Orem自理模式对晚期肝癌患者心理负担、负性情绪、自理能力及生活质量的影响

目的 探讨Orem自理模式对晚期肝癌患者心理负担、负性情绪、自理能力及生活质量的影响.方法 根据住院期间干预方法的不同将120例晚期肝癌患者分为对照组(n=60)和观察组(n=60),对照组患者给予常规干预,观察组患者在对照组的基础上实施基于Orem自理模式的干预,两组患者均干预1个月.比较两组患者的依从性、心理负担、负性情绪、自理能力及生活质量.结果 干预后,观察组患者的依从率为95.00％,明显高于对照组的75.00％(P<0.01).干预后,观察组患者自我感受负担量表(SPBS)中身体负担、情感负担评分及总分均明显低于对照组(P<0.01);而观察组患者的经济负担评分为(7.14±0.85)分,与对照组患者的(7.27±0.93)分比较,差异无统计学意义(P>0.05).干预后,观察组患者的焦虑自评量表(SAS)及抑郁自评量表(SDS)评分均明显低于对照组(P<0.01),Barthel指数评定量表评分及肝癌患者生命质量测定量表(QOL-LC)评分均明显高于对照组(P<0.01).结论 基于Orem自理模式的干预能够减轻晚期肝癌患者的心理负担及负性情绪,提高其自理能力和生活质量.     

多学科协作干预模式对宫颈癌放化疗患者营养指标、应激压力及生活质量的影响

目的 探讨多学科协作干预模式对宫颈癌放化疗患者营养指标、应激压力及生活质量的影响.方法 根据干预模式的不同将87例接受放化疗的宫颈癌患者分为对照组(n=38,采用常规干预模式)和观察组(n=49,采用多学科协作干预模式).比较两组患者的营养指标、应激压力量表评分、肿瘤患者生活质量测定量表评分以及并发症发生情况.结果 干预后3个月、6个月,观察组患者的营养不良炎症评分(MIS)均低于对照组,体重指数、血清白蛋白水平、血红蛋白水平均高于对照组,差异均有统计学意义(P﹤0.05).干预后3个月、6个月,观察组患者应激压力量表中生理痛苦、生活被干扰、负性情感、心理疾患评分均低于对照组,社会支持、身体健康、生活满意度、心理应对、积极影响评分均高于对照组,差异均有统计学意义(P﹤0.05).干预后3个月、6个月,观察组患者身体功能、角色功能、情绪功能、认知功能、社会功能评分均高于对照组,差异均有统计学意义(P﹤0.05).干预后,观察组患者放射性膀胱炎、放射性结直肠炎、恶心/呕吐、白细胞/血小板计数下降的发生率均低于对照组,差异均有统计学意义(P﹤0.05).结论 多学科协作干预模式可提高宫颈癌放化疗患者的营养指标、生活质量,降低应激压力,有利于提高患者预后.     

心智觉知训练对乳腺癌化疗患者自我效能、负性情绪及认知功能的影响

目的探讨心智觉知训练对乳腺癌化疗患者自我效能、负性情绪及认知功能的影响。方法选取300例乳腺癌化疗患者,根据干预方法的不同分为观察组和对照组,每组150例。对照组患者化疗期间接受常规护理干预,观察组患者在此基础上联合心智觉知训练,干预时间均为12周,比较两组患者干预前后自我效能、负性情绪、认知功能及生活质量的变化。结果干预前,两组患者自我效能、蒙特利尔认知评估(MoCA)量表、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分,以及36项健康调查简表(SF-36)量表各维度评分比较,差异均无统计学意义(P﹥0.05)。干预后,两组患者自我效能、MoCA评分和SF-36量表各维度评分均明显高于本组干预前,SAS、SDS评分均明显低于本组干预前,差异均有统计学意义(P﹤0.01);且观察组患者自我效能、MoCA评分和SF-36量表各维度评分均明显高于对照组患者,SAS、SDS评分均明显低于对照组患者,差异均有统计学意义(P﹤0.01)。结论心智觉知训练可有效提高乳腺癌化疗患者自我效能,减轻患者化疗期间焦虑、抑郁情绪,改善患者的认知功能,提高患者的生活质量。     

认知行为干预对子宫内膜癌手术患者心理状态、自我效能及生活质量的影响

目的 探讨认知行为干预对子宫内膜癌(EC)手术患者心理状态、自我效能及生活质量的影响.方法 将接受手术治疗的127例子宫内膜癌患者根据干预方案不同分为对照组(n=66,接受常规干预)和观察组(n=61,接受常规干预+认知行为干预).比较两组患者干预前后的心理状态、自我效能、生活质量改善情况并分析干预效果的影响因素.结果 两组患者术中出血量、术后抗生素使用时间比较,差异均无统计学意义(P﹥0.05);观察组患者术后住院时间明显短于对照组(P﹤0.01).干预后,两组患者的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分均明显低于本组干预前,自我效能感量表(GSES)评分明显高于本组干预前,差异均有统计学意义(P﹤0.01);且观察组患者的SAS、SDS评分均明显低于对照组,GSES评分明显高于对照组,差异均有统计学意义(P﹤0.01).干预后,两组患者生活质量(QOL)评分量表各维度评分均明显高于本组干预前(P﹤0.01),且观察组患者QOL量表各维度评分均明显高于对照组(P﹤0.01).Logistic回归模型分析结果显示,年龄≥65岁、文化程度为小学及以下、SAS评分≥50分、SDS评分≥53分、GSES评分﹤30分、QOL评分﹤76分均是EC患者不良干预效果的独立危险因素(P﹤0.05).结论 认知行为干预可改善EC手术患者负性情绪,提高患者的自我效能及生活质量,是一种具有应用前景的新干预模式,可在临床进行推广.     

叙事疗法对肺癌患者疼痛应激、心理弹性和生活质量的影响

目的 探讨叙事疗法对肺癌患者疼痛应激、心理弹性和生活质量的影响.方法 依据干预方法将120例肺癌患者分为观察组(n=65)和对照组(n=55),对照组患者给予常规宣教心理疏导,观察组患者在此基础上给予五步式叙事疗法干预.干预前后,比较两组患者的疼痛应激因子[血清P物质、去甲肾上腺素(NE)、皮质醇、前列腺素E2(PGE2)]水平、情绪状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)和正负性情绪量表(PANAS)]、心理弹性[心理弹性量表(CD-RISC)]、生活质量[简明健康状况调查问卷(SF-36)].结果 干预后,两组患者P物质、NE、皮质醇、PGE2水平均明显低于本组干预前(P﹤0.01),且观察组患者P物质、NE、皮质醇、PGE2水平均明显低于对照组(P﹤0.01).干预后,两组患者PA分量表评分均明显高于本组干预前(P﹤0.01),SAS、SDS和NA分量表评分均明显低于本组干预前(P﹤0.01),且观察组患者PA分量表评分明显高于对照组(P﹤0.01),SAS、SDS和NA分量表评分均明显低于对照组(P﹤0.01).干预后,两组患者SF-36量表各维度评分、CD-RISC量表各维度评分及总分均明显高于本组干预前(P﹤0.01),且观察组患者SF-36量表各维度评分、CD-RISC量表各维度评分及总分均明显高于对照组(P﹤0.01).结论 叙事疗法可有效降低肺癌患者的疼痛应激水平,减轻焦虑、抑郁等负性情绪,增强心理弹性,提高生活质量.     

整合式心理干预对肺癌患者自我感受负担、负性情绪及遵医行为的影响

目的探讨整合式心理干预对肺癌患者自我感受负担、负性情绪及遵医行为的影响。方法选择100例肺癌患者,采用随机数字表法将患者分为对照组和观察组,每组50例。观察组患者给予整合式心理干预,包括错误认知干预、不良行为干预、情感心理支持、疑惑解答支持和运动放松支持5个方面,对照组患者给予常规心理干预。分别采用自我感受负担量表和简明心境量表调查患者的心理负担和负性情绪,应用依从性调查表从运动、饮食、心理和药物4个维度评价患者的遵医行为。比较心理干预前和心理干预6周后患者的自我感受负担、负性情绪、遵医行为评分。结果心理干预前,两组患者的自我感受负担、负性情绪和遵医行为评分比较,差异均无统计学意义(P﹥0.05)。心理干预后,观察组患者的自我感受负担评分为(61.05±6.48)分,明显低于对照组的(71.54±5.16)分,差异有统计学意义(P﹤0.01);观察组患者焦虑、抑郁、愤怒、疲劳、困惑5种负性情绪评分和总评分均明显低于对照组(P﹤0.01);观察组患者在运动、饮食、心理、药物方面的遵医行为评分及总评分均明显高于对照组(P﹤0.01)。结论整合式心理干预有助于减轻肺癌患者的自我感受负担和负性情绪,增强患者的遵医行为,有利于患者积极接受治疗,获得更好的预后。     

聚焦解决模式对肝癌经导管动脉栓塞化疗术患者负性情绪及生活质量的影响

目的 探讨聚焦解决模式对肝癌经导管动脉栓塞化疗术(TACE)患者负性情绪及生活质量的影响.方法 将100例行TACE术的肝癌患者按不同干预方式分为对照组和观察组,每组50例,对照组患者予以术后常规干预,观察组患者在对照组基础上施以聚焦解决模式.两组患者均干预2个月,比较两组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、并发症发生率、生活质量指数量表(QLI)评分、满意度、术后1及2年复发率、生存率.结果 干预后,观察组患者SAS、SDS评分均明显低于对照组(P﹤0.01).观察组患者术后并发症总发生率为12.00％,明显低于对照组的48.00％(P﹤0.01).干预后,观察组患者QLI量表各维度评分均明显高于对照组(P﹤0.01).观察组患者干预态度、干预水平、沟通能力及教育全面性满意度评分均明显高于对照组(P﹤0.01).两组患者术后1、2年复发率及生存率比较,差异均无统计学意义(P﹥0.05).结论 聚焦解决模式可显著改善肝癌患者TACE术后负性情绪,降低术后并发症发生率,提高患者生活质量和满意度.     

陪护家属心理疏导对肝癌合并肾功能衰竭患者焦虑、抑郁情绪及自我管理效能的影响

目的 探讨陪护家属心理疏导对肝癌合并肾功能衰竭患者焦虑、抑郁情绪及自我管理效能的影响.方法 根据术后干预方式的不同将108例肝癌合并肾功能衰竭患者分为观察组(n=55,给予常规干预联合陪护家属心理疏导)和对照组(n=53,给予常规干预).干预前后,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估两组患者的焦虑、抑郁状态;采用健康促进策略量表(SUPPH)评估两组患者的自我管理效能;采用中文版36条目简明健康状况调查问卷(SF-36)评估两组患者的生活质量.结果 干预后,观察组患者的SDS、SAS评分均低于对照组患者,差异均有统计学意义(P﹤0.05).干预后,观察组患者SUPPH量表中正性态度、自我减压、自我决策维度的评分及总分均高于对照组患者,差异均有统计学意义(P﹤0.05).干预后,观察组患者SF-36量表中生理功能、生理职能、社会功能、躯体疼痛、情感职能、活力、精神健康、总体健康维度的评分均高于对照组,差异均有统计学意义(P﹤0.05).结论 陪护家属心理疏导干预模式可缓解肝癌合并肾功能衰竭患者的不良情绪,改善患者的自我管理效能和生活质量.     

基于同伴支持的PDCA循环管理对宫颈癌术后康复进程及负性情绪的影响

目的 探究基于同伴支持的PDCA循环管理对宫颈癌术后康复进程及负性情绪的改善作用.方法将96例宫颈癌患者随机分为观察组和对照组,每组48例.对照组患者采用常规的PDCA循环管理,观察组患者在对照组的基础上予以同伴支持.观察并比较两组患者自护能力、负性情绪、生活质量、性功能以及护理满意度.结果 干预后,两组患者自护能力量表(ESCA)中健康知识、自我概念、自护技能、责任感评分及总分均明显高于本组干预前(P﹤0.01),且观察组均明显高于对照组(P﹤0.01).干预后,两组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均明显低于本组干预前(P﹤0.01),且观察组均明显低于对照组(P﹤0.01).干预后,两组患者简明健康状况调查问卷(SF-36)中角色功能、认知功能、躯体功能、社会功能及情绪功能评分均明显高于本组干预前(P﹤0.01),且观察组均明显高于对照组(P﹤0.01).观察组患者术后性交疼痛、阴道干涩发生率均低于对照组,护理满意度高于对照组,差异均有统计学意义(P﹤0.05).结论 基于同伴支持的PDCA循环用于宫颈癌患者术后康复进程中效果较理想,显著提高患者自护能力,有效缓解患者负性情绪,改善患者生活质量以及性功能障碍等,同时有利于提高护理满意度,值得在临床实践中推广使用.     

多模式健康宣教对肝癌经导管动脉栓塞化疗患者生活质量的影响

目的 探讨多模式健康宣教对肝癌经导管动脉栓塞化疗(TACE)患者生活质量的影响.方法 按照健康宣教方式不同将210例肝癌TACE患者分为观察组和对照组,每组105例,对照组患者给予常规健康教育,观察组患者给予多模式健康宣教.干预前和干预1个月,比较两组患者负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、健康知识掌握度、自我效能、遵医行为和生活质量[癌症患者生命质量测定量表(QLICP)].结果 干预后,两组患者SDS、SAS评分低于本组干预前(P﹤0.05),健康知识掌握度、自我效能和遵医行为评分均高于本组干预前(P﹤0.05),且观察组患者SDS、SAS评分均低于对照组(P﹤0.05),健康知识掌握度、自我效能和遵医行为评分均高于对照组(P﹤0.05).干预后,观察组患者QLICP量表各维度评分及总均分均高于本组干预前和对照组(P﹤0.05).观察组患者的满意度为96.19％,明显高于对照组患者的85.71％(P﹤0.01).结论 多模式健康宣教能够有效改善肝癌TACE患者焦虑、抑郁等负性情绪,改善治疗依从性、自我效能和生活质量.     

Premenopausal intakes of vitamins A, C, and E, folate, and carotenoids, and risk of breast cancer.

Intakes of vitamins A, C, and E, folate, and carotenoids have been hypothesized to reduce the risk of breast cancer. However, previous epidemiological studies on these nutrients and breast cancer risk have been inconclusive, and have included primarily postmenopausal women. We examined the intake of these nutrients in relation to breast cancer risk among 90,655 premenopausal women ages 26-46 years in 1991 in the Nurses' Health Study II. Nutrient intake was assessed with a validated food-frequency questionnaire at baseline in 1991 and in 1995. During 8 years of follow-up from 1991 to 1999, we documented 714 incident cases of invasive breast cancer. Overall, none of the vitamins and carotenoids was strongly related to a reduced risk of breast cancer. However, intake of vitamin A, including preformed vitamin A and carotenoids, was associated with a reduced risk of breast cancer among smokers; participants in the highest quintile of total vitamin A intake had a multivariate relative risk of 0.28 (95% confidence interval 0.12-0.62; P, test for trend <0.001; P, test for interaction <0.001) compared with those in the lowest quintile of intake. We found no evidence that higher intakes of vitamins C and E, and folate in early adult life reduce risk of breast cancer. However, intake of vitamin A may be related to a reduced risk of breast cancer among smokers.     

Intakes of fruits, vegetables, vitamins A, C, and E, and carotenoids and risk of renal cell cancer.

BACKGROUND: Fruits and vegetables rich in antioxidants have been proposed to reduce the risk of renal cell cancer. However, few prospective studies have examined the intakes of fruits, vegetables, and antioxidant vitamins in relation to the risk of renal cell cancer. METHODS: We prospectively examined the associations between the intakes of fruits, vegetables, vitamins A, C, and E, and carotenoids and risk of renal cell cancer in women and men. We followed 88,759 women in the Nurses' Health Study from 1980 to 2000, and 47,828 men in the Health Professionals Follow-up Study from 1986 to 2000. We assessed dietary intake every 2 to 4 years using a validated semiquantitative food frequency questionnaire. The Cox proportional hazards model was used to estimate study-specific multivariate relative risks (RR), which were pooled using a random effects model. RESULTS: A total of 248 (132 women and 116 men) incident renal cell cancer cases were ascertained during 2,316,525 person-years of follow-up. The consumption of fruits and vegetables was associated with a decreased risk of renal cell cancer in men (multivariate RR, 0.45; 95% CI, 0.25-0.81, for >or=6 servings of fruit and vegetable intake/d versus <3 servings/d; P test for trend = 0.02), but not in women (multivariate RR, 1.17; 95% CI, 0.66-2.07, for the same contrast; P test for trend = 0.25; P test for between-studies heterogeneity = 0.02). Intakes of vitamins A and C from food and carotenoids were inversely associated with the risk of renal cell cancer in men only, but we cannot exclude the possibility that this was due to other factors in fruit and vegetables. No clear association was observed for vitamin E in women or men. CONCLUSIONS: Fruit and vegetable consumption may reduce the risk of renal cell cancer in men.     

Occurrence,Efficacy, Metabolism,and Toxicity of Triclosan

Triclosan has broad-spectrum anti-microbial activity against most gram-negative and gram-positive bacteria. It is widely used in personal care products, household items, medical devices, and clinical settings. Due to its extensive use, there is potential for humans in all age groups to receive life-time exposures to triclosan, and, indeed, triclosan has been detected in human tissues and the environment. Data gaps exist regarding the chronic dermal toxicity and carcinogenicity of triclosan, which is needed for the risk assessment of triclosan. The US Food and Drug Administration (FDA) nominated triclosan to the National Toxicology Program (NTP) for toxicological evaluations. Currently, the NTP is conducting several dermal toxicological studies to determine the carcinogenic potential of triclosan, evaluate its endocrine and developmental-reproductive effects, and investigate the potential UV-induced dermal formation of chlorinated phenols and dioxins of triclosan. This paper reviews data on the human exposure, environmental fate, efficacy of anti-microbial activity, absorption, distribution, metabolism and elimination, endocrine disrupting effects, and toxicity of triclosan.     

Age,Race, Sex,Stage, and Incidence of Cutaneous Lymphoma

BackgroundThe incidence of the T- and B-cell CLs has been well documented, but information pertaining to racial incidence by age, and by burden of disease (stage) have not been extensively documented.Materials and MethodsThe SEER 2004-2008 public use database was investigated. The relative incidence of CL in different races and age groups was examined. Univariate and multivariate stepwise logistic regression was performed for the likelihood of presenting at a higher stage.ResultsOf 4496 patients diagnosed with CL between 2004 and 2008; 1713 patients were diagnosed with MF, 1518 with non-MF cutaneous T-cell lymphoma, and 1265 patients with cutaneous B-cell lymphoma. For MF, there was a trend for females to be less likely to present with a higher T-stage (T3-T4) than males (odds ratio [OR], 0.73) on multivariate analysis (P = .06). For race, AA had a significantly increased risk of presenting with higher T-stage (T3-T4) MF (OR, 1.72) on multivariate analysis (P = .02), compared with white patients. For white, AA, Asian/Pacific Islander, and Native American/other/unknown, the mean age at diagnosis was 59.2, 51.5, 51.3, and 53.8. These groups presented at a significantly different age than white (P = .0001, 0.0001, and 0.0006).ConclusionNonwhite racial groups present with MF at an earlier age compared with white, and AA have increased risk of presenting with higher T-stage compared with white. These findings have significant implications regarding need for earlier diagnosis and understanding the reasons for racial disparity in age and stage of presentation.     

Fat, fiber, fruits, vegetables, and risk of colorectal adenomas

A case-control study was conducted at the National Naval Medical Center (Maryland, USA) from 1994 to 1996 to investigate the possible association between dietary factors and colorectal adenomas. Cases (n = 239) were subjects diagnosed with adenomas (146 new and 93 recurrent) by sigmoidoscopy or colonoscopy. Those with no evidence of adenomas found by sigmoidoscopy were recruited as controls (n = 228). Dietary variables, assessed by a 100-item food frequency questionnaire, were analyzed by the logistic regression model, which was adjusted for age, gender and total energy intake. Variables of fat intake were further adjusted for red meat intake. An increased risk of 7% [odds ratio (OR): 1.07; 95% confidence interval (95% CI): 0.94-1.22] per 5% energy/day from total fat was observed. Every additional 5% unit of oleic acid intake/day significantly increased the adenoma risk by 115% (OR: 2.15; 95% CI: 1.05-4.39). Red meat fat increased the risk by 20% (OR: 1.20; 95% CI: 0.71-2.04), and white meat fat decreased the risk by 67% (OR: 0.33; 95% CI: 0.19-0.95) for every additional 5% unit of respective intake/day. Risk decreased by 41% (OR: 0.59; 95% CI: 0.41-0.86) for every additional 5% unit of fiber intake/day. Vegetable [OR per 100 g of vegetable intake/day: 0.83, 95% CI: 0.67-1.04] and fruit (OR per 100 g of fruit intake/day: 0.92, 95% CI: 0.82-1.03) intake showed an inverse association, and the results are suggestive of an association with the risk for adenomas. In conclusion, a strong positive association between oleic acid intake and colorectal adenoma risk was observed. This is likely to be an indicator of "unhealthy" food (meat, dairy, margarine, mayonnaise, sweet baked food) consumption in this population. Increased intake of dietary fiber was associated with a moderately decreased risk of adenomas.     

Tobacco, alcohol, diet, occupation, and carcinoma of the esophagus

Information on occupation, smoking, food and beverage consumption, and medical history were compared between 275 incident cases of carcinoma of the esophagus and 275 neighborhood controls who were matched to the cases on age (within 5 years), race, and sex. Tobacco use, mainly cigarette smoking, was a significant risk factor for carcinoma of the esophagus. Ex-smokers of cigarettes showed a reduced risk relative to those who continued to smoke, and current smokers of two or more packs per day displayed a higher risk than those who smoked less. Alcohol consumption was another significant risk factor for carcinoma of the esophagus; there was a highly significant trend with average daily dose of ethanol. Relative to controls, cases also consumed significantly more fried bacon or ham, less fresh fruits and raw vegetables, and were more likely to prefer white than whole grain bread. Finally, there was a significant association between carcinoma of the esophagus and long-term occupational exposure to metal dust; this association was largely confined to the lower one-third section of the esophagus.     

Antitumor activity of halogen analogs of phosphoramide,isophosphoramide, and triphosphoramide mustards,the cytotoxic metabolites of cyclophosphamide,ifosfamide, and trofosfamide

A series of halogen analogs of phosphoramide mustard, isophosphoramide mustard, and triphosphoramide mustard, the cytotoxic metabolites of the antitumor drugs cyclophosphamide, ifosfamide, and trofosfamide, respectively, was evaluated in vitro against human tumor cell lines and in vivo against experimental tumors to investigate the effect of replacement of chlorine with bromine or fluorine on the antitumor activity of the parent phosphoramide mustards. In the experimental tumors L1210 leukemia, B16 melanoma, mammary adenocarcinoma 16/C, and ovarian sarcoma M5076, the antitumor activity of the analogs was observed to be generally comparable with that of the parent mustards when chlorine was replaced by bromine but uniformly lower when chlorine was replaced by fluorine. Furthermore, the monobromo analog of isophosphoramide mustard displayed equal or somewhat greater activity in comparison with cyclophosphamide when evaluated against subcutaneously implanted L1210 leukemia with intraperitoneal drug treatment and against mammary adenocarcinoma 16/C.This work was financially supported by NIH, NCI grant PO1 CA34200     

Consumption of alcohol,coffee, and tobacco,and gastric cancer in Spain

A case-control study on gastric cancer was carried out between 1987 and 1989 in four regions of Spain. Three hundred and fifty-four cases of histologically confirmed adenocarcinoma were included (235 men and 119 women). For each case, a control was selected, matched by sex, age, and area of residence, from the same hospital as the case. No association was observed with smoking, nor with the consumption of coffee or tea. The usual consumption of alcohol was associated with gastric cancer in men (odds ratio = 1.54, 95 percent confidence interval = 1.03–2.31), but there was no dose-response relationship. No association was observed in women. All estimations were carried out taking into account the effect of the dietary factors associated with gastric cancer. In accordance with previous evidence, the association observed between gastric cancer and alcohol appears not to be causal.Drs Agudo and González are with the Unit of Epidemiology, Hospital de Mataró, Mataró, Spain. Dr Marcos is with the Department of Preventive Medicine, Hospital Clínico, Zaragoza, Spain. Dr Sanz is with the Department of Pathology, Hospital del INSALUD, Soria, Spain. Dr Saigi is with the Department of Oncology, Hospital General de Granollers, Granollers, Spain. Dr Verge is with the Department of Surgery, Hospital de Terrassa, Terrassa, Spain. Dr Boleda is with the Department of Oncology, Hospital S. Camil, Sant Pere de Riba, Sapin. Dr Ortego is with the Department of Pathology, Hospital Clínico, Zaragoza, Spain. Address correspondence to Dr Agudo, Unit of Epidemiology, Hospital de Mataró, c. Hospital 31, 08301 Mataró, Spain. This study received financial support from the Health Research Fund (FIS) of the Spanish Ministry of Health (Financial Aid for Research exp. 87/1703, exp. 89/0018 and exp. 89/0743) and from the International Agency for Research on Cancer (Collaborative Research Agreement AEP/88/02).     

A comparison of general,genitourinary, bowel,and sexual quality of life among long term survivors of prostate,bladder, colorectal,and lung cancer

ObjectivesStudies of local stage prostate cancer survivors suggest that treatments carry risk of persistent impotence, incontinence, and bowel dysfunction. To examine impacts of cancer type and side effects on health-related quality of life (HRQoL) in long-term cancer survivorship, we evaluated 5-year follow-up of patients with prostate cancer and compared results with a matched group of male long-term survivors of other local-stage cancers.Materials and MethodsWe examined genitourinary, bowel and sexual symptoms, and general quality of life. Matched survivors of colorectal, lung, and bladder cancers were recruited via registries in 3 different regions in the United States. Patients were surveyed 3–5 years after diagnosis with the SF-12 and EPIC to evaluate general mental and physical health-related quality of life (HRQoL) and patient function and bother.ResultsWe analyzed responses from long-term prostate (n = 77) and bladder, colorectal, and lung cancer (n = 124) patients. In multivariate analysis, long-term local stage prostate cancer survivors had significantly higher SF-12 physical component scores but did not differ from long-term survivors of other cancers in terms of their SF-12 mental summary scores. Prostate survivors had similar mental, urinary, bowel, and sexual HRQoL compared to long-term survivors of other local stage cancers.ConclusionLong-term general and prostate-specific HRQoL was similar between local stage prostate and bladder, colorectal, and lung patients with cancer. Future research focusing on factors other than initial treatment and the cancer type per se may provide more meaningful information regarding factors that predict disparities on HRQoL among longer-term survivors of early stage male cancers.