Health-related quality of life among cancer patients in their last year of life: results from the PROFILES registry

Raijmakers, Natasja; Zijlstra, Myrte; Roij, Janneke van; Husson, Olga; Oerlemans, Simone; Poll‐Franse, Lonneke V. van de

doi:10.1007/s00520-018-4181-6

Cited by 33 publications

(26 citation statements)

References 27 publications

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“…Comparing our results directly to data from other studies is difficult because of the wide variety of population characteristics, data collection methods and instruments used across studies. Our findings are, however, generally consistent with available evidence suggesting that QoL, functioning and symptom distress change at different rates at different points in time, and that decline tends to spiral downwards more rapidly in the last months or weeks of life (‘terminal drop’) [20–26]. Additionally, it is interesting to note that pain, fatigue and appetite loss not only were the three symptoms starting to deteriorate most early, but were also the most severe symptoms (i.e., highest mean scores) in all three different periods of time before death.…”

Section: Discussionsupporting

confidence: 90%

Quality of life and symptom intensity over time in people with cancer receiving palliative care: Results from the international European Palliative Care Cancer Symptom study

et al. 2019

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BackgroundPeople with advanced cancer experience multiple symptoms during their illness trajectory, which can fluctuate in intensity.AimTo describe the course of self-reported quality of life, emotional functioning, physical functioning and symptom intensity over time in cancer patients receiving palliative care.DesignLongitudinal study with monthly assessments, using the EORTC QLQ-C15-PAL. Data were analysed (1) prospectively, from baseline to ≥8-month follow-up; and (2) retrospectively, by taking death as index date and comparing results from three cross-sectional subsamples at different stages of illness (time to death ≥6, 5–3 and 2–0 months). Linear mixed models were calculated.Setting/participantsA total of 1739 patients (mean age 66, 50% male) from 30 palliative care centers in 12 countries were included.ResultsIn prospective analyses, quality of life, functioning and symptoms–except nausea/vomiting–remained generally stable over time. In retrospective analyses, patients 2–0 months before death reported significantly lower quality of life and physical functioning scores than those 5–3 months before death, who in turn scored lower than those ≥6 months before death, suggesting progressive decline. Emotional functioning remained initially unchanged, but decreased in the last months. Pain, fatigue and appetite loss showed a stable increase in intensity towards death. Dyspnea, insomnia and constipation increased from 5–3 to 2–0 months before death. Nausea/vomiting only increased when comparing those ≥6 months before death with those 2–0 months before death.ConclusionWhile the prospective approach showed predominantly stable patterns for quality of life, functioning and symptom severity throughout study duration, retrospective analyses indicated that deterioration was already apparent before the terminal phase and accelerated close to death. Our findings support the importance of early symptom identification and treatment in this population, and highlight the need for further studies to explore what characterizes those with either lower or higher symptom burden at different time points towards death.

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Section: Discussionsupporting

confidence: 90%

Quality of life and symptom intensity over time in people with cancer receiving palliative care: Results from the international European Palliative Care Cancer Symptom study

et al. 2019

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“…Patients were eligible for the study if they (1) were ≥18 years, (2) had been diagnosed with lung cancer, (3) had an expected survival time >3 months, (4) had no significant cognitive impairment and (5) were able to communicate with interviewers. Studies show that cancer patients may experience a steep decline in HRQoL during the last 3 months of life 44. Therefore, we purposefully included only those with an expected survival time of at least 3 months.…”

Section: Methodsmentioning

confidence: 99%

Coping, mood and health-related quality of life: a cross-sectional study in Chinese patients with advanced lung cancer

Hong

Yan

et al. 2019

BMJ Open

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ObjectivesThe ways patients cope with advanced cancer can influence their health-related quality of life (HRQoL). This study aims to examine the mediating role of positive and negative mood in the relationship between coping and HRQoL in patients with advanced lung cancer.MethodsA consecutive sample of 261 patients (mean age: 59.99±9.53) diagnosed with stage III or IV lung cancer was recruited from the inpatient unit in a hospital that specialises in chest-related disease in Shanghai, China. Participants completed measurements including Medical Coping Modes Questionnaire, Positive and Negative Affect Schedule, and 5-level EuroQol 5-dimension instrument.ResultsAlthough the total effects of confrontation on HRQoL were not significant, competing indirect effects via mood were identified: (1) positive indirect effects through positive mood were found for confrontation on mobility, usual activities, pain/discomfort and overall utility index (indirect effect=0.01, 95% CI 0.003 to 0.03); (2) negative indirect effects through negative mood were found for confrontation on mobility, pain/discomfort, anxiety/depression and overall utility index (indirect effect=−0.01, 95% CI −0.03 to −0.001). Resigned acceptance was negatively associated with HRQoL, and indirect effects via mood were identified: (1) negative indirect effects through positive mood were found for resigned acceptance on mobility, self-care, usual activities, pain/discomfort and overall utility index (indirect effect=−0.01, 95% CI −0.03 to −0.003); (2) negative indirect effects through negative mood were found for resigned acceptance on domains of HRQoL and overall utility index (indirect effect=−0.04, 95% CI −0.06 to −0.02).ConclusionsConfronting advanced lung cancer can fuel ambivalent emotional experiences. Nevertheless, accepting the illness in a resigned way can be maladaptive for health outcomes. The findings suggest interventions that facilitate adaptive coping, reduce negative mood and enhance positive mood, as this could help to improve or maintain HRQoL in patients with advanced lung cancer.

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“…Disease status was obtained from the medical files at the end of the study. Data from the twelve patients that died during the follow-up period from a cause other than disease progression or recurrence were excluded from 6 months prior to death, because their HRQoL may be affected in that period [16]. Patients with an unknown date of the diagnosis of recurrence and patients with missing data on all HRQoL scales at baseline were excluded as well.…”

Section: Populationmentioning

confidence: 99%

Changes in health-related quality of life among gynecologic cancer survivors during the two years after initial treatment: a longitudinal analysis

et al. 2019

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Background: While many cancer survivors experience persistent impairments in health-related quality of life (HRQoL) for extended periods of time, others recover soon after treatment. The aim of this research is to assess changes in health-related quality of life in endometrial and ovarian cancer survivors during two years post initial treatment, and to assess clinical and sociodemographic characteristics associated with those changes. Methods: This prospective population-based cohort study includes longitudinal data of endometrial (N ¼ 221) and ovarian (N ¼ 174) cancer survivors diagnosed between 2011 and 2014. The EORTC QLQ-C30 functioning scales were used to assess HRQoL after initial treatment and after 6, 12 and 24 months. Clinical (stage, treatment and comorbidities) and sociodemographic (age, marital status and socioeconomic status) characteristics were obtained from the Netherlands Cancer Registry and through self-administered questionnaires. Linear mixed models were used to assess changes in HRQoL over time and characteristics associated with these changes. Results: Among both endometrial and ovarian cancer patients, HRQoL improved within the first 6 months after initial treatment. Changes in HRQoL were mainly associated with clinical characteristics including comorbidities, treatment and tumor stage, and to a lesser extent with sociodemographic characteristics such as socioeconomic status. However, these associations varied per tumor type. Endometrial cancer survivors, who received radiotherapy and had no comorbidities, reported greater improvements in some HRQoL scales over time. Ovarian cancer patients who received chemotherapy and with advanced tumor stages reported poorer functioning during treatment. Most functioning domains (global health, physical and role functioning) recovered to levels of patients without chemotherapy or with early-stage disease after 12 months, but cognitive and social functioning remained impaired. Conclusion: Some subgroups of patients, including those with multiple comorbidities, with an advanced tumor stage and who received chemotherapy, may be in need of additional support as they are less likely to show improvements in HRQoL over time.

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Health-related quality of life among cancer patients in their last year of life: results from the PROFILES registry

Cited by 33 publications

References 27 publications

Quality of life and symptom intensity over time in people with cancer receiving palliative care: Results from the international European Palliative Care Cancer Symptom study

Quality of life and symptom intensity over time in people with cancer receiving palliative care: Results from the international European Palliative Care Cancer Symptom study

Coping, mood and health-related quality of life: a cross-sectional study in Chinese patients with advanced lung cancer

Changes in health-related quality of life among gynecologic cancer survivors during the two years after initial treatment: a longitudinal analysis

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