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The impact of disease progression on perceived health status and quality of life of long-term cancer survivors.

Thong MS, Mols F, Coebergh JW, Roukema JA, van de Poll-Franse LV - J Cancer Surviv (2009)

Bottom Line: Compared with DF survivors, DP survivors exhibited significantly lower scores on all SF-36 and QOL-CS (except spiritual well-being) dimensions.Among survivors with DP, those with short survival (<5 years) had significantly poorer HS scores on all dimensions except bodily pain compared with the normative population.Although DP survivors report poorer long-term HRQL compared with DF cancer survivors, results suggest that time can attenuate the distress of DP on HRQL.

View Article: PubMed Central - PubMed

Affiliation: Comprehensive Cancer Center South (CCCS), Eindhoven Cancer Registry, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands. M.Thong@ikz.nl

ABSTRACT

Introduction: The number of cancer survivors experiencing disease progression (DP) is increasing with the number of cancer survivors. However, little is known whether DP affects health-related quality of life (HRQL) of long-term cancer survivors. We aimed therefore to compare the health status (HS) and HRQL of DP and disease-free (DF) survivors up to 15 years after initial diagnosis.

Methods: 232 cancer survivors with DP identified through the Eindhoven Cancer Registry were matched with 232 DF survivors of similar demographic and clinical characteristics. Patients completed generic HS (SF-36) and cancer-specific HRQL (QOL-CS) questionnaires 5-15 years after diagnosis.

Results: Compared with DF survivors, DP survivors exhibited significantly lower scores on all SF-36 and QOL-CS (except spiritual well-being) dimensions. DF survivors had better scores than the normative population on all SF-36 dimensions. Among survivors with DP, those with short survival (<5 years) had significantly poorer HS scores on all dimensions except bodily pain compared with the normative population. Comparatively, the long survival (>or=5 years) DP group had better HRQL than the short DP group but poorer HRQL than the normative population. In multivariate analyses, DP and DF survival time were independently associated with aspects of HS and HRQL in cancer survivors.

Discussions/conclusions: DP cancer survivors have poorer long-term HS and HRQL compared with DF survivors. However, there is suggestion that HS and HRQL does improve over time following DP.

Implication for cancer survivors: Although DP survivors report poorer long-term HRQL compared with DF cancer survivors, results suggest that time can attenuate the distress of DP on HRQL. Psycho-educational programs could help to increase patients' sense of empowerment and personal control should DP occur.

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Related in: MedlinePlus

Comparison of SF-36 scores according to disease status to the normative population standardized for age. An asterisk above a subgroup indicates a difference in the mean score between that subgroup and the normative population. PCS=Physical Component Summary score. MCS=Mental Component Summary score. **p < 0.001; *p < 0.05. ξ Indicates clinically significant difference in mean score between the subgroup and the norm population.
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Fig2: Comparison of SF-36 scores according to disease status to the normative population standardized for age. An asterisk above a subgroup indicates a difference in the mean score between that subgroup and the normative population. PCS=Physical Component Summary score. MCS=Mental Component Summary score. **p < 0.001; *p < 0.05. ξ Indicates clinically significant difference in mean score between the subgroup and the norm population.

Mentions: The generic HS of DF and DP survivors was compared with that of a normative population, standardized for age. DF survivors had better HS than the normative population on all dimensions of the SF-36, with physical functioning, bodily pain, social functioning, role functioning emotional, and physical component summary score statistically significantly better than that of the normative population (Fig. 2). Among the DP group with known time of progression, survival time was dichotomized into short (<5 years) and long (≥5 years) survival since progression. Compared with the normative population, the short DP group had statistically significantly poorer HS scores on all dimensions except on bodily pain. Clinically significant differences between the two groups were noted in general health and mental component summary scores. Similarly, the long DP group had poorer HS than the normative population, although only general health and the mental component summary scores showed statistically but not clinically significant differences. However long DP survivors report having better HS than short DP survivors (Table 3). Long DP survivors exhibited significantly better mental component summary score and the difference in general health scores approached significance. For those DP patients (n = 29) whose date of DP were not known, their HS scores were generally compatible with those of the long DP survivors (data not shown).FIGURE 2


The impact of disease progression on perceived health status and quality of life of long-term cancer survivors.

Thong MS, Mols F, Coebergh JW, Roukema JA, van de Poll-Franse LV - J Cancer Surviv (2009)

Comparison of SF-36 scores according to disease status to the normative population standardized for age. An asterisk above a subgroup indicates a difference in the mean score between that subgroup and the normative population. PCS=Physical Component Summary score. MCS=Mental Component Summary score. **p < 0.001; *p < 0.05. ξ Indicates clinically significant difference in mean score between the subgroup and the norm population.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2714447&req=5

Fig2: Comparison of SF-36 scores according to disease status to the normative population standardized for age. An asterisk above a subgroup indicates a difference in the mean score between that subgroup and the normative population. PCS=Physical Component Summary score. MCS=Mental Component Summary score. **p < 0.001; *p < 0.05. ξ Indicates clinically significant difference in mean score between the subgroup and the norm population.
Mentions: The generic HS of DF and DP survivors was compared with that of a normative population, standardized for age. DF survivors had better HS than the normative population on all dimensions of the SF-36, with physical functioning, bodily pain, social functioning, role functioning emotional, and physical component summary score statistically significantly better than that of the normative population (Fig. 2). Among the DP group with known time of progression, survival time was dichotomized into short (<5 years) and long (≥5 years) survival since progression. Compared with the normative population, the short DP group had statistically significantly poorer HS scores on all dimensions except on bodily pain. Clinically significant differences between the two groups were noted in general health and mental component summary scores. Similarly, the long DP group had poorer HS than the normative population, although only general health and the mental component summary scores showed statistically but not clinically significant differences. However long DP survivors report having better HS than short DP survivors (Table 3). Long DP survivors exhibited significantly better mental component summary score and the difference in general health scores approached significance. For those DP patients (n = 29) whose date of DP were not known, their HS scores were generally compatible with those of the long DP survivors (data not shown).FIGURE 2

Bottom Line: Compared with DF survivors, DP survivors exhibited significantly lower scores on all SF-36 and QOL-CS (except spiritual well-being) dimensions.Among survivors with DP, those with short survival (<5 years) had significantly poorer HS scores on all dimensions except bodily pain compared with the normative population.Although DP survivors report poorer long-term HRQL compared with DF cancer survivors, results suggest that time can attenuate the distress of DP on HRQL.

View Article: PubMed Central - PubMed

Affiliation: Comprehensive Cancer Center South (CCCS), Eindhoven Cancer Registry, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands. M.Thong@ikz.nl

ABSTRACT

Introduction: The number of cancer survivors experiencing disease progression (DP) is increasing with the number of cancer survivors. However, little is known whether DP affects health-related quality of life (HRQL) of long-term cancer survivors. We aimed therefore to compare the health status (HS) and HRQL of DP and disease-free (DF) survivors up to 15 years after initial diagnosis.

Methods: 232 cancer survivors with DP identified through the Eindhoven Cancer Registry were matched with 232 DF survivors of similar demographic and clinical characteristics. Patients completed generic HS (SF-36) and cancer-specific HRQL (QOL-CS) questionnaires 5-15 years after diagnosis.

Results: Compared with DF survivors, DP survivors exhibited significantly lower scores on all SF-36 and QOL-CS (except spiritual well-being) dimensions. DF survivors had better scores than the normative population on all SF-36 dimensions. Among survivors with DP, those with short survival (<5 years) had significantly poorer HS scores on all dimensions except bodily pain compared with the normative population. Comparatively, the long survival (>or=5 years) DP group had better HRQL than the short DP group but poorer HRQL than the normative population. In multivariate analyses, DP and DF survival time were independently associated with aspects of HS and HRQL in cancer survivors.

Discussions/conclusions: DP cancer survivors have poorer long-term HS and HRQL compared with DF survivors. However, there is suggestion that HS and HRQL does improve over time following DP.

Implication for cancer survivors: Although DP survivors report poorer long-term HRQL compared with DF cancer survivors, results suggest that time can attenuate the distress of DP on HRQL. Psycho-educational programs could help to increase patients' sense of empowerment and personal control should DP occur.

Show MeSH
Related in: MedlinePlus