All's Well That Ends Well? Quality of Life and Physical Symptom Clusters in Long-Term Cancer Survivors Across Cancer Types

  • A.C. Z
  • A.W. B
  • W. L
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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 (alpha = 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. © 2012 U.S. Cancer Pain Relief Committee.

Author-supplied keywords

  • *cancer survivor
  • *neoplasm
  • *quality of life
  • *survivor
  • United States
  • adult
  • analgesia
  • anorexia
  • breast
  • cancer pain
  • cancer patient
  • constipation
  • diagnosis
  • diarrhea
  • dyspnea
  • factorial analysis
  • fatigue
  • health practitioner
  • human
  • insomnia
  • melanoma
  • nausea and vomiting
  • non profit organization
  • pain
  • patient
  • population
  • prediction
  • prostate
  • questionnaire

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  • Zucca A.C.

  • Boyes A.W.

  • Linden W.

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