Quality of life and the patient with cancer. Individual and policy implications.

This article reviews the developments during the past decade that have led to a better definition and conceptualization of the term "quality of life." There is growing consensus regarding the dimensions of quality of life, along with an expansion of the number of tools appropriate for measuring quality of life in patients with cancer. Quality of life increasingly is being used as an outcome in research, especially clinical trials. However, there remain some areas of controversy, including the application of economic analyses (utility and cost-effectiveness studies) and the potential conflict between the needs of the individual versus society. In the future, we can expect development of a theoretical framework for quality of life research. Clinicians may begin to routinely evaluate quality of life in their patients and use these evaluations as part of the clinical decision making process in individual patients. Ultimately, policy decisions also may incorporate some form of quality of life assessment.