Lifestyle and quality of life in colorectal cancer survivors

Purpose  

As cancer survival rates improve, there is growing interest in the role of lifestyle in longer-term health and quality of life (QoL). This study examined the prevalence of health-related behaviours, and the associations between health behaviours and QoL, in colorectal cancer survivors.     

A prospective comparison of quality of life measures for patients with esophageal cancer

Among the most widely used instruments to assess quality of life (QOL) in patients with cancer are the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30) and the Functional Assessment of Chronic Illness Therapy, cancer instrument (FACT-G). This study compared these approaches in patients who had undergone esophagectomy for cancer. The EORTC core questionnaire and esophageal module and the FACT-G and esophageal scale were completed by 57 patients. Missing data, relationships between QOL scales and analyses of patients preferences were examined. There were 14/2736 (0.5%) missing items from EORTC questionnaires and 45/2565 (1.8%) from FACT instruments (p < 0.01). Relationships between corresponding generic EORTC and FACT scales were average to good (r 0.57) except for the social function scale (r = 0.01). EORTC symptom scores were moderately correlated with the FACT general scale, but poorly related to the FACT esophageal scale (r < 0.28). EORTC swallowing scores were moderately correlated with all FACT scales. The FACT-E and EORTC QLQ-C30 measure assess similar generic aspects of QOL (except social function). EORTC esophageal symptom scores relate poorly to FACT esophageal scales, except for swallowing. Choice of QOL measure after esophagectomy for cancer depends upon outcomes of interest. Future studies will determine which instruments are appropriate in each context.     

A prospective longitudinal study investigating neuroticism and mastery as predictors of quality of life among Chinese gynecologic cancer survivors

Purpose  

The aim of the study was to examine the role of neuroticism and mastery in predicting the quality of life (QOL) among Chinese gynecologic cancer survivors.     

Health-related quality of life in family members of patients with an advanced cancer diagnosis: A one-year prospective study

ABSTRACT: BACKGROUND: Receiving a cancer diagnosis affects family members as well as the person diagnosed. Family members often provide support for the sick person in daily life out of duty and love, and may not always think of their own vulnerability to illness. To individualise support for them, family members who are most at risk for becoming ill must be identified. The aim of this study was to investigate health-related quality of life (HRQOL) in family members of patients with advanced lung or gastrointestinal cancer 3 to 15 months after diagnosis. METHODS: Data on mental and physical dimensions of HRQOL were collected from family members of these patients in this prospective quantitative study. Five assessments using the Short Form 36 Health Survey (SF-36) and EuroQol (EQ-5D) were conducted during a 1-year period starting 3 months after diagnosis. Thirty-six family members completed the study, i.e. participated in all five data collections. RESULTS: No statistically significant changes in physical or mental HRQOL within the study group appeared over the 1-year follow-up. Compared with norm-based scores, family members had significantly poorer mental HRQOL scores throughout the year as measured by the SF-36. Family members also scored statistically significantly worse on the EQ-5D VAS in all five assessments compared to the norm-based score. Findings showed that older family members and partners were at higher risk for decreased physical HRQOL throughout the 1-year period, and younger family members were at higher risk for poorer mental HRQOL. CONCLUSIONS: It is well known that ill health is associated with poor HRQOL. By identifying family members with poor HRQOL, those at risk of ill health can be identified and supported. Future large-scale research that verifies our findings is needed before making recommendations for individualised support and creating interventions best tailored to family members at risk for illness.     

Predictors of health-related quality of life in patients with colorectal cancer

Background  

Most studies that have identified variables associated with the health-related quality of life (HRQL) of patients with colorectal cancer have been cross-sectional or included patients with other diagnoses. The objectives of this study were to identify predictors of HRQL in patients with colorectal cancer and interpret the clinical importance of the results.     

Longitudinal associations of light-intensity physical activity with quality of life,functioning and fatigue after colorectal cancer

Quality of Life Research - Evidence from cross-sectional studies suggests that higher levels of light-intensity physical activity (LPA) are associated with better health-related quality of life...     

Alcohol drinking and colorectal cancer: A population-based prospective cohort study in China

Study objective: To asses the association between alcohol consumption and the risk of colorectal cancer (CRC) in the Chinese population. Design: A population-based prospective cohort study was initiated from the colorectal cancer screening population in Jiashan County in 1989–1990. The drinking habits of individuals were investigated with demographic information. Setting: A cohort study was followed-up from 1st May 1990 to 1st January 2001 and censored at the date of diagnosis of CRC, at death from any causes, or at 1st January 2001, whichever came first, and the person-time was computed. Participants: Two hundred and forty two CRC patients were diagnosed during the study period and 64,100 individuals finished the follow-up. Results: The distribution of sex, smoking status, occupation, education level and marital status were all significantly different among different drinking habits at baseline. When the above factors were adjusted, no significant association was observed between alcohol consumption and the risk of CRC. Exclusion of individuals diagnosed cancer less than 1 year after the examination date did not alter the strength of an alcohol–CRC relationship. Further analysis in sex strata also did not show a significant relationship. Conclusions: Alcohol drinking may not be associated with a higher risk of CRC in the Chinese population.This revised was published online in April 2005. In the previous version the article category was missing.     

Measurement of the quality of life after cancer treatment

Until treatment is totally effective and side effects nonexistent it is important that the quality of life of patients undergoing cancer treatment is properly evaluated. Such studies will improve clinical investigations and shift the emphasis away from disease activity to patient benefit.     

Professional quality of life and organizational changes: a five-year observational study in Primary Care

Background  

The satisfaction and the quality of life perceived by professionals have implications for the performance of health organizations. We have assessed the variations in professional quality of life (PQL) and their explanatory factors during a services management decentralization process.     

Quality of life after stroke: a prospective longitudinal study

Purpose  

To measure the impact of stroke on quality of life (QOL), and analyze whether race, gender, age, income, or living alone moderated those changes, using prospective longitudinal methods.     

A comparison of prospective and retrospective assessments of diet in a study of colorectal cancer

Dietary factors are widely studied as risk factors for colorectal cancer, with much information from case-control studies. We evaluated the validity of dietary data from a retrospective case-control study of diet and colorectal cancer. As part of the alpha-Tocopherol, beta-Carotene Cancer Prevention Study, diet was assessed at baseline and after diagnosis for colorectal cancer cases and at baseline and regularly during the trial for a random control group. The dietary assessment referred to the previous 12 months (in cases before diagnosis). In the two dietary assessments, the cases reported a greater increase in consumption of fruits and dairy products and a decrease in consumption of potatoes. Accordingly, relative risks for colorectal cancer by baseline dietary data differed markedly from odds ratios from case-control data; e.g., relative risk for a 652-mg increase in calcium intake was 0.79 (95% confidence interval = 0.48-1.30) in case-cohort analysis vs. an odds ratio of 1.57 (95% confidence interval = 1.06-2.33) for case-control analysis. The most likely explanation is the influence of current diet on recall of prediagnosis diet and effects of occult cancer on diet in the year before cancer diagnosis, which have implications for interpretation of case-control studies in evaluating associations between diet and colorectal cancer.     

A comparison of prospective and retrospective assessments of diet in a study of colorectal cancer

Dietary factors are widely studied as risk factors for colorectal cancer, with much information from case‐control studies. We evaluated the validity of dietary data from a retrospective case‐control study of diet and colorectal cancer. As part of the α‐Tocopherol, β‐Carotene Cancer Prevention Study, diet was assessed at baseline and after diagnosis for colorectal cancer cases and at baseline and regularly during the trial for a random control group. The dietary assessment referred to the previous 12 months (in cases before diagnosis). In the two dietary assessments, the cases reported a greater increase in consumption of fruits and dairy products and a decrease in consumption of potatoes. Accordingly, relative risks for colorectal cancer by baseline dietary data differed markedly from odds ratios from case‐control data; e.g., relative risk for a 652‐mg increase in calcium intake was 0.79 (95% confidence interval = 0.48–1.30) in case‐cohort analysis vs. an odds ratio of 1.57 (95% confidence interval = 1.06–2.33) for case‐control analysis. The most likely explanation is the influence of current diet on recall of prediagnosis diet and effects of occult cancer on diet in the year before cancer diagnosis, which have implications for interpretation of case‐control studies in evaluating associations between diet and colorectal cancer.     

A study of quality of life in cancer patients receiving palliative chemotherapy.

Although primary treatment for cancer has been associated with psychosocial distress, less research has focused on patients with advanced disease. Traditionally, the outcomes of treatment have been assessed using biomedical criteria, including tumour regression, progression and survival. It is argued that these data are inadequate to understand the impact of cancer upon the patient. Instead, quality of life considerations are crucial when treatments are aversive, especially when the aims are palliative rather than curative. Fifty-three patients with advanced breast cancer or ovarian cancer were studied prospectively for 6 months to assess whether the site and method of chemotherapy administration influenced their quality of life. Patients received palliative chemotherapy either at home or in hospital. Quality of life was operationalized as measurement of anxiety, depression, self-esteem, health locus of control, physical performance and symptoms. In addition, semi-structured interviews explored social roles, relationships, and perceptions of treatment. Hospital administered chemotherapy was perceived to be most distressing. Regression analysis indicated that anxiety and depression accounted for most of the variance in quality of life. Patients who died during the study 13 (24%) experienced considerable psychological and physical morbidity. Women over 60 years, experienced less psychological and physical distress. Quality of life broadens the criteria by which cancer treatments are evaluated, to include the experience of the patient.     

Determinants of global quality of life before and after major cancer surgery: an exploratory study

Objective  

To explore whether determinants of global quality of life (QOL) change before and after major cancer surgery.     

Gender-specific changes in quality of life following cardiovascular disease: a prospective study

Gender-specific changes in Quality of Life (QoL) following cardiovascular disease (CVD) were studied in 208 patients to determine whether gender-related differences in postmorbid QoL result from differences in disease severity, premorbid QoL, or different CVD-related recovery. Premorbid data were available from a community-based survey. Follow-ups were done at 6 weeks, 6 months, and 12 months after diagnosis. Results showed that females had worse QoL at all three postmorbid assessments compared to males. However, multivariate analyses adjusting for premorbid gender differences and disease severity showed no significant gender-related differences for physical and psychologic functioning. Therefore, gender differences in QoL following CVD mainly result from premorbid differences in QoL, age, comorbidity, and disease severity at the time of diagnosis, and do not appear to be the consequence of gender-specific recovery. However, in clinical practice it is important to acknowledge the poorer QoL of females following CVD.     

结直肠癌患者生命质量及其影响因素研究

目的评价结直肠癌患者的生命质量和社会支持,并探讨其相关的影响因素。方法采用欧洲癌症研究与治疗组织（EORTC）QLQ-C303.0生命质量问卷（中文版）和社会支持评价量表（SSRS）对103例结直肠癌术后患者进行调查。结果结直肠癌患者社会支持的总体状况较好。生命质量得分的多元线性回归分析结果表明,术后症状数目多是影响结直肠癌患者生命质量的不利因素,而高文化程度、好的社会支持、性格外向是影响结直肠癌患者生命质量的有利因素。结论加强术后护理,减少结直肠癌患者术后合并症状,增加结直肠癌患者的社会支持以及开展术后心理督导有利于改善结直肠癌患者的生命质量。     

A follow-up study of the quality of life in cancer patients with different prognoses

The present study examines differences in quality of life between two points in time in a heterogeneous sample of cancer patients with different prognoses. The original sample comprised 253 patients, while the follow-up data obtained 3–4 years later included 75 patients, that is, 92% of the survivors. All the patients completed a questionnaire including the EORTC QLQ-C30. The research questions focus on overall changes in quality of life, and whether patients with a good prognosis would show less negative changes in quality of life than patients with a poor prognosis. The overall observed changes in quality of life were surprisingly small over a 3–4 year period. This study shows that prognoses do predict changes in social functioning and in some physical aspects of quality of life over a 3–4 year period after the assessment of prognoses by physicians. Prognoses did not, however, predict changes in psychological aspects of quality of life.