- Title
- All's well that ends well?: quality of life and physical symptom clusters in long-term cancer survivors across cancer types
- Creator
- Zucca, Alison C.; Boyes, Allison W.; Linden, Wolfgang; Girgis, Afaf
- Relation
- Journal of Pain and Symptom Management Vol. 43, Issue 4, p. 720-731
- Publisher Link
- http://dx.doi.org/10.1016/j.jpainsymman.2011.04.023
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2012
- Description
- 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.
- Subject
- cancer; survivor; long term; multiple symptoms; symptom clusters; quality of life
- Identifier
- http://hdl.handle.net/1959.13/1038581
- Identifier
- uon:13559
- Identifier
- ISSN:0885-3924
- Rights
- ©2012. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
- Language
- eng
- Full Text
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