Unmet needs mediate the relationship between symptoms and quality of life in breast cancer survivors

Abstract

Results suggest that breast cancer survivors continue to endure many symptoms independent of the survivorship period. The unmet needs mediate the relationship between symptom burden and survivors' QoL.

Prevalence and factors associated with unmet needs in post‐treatment cancer survivors: A systematic review

“…A high prevalence was mostly observed in breast cancer studies (Brennan et al, 2016;Fang et al, 2016;So et al, 2014). Other studies including breast cancer were also reasonably consistent with that reporting 49% to 62% prevalence rates (Cheng, Darshini Devi, Wong, & Koh, 2014;Cheng, Wong, & Koh, 2016;Park & Hwang, 2012). Studies that included gynaecological cancer with a roughly similar time since treatment (3.7 and 4 years post-diagnosis) reported similar prevalence rates, ranging from 52% to 56% (Hodgkinson, Butow, Fuchs, et al, 2007;Urbaniec, Collins, Denson, & Whitford, 2011), and so did the studies covering younger patients with testicular cancer (mean age <40 years), in which the prevalence ranged from 63% to 66% (Bender et al, 2012;Smith et al, 2013).…”

“…The most frequently identified domains of unmet needs were the psychological domain , specifically “managing concerns about the cancer coming back” and the information domain , specifically “being informed about the things you can do to help yourself to get well.” Most studies that recognised FCR concern as unmet were conducted in countries with well‐developed health care and included survivors who had more recently ended their treatment (see Table ). Similarly, studies which reported that unmet needs most commonly relate to the information domain also concerned survivors who had more recently ended their treatment (Cheng et al, ; Faghani et al, ; Park & Hwang, ; Santin et al, ; So et al, ), and on the contrary, with the exception of a study carried out with colorectal survivors (Santin et al, ), were conducted in countries with less‐developed health care (Singapore, China and Iran). In the studies of haematological and head and neck cancer, the most common unmet needs related to the items “dealing with feeling tired” (Hall et al, ), “not being able to do things you used to do” (Oberoi, White, Seymour, Miles Prince, et al, ; Oberoi, White, Seymour, Prince, et al, ) or “lack of energy/tiredness” (O'Brien et al, ).…”

“…Inconsistent evidence was observed for the time since treatment/diagnosis, the stage of the disease at diagnosis, and depression. While two studies reported that survivors for whom less time had passed since the diagnosis/treatment had more unmet needs (Cheng et al, ; Molassiotis et al, ), the majority concluded that time since treatment/diagnosis was unrelated to unmet needs (Hodgkinson, Butow, Fuchs, et al, ; Hodgkinson, Butow, Hunt, Pendlebury, Hobbs, & Wain ; Willems et al, ). In terms of a more advanced stage of disease, two studies reported a relationship to unmet needs (Hodgkinson, Butow, Fuchs, et al, ; Rowlands et al, ), while one could not confirm these findings (Urbaniec et al, ).…”

“…In the information domain , strong evidence was found for time since treatment/diagnosis and physical health. Survivors who had more unmet needs for having up to date information were more usually at the beginning of their post‐treatment path (Cheng et al, ; Lee et al, ; Willems et al, ) and reported more comorbid disorders, lack of energy and HNC recurrence (Armes et al, ; Cheng et al, ; O'Brien et al, ). Inconclusive evidence emerged for anxiety and depression, with one study reporting the relationship (Oberoi, White, Seymour, Miles Prince, et al, ; Oberoi, White, Seymour, Prince, et al, ) and the other not (Willems et al, ).…”

Quality of Life for Patients Surviving Cancer: Are We Moving Ahead?

“…Although many patients continue to see their oncologists after active anticancer treatments are completed, others want to return to the family physician for support and help with their various other medical issues. However, reports have demonstrated that many family physicians lack expertise in this area and are not able to meet the survivor's needs 4,5 . Many patients therefore find themselves feeling hopeless, helpless, and abandoned.…”