitabh Gulati; Dawn Lemanne; Natalie Moryl; Kevin C Oeffinger; Judith A Paice; Michael D Stubblefield; Karen L Syrjala Journal: J Clin Oncol Date: 2014-05-05 Impact factor: 44.544