Quality of life after treatment of pancreatic cancer

Fitzsimmons, Deborah; Johnson, C. D.

doi:10.1007/s004230050106

Cited by 43 publications

(28 citation statements)

References 22 publications

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“…Finally, radiotherapy was associated with chronic radiation dermatitis, chronic diarrhea, and strictures/obstruction. These findings are consistent with previous studies with patient-reported outcomes, many of which utilize the QLQ-PAN26, an EORTC-affiliated disease-specific quality of life questionnaire (10)(11)(12)(13). The use of patient-reported outcomes is especially important in cancers with poor prognoses to ensure that any intervention to extend survival is undertaken in a meaningful manner, as judged by the patients themselves.…”

Section: Discussionsupporting

confidence: 87%

Survivorship after treatment of pancreatic cancer: insights via an Internet-based survivorship care plan tool

Frick

Vachani

Hampshire

et al. 2017

J. Gastrointest. Oncol.

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Pancreatic cancer survivors face a unique set of challenges in survivorship, yet structured survivorship care planning is lacking in practice. Survivorship care plans (SCPs) are an essential part of quality cancer care and can facilitate the transition following active treatment; the use of SCPs in pancreatic cancer survivors, however, has not been explored. With a convenience sample of 117 pancreatic cancer survivors and proxies who used an Internet-based SCP tool, we examined treatment details, patientreported outcomes, and survivorship practices. Thirty-one percent of survivors were 2 years or greater from diagnosis with a median current age of 62 years. Most patients had received multimodality therapy (67%): 68%, 86%, and 43% reported surgical intervention, intravenous chemotherapy, and radiation therapy for their pancreatic cancer, respectively. Survivors commonly reported fatigue, cognitive change, neuropathy, pancreatic insufficiency, and chronic radiation dermatitis related to treatment. Most survivors are managed (47%) or co-managed (35%) by an oncology specialist; however, this percentage decreases over time with consequent increase in management by primary care providers alone. Only 5% had previously been offered an SCP. Of the 24 users who responded to a follow-up satisfaction survey, 83% indicated they would share the SCP with their healthcare team although half of respondents felt it should include more information.In all, our results demonstrate that there is a population of pancreatic cancer survivors who exist and seek survivorship support although structured survivorship care planning is lacking in practice. SCPs have a potentially valuable role for these survivors via communication of treatment-related effects and coordination across multidisciplinary healthcare teams. Further development and evaluation of SCPs is needed for this underserved survivor population.

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Section: Discussionsupporting

confidence: 87%

Survivorship after treatment of pancreatic cancer: insights via an Internet-based survivorship care plan tool

Frick

Vachani

Hampshire

et al. 2017

J. Gastrointest. Oncol.

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“…QOL assessment in pancreatic diseases, both malignant and benign, is still in the early stages of data retrieval and evaluation, and there are many opportunities for future research and development. 34 Additional studies incorporating both preoperative and serial postoperative QOL assessment are needed. Studies are also needed to evaluate QOL for the various nonsurgical management strategies in pancreatic disease.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life and Outcomes After Pancreaticoduodenectomy

et al. 2000

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ObjectiveTo assess the quality of life (QOL) and functional outcome of patients after pancreaticoduodenectomy. Summary Background DataPancreaticoduodenectomy is gaining acceptance and is being performed in increasing numbers for various malignant and benign diseases of the pancreas and periampullary region. There is a general impression that pancreaticoduodenectomy can severely impair QOL and alter normal activities. Only a few small studies have evaluated QOL after pancreaticoduodenectomy. MethodsA standard QOL questionnaire was sent to 323 patients surviving pancreaticoduodenectomy who had undergone surgery at The Johns Hopkins Hospital between 1981 and 1997. Thirty items on a visual analog scale were categorized into three domains: physical (15 items), psychological (10 items), and social (5 items). Scores are reported as a percentile, with 100% being the highest possible score. The same QOL questionnaire was also sent to laparoscopic cholecystectomy patients and healthy controls. A separate component of the questionnaire asked about functional outcomes and disabilities. ResultsOverall QOL scores for the 192 responding pancreaticoduodenectomy patients in the three domains (physical, psychological, social) were 78%, 79%, and 81%, respectively. These QOL scores were comparable to those of the 37 laparoscopic cholecystectomy patients and the 31 healthy controls. The pancreaticoduodenectomy patients were subgrouped into chronic pancreatitis, other benign disease, pancreatic adenocarcinoma, and other cancers. Patients who underwent resection for chronic pancreatitis and pancreatic adenocarcinoma had significantly lower QOL scores in the physical and psychological domains compared with the laparoscopic cholecystectomy patients and the healthy controls. Common problems after pancreaticoduodenectomy were weight loss, abdominal pain, fatigue, foul stools, and diabetes. ConclusionsThis is the largest single-institution experience assessing QOL after pancreaticoduodenectomy. These data demonstrate that as a group, patients who survive pancreaticoduodenectomy have near-normal QOL scores. Many patients report weight loss and symptoms consistent with pancreatic exocrine and endocrine insufficiency. Most patients have QOL scores comparable to those of control patients and can function independently in daily activities.Pancreaticoduodenectomy is gaining acceptance as an appropriate procedure for various malignant 1-7 and benign diseases 8,9 of the pancreas and periampullary region. In many tertiary referral centers, pancreaticoduodenectomy is now performed with complication rates less than 40% and with death rates of 5% or lower. 4,10 -14 As experience with pancreaticoduodenectomy grows, there are increasing numbers of pancreaticoduodenectomy survivors who have recovered from the procedure and who live with the requisite altered upper gastrointestinal anatomy. These survivors have not been adequately studied in terms of their postprocedure quality of life (QOL) and outcomes such as pain, stool habits, activity levels, and o...

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“…Fitzsimmons and Johnson [16] accounted a 25-fold increase in the number of references in the literature to QoL in pancreatic cancer. Of 78 papers reviewed, only 9 used a previously validated QoL questionnaire.…”

Section: Quality Of Life In Surgery For Pancreatic Cancermentioning

confidence: 99%

“…Little research has been conducted to support or disprove such assumptions. An assessment of the effect of such interventions on QoL is urgently required in a second step in a randomized controlled trial [16].…”

Section: Quality Of Life In Surgery For Pancreatic Cancermentioning

confidence: 99%