Quality of life as a predictor of cancer survival among Chinese liver and lung cancer patients

The utility of quality of life (QoL) scores in predicting cancer survival remains inconclusive because of methodological and/or statistical heterogeneity. We examined whether QoL scores predicted survival among Chinese liver (n=176) and lung cancer (n=358) patients. Cox proportional hazards models examined if QoL and psychosocial variables predicted survival after fully adjusting for sociodemographic and clinical factors. The results showed that global QoL scores did not predict survival in either patient group. Less advanced cancer stage (HR=2.574, p<0.05) was associated with longer survival in liver cancer. Longer survival in lung cancer was predicted by younger age (HR=1.016, p<0.05), less advanced cancer stage (HR=1.978, p<0.001), having had treatment before baseline (HR=0.671, p<0.05), better physical well-being (HR=0.941, p<0.001) and better appetite (HR=0.888, p<0.001). Global QoL (FACT-G(Ch)) scores do not predict survival in Chinese liver and lung cancer patients. QoL physical well-being subscale predicted lung cancer survival.     

Depressive symptoms, eating psychopathology, and physical activity in obese breast cancer survivors

Psychosocial problems such as depression are present as long-term sequelae of breast cancer and its treatment in a substantial minority of patients. In general and patient populations, lifestyle factors such as obesity and physical activity have been associated with depression, and these and related characteristics may be associated with depression in breast cancer survivors. The purpose of this cross-sectional study was to examine factors associated with depression in overweight or obese women (n=85) who had been diagnosed and treated for early stage breast cancer. Depressive symptoms were measured with the Beck depression inventory (BDI), eating psychopathology was assessed with the eating disorder examination--questionnaire (EDE-Q), and physical activity was estimated with the seven-day physical activity recall. BDI was directly correlated with global EDE-Q score (r=0.56, P<0.01) and inversely associated with age (r=-0.22, P<0.05) in bivariate analysis. Controlling for body mass index, age, education and other factors, BDI was directly associated with global EDE-Q score (P<0.001) and inversely associated with level of physical activity (P<0.05) in a model that explained 61% of the variance. Eating attitudes and behaviors, and physical activity level, are independently associated with depressive symptoms in overweight or obese breast cancer survivors.     

Impact of Healthy Eating Practices and Physical Activity on Quality of Life among Breast Cancer Survivors

Following breast cancer diagnosis, women often attempt to modify their lifestyles to improve their healthand prevent recurrence. These behavioral changes typically involve diet and physical activity modification. Theaim of this study was to determine association between healthy eating habits and physical activity with qualityof life among Iranian breast cancer survivors. A total of 100 Iranian women, aged between 32 to 61 years wererecruited to participate in this cross-sectional study. Eating practices were evaluated by a validated questionnairemodified from the Women’s Healthy Eating and Living (WHEL) study. Physical activity was assessed usingthe International Physical Activity Questionnaire (IPAQ). A standardized questionnaire by the EuropeanOrganization of Research and Treatment of Cancer Quality of Life and its breast cancer module (EORTCQLQ-C30/+BR-23) were applied to determine quality of life. Approximately 29% of the cancer survivors werecategorized as having healthy eating practices, 34% had moderate eating practices and 37% had poor eatingpractices based on nutrition guidelines. The study found positive changes in the decreased intake of fast foods(90%), red meat (70%) and increased intake of fruits (85%) and vegetables (78%). Generally, breast cancersurvivors with healthy eating practices had better global quality of life, social, emotional, cognitive and rolefunctions. Results showed that only 12 women (12%) met the criteria for regular vigorous exercise, 22% hadregular moderate-intensity exercise while the majority (65%) had low-intensity physical activity. Breast cancersurvivors with higher level of physical activity had better emotional and cognitive functions. Healthy eatingpractices and physical activity can improve quality of life of cancer survivors. Health care professionals shouldpromote good dietary habits and physical activity to improve survivors’ health and quality of life.     

The value of quality of life and health status measurements in the evaluation of the well-being of breast cancer survivors

Background

Quality of life (QoL) in breast cancer survivors has become increasingly important. However, QoL is often assessed using a questionnaire meant to assess health status (HS). In this study the differences in outcomes between a HS and QoL questionnaire are shown and the correlation between both questionnaires is assessed.

Methods

From the 140 breast cancer survivors that participated in the study, 68 received breast conserving therapy (BCT) and 72 were treated with mastectomy (MTC). HS was measured using the RAND-36 and QoL was assessed with the WHOQOL-100. Scores were compared with healthy reference populations.

Results

The scores on QoL in both treatment groups were comparable to those of healthy women. HS scores showed lower physical functioning and general health perceptions for the MTC women. Pearson correlations between both questionnaires ranged between 0.19 and 0.75. Thus, the results of both questionnaires were not interchangeable.

Conclusion

A HS questionnaire reflects functional impairments and reveals different areas of concern compared with a QoL questionnaire. The latter reflects the (dis)satisfaction of a patient and this seems not to mirror the functional limitations. Assessment of both objective functioning and subjective appraisal of functioning will result in treatment suggestions that meet the patients needs.     

中山市2006年恶性肿瘤发病概况

[目的]分析研究2006年中山市恶性肿瘤发病情况,为中山市恶性肿瘤防治提供科学依据。[方法]收集整理2006年中山市肿瘤登记处登记的恶性肿瘤发病资料,统计分析其发病数、粗发病率、中国与世界标化发病率、发病构成比等指标。[结果]2006年中山市恶性肿瘤男女世界标化发病率分别为234.09/10万与159.31/10万,男性发病前5位恶性肿瘤依次是肺、肝、鼻咽、食管和胃恶性肿瘤,女性依次是乳腺、肺、宫体、鼻咽和结肠癌,鼻咽癌占中山市同期男女恶性肿瘤发病顺位的第3、4位。[结论]2006年中山市恶性肿瘤发病位于国内外发病较高水平,且其发病有上升趋势,提示应加强中山市恶性肿瘤防治工作。     

Associations between lifestyle factors and quality of life among older long‐term breast,prostate, and colorectal cancer survivors

BACKGROUND:

Older cancer survivors are at increased risk for secondary cancers, cardiovascular disease, obesity, and functional decline and, thus, may benefit from health‐related interventions. However, to the authors' knowledge, little is known regarding the health behaviors of older cancer survivors and the associations of those behaviors with quality‐of‐life outcomes, especially during the long‐term post‐treatment period.

METHODS:

In total, 753 older (aged ≥65 years) long‐term survivors (≥5 years postdiagnosis) of breast, prostate, and colorectal cancer completed 2 baseline telephone interviews to assess their eligibility for a diet and exercise intervention trial. The interviews assessed exercise, diet, weight status, and quality of life.

RESULTS:

Older cancer survivors reported a median of 10 minutes of moderate‐to‐vigorous exercise per week, and only 7% had Healthy Eating Index scores >80 (indicative of healthful eating habits relative to national guidelines). Despite their suboptimal health behaviors, survivors reported mental and physical quality of life that exceeded age‐related norms. Greater exercise and better diet quality were associated with better physical quality‐of‐life outcomes (eg, better vitality and physical functioning; P < .05), whereas greater body mass index was associated with reduced physical quality of life (P < .001).

CONCLUSIONS:

The current results indicated a high prevalence of suboptimal health behaviors among older, long‐term survivors of breast, prostate, and colorectal cancer who were interested in lifestyle modification. In addition, the findings pointed to the potential negative impact of obesity and the positive impact of physical activity and a healthy diet on physical quality of life in this population. Cancer 2009. © 2009 American Cancer Society.     

Familial cancer history and lung cancer risk in United States nonsmoking men and women.

The authors conducted a population-based case-control study of lung cancer in nonsmoking men and women in New York State from 1982 to 1984. Nonsmokers included both never smokers (45%) and former smokers who had quit at least 10 years before diagnosis/interview (55%). In-person interviews were completed for 437 lung cancer cases and 437 matched population controls. Cases and controls were asked to report on their family history of cancer, as well as smoking status of family members. Cases were significantly more likely than controls to report having a paternal history of any cancer [odds ratio (OR), 1.67] and aerodigestive tract cancers (OR, 2.78); a maternal history of breast cancer (OR, 2.00); a history of any cancer in brothers (OR, 1.58) and sisters (OR, 1.66); and a nearly significant excess of lung cancer (OR, 4.14; P = 0.07), aerodigestive tract cancer (OR, 3.50; P = 0.06), and breast cancer (OR, 2.07; P = 0.053) in sisters. The excess risk in relatives of cases as compared to relatives of controls also was evident in a cohort analysis of the relatives. These results support the hypothesis of a genetic susceptibility to various cancers in families with lung cancer in nonsmokers.     

Cancer in Alaskan Indians, Eskimos, and Aleuts

Standard incidence ratios for cancers that occurred during 1969--73 among Alaskan Natives (Indians and Eskimo-Aleuts) were reported. Although data suggested that the overall rate of cancer in this population was close to that of U.S. whites, differences existed for certain cancer sites. Thus increased risks in Alaskan Natives were observed for nasopharyngeal, salivary gland, kidney, and gallbladder and liver cancers. Conversely, decreased risks were found for cancers of the lung, larynx, bladder, prostate gland, breast, and corpus uterus and for melanoma and lymphoma.     

Health‐related quality of life associated with different cancer treatments in Chinese breast cancer survivors in Taiwan

We assessed the quality of life (QoL) associated with patient's characteristics and different cancer treatments among Chinese breast cancer survivors in Taiwan. A cross‐sectional survey was conducted in 2017 where 193 patients with hormone receptor‐positive/human epidermal growth factor receptor‐2‐negative metastatic breast cancer were recruited. Three QoL questionnaires were administered: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ‐C30), its breast cancer supplementary measure (QLQ‐BR23) and EQ‐5D‐5L. Multiple linear regression was performed to assess the association between QoL and cancer treatments, with adjustment for patient's characteristics. The mean age of study participants was 55.52 years. Simple linear regression showed that cancer stage and receiving chemotherapy were significantly associated with QoL scores (p < 0.05). Significant adverse effects of chemotherapy on QoL were found among early‐stage cancer women (i.e., I or II), including poor cognitive and sexual functioning, and a higher symptom burden (i.e., dyspnoea, constipation, systematic therapy side effects). Multiple linear regression also revealed that receiving chemotherapy was significantly associated with poor QoL (e.g., lower functional health and higher symptom burden measured by the QLQ‐BR23), compared to none chemotherapy (p < 0.05). Receiving chemotherapy was associated with poor QoL, especially among early‐stage breast cancer patients.     

Impact of fatigue on overall quality of life in lung and breast cancer patients selected for high-dose radiotherapy.

BACKGROUND: Although studies show that cancer patients consider fatigue as an important problem, few, if any, studies have quantified the impact of fatigue on overall quality of life (QoL) in cancer patients. In the present study, we evaluated the relative impact of different QoL domains/subscales, including fatigue, on overall QoL in cancer patients preceding radiotherapy. PATIENTS AND METHODS: Sixty-four patients with lung or breast cancer selected for high-dose radiotherapy on the primary tumour completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Multivariate models were fitted to define the impact of QLQ-C30 subscales, including fatigue, on overall QoL. RESULTS: Of all QLQ-C30 subscales, fatigue showed by far the strongest univariate correlation with overall QoL (r = -0.76, P < 0.001); correlations for functioning subscales (r = 0.44-0.55) and symptom subscales (r = -0.31 to -0.45) were considerably lower. In multivariate analyses, adjusting for potential confounders, fatigue was the only subscale that independently contributed to overall QoL (standardized regression coefficient-0.57, P < 0.001). CONCLUSION: Our results indicate that, of all QoL domains/subscales, fatigue is by far the predominant contributor to patient-perceived overall QoL in both lung and breast cancer patients preceding high-dose radiotherapy.     

Temporal relationship between cancers of the lung and upper aerodigestive tract

We retrospectively reviewed the chart records at the Veterans General Hospital-Taipei for the period between January 1985 and December 1994 to examine the temporal relationship between cancers of the lung and upper aerodigestive tract. A total of 56 patients (54 males, 2 females) with histocytologically proven double primary cancers, with either lung cancer or upper aerodigestive tract cancers appearing first, were found. Squamous cell carcinoma was the most frequent histologic type of lung cancer (squamous 57%, adenocarcinoma 27%, poorly differentiated carcinoma 9%, small cell lung cancer 7%). The incidence of lung cancer patients with upper aerodigestive tract cancer was 0.9% (56/6412). There was no significant difference in the occurrence of upper aerodigestive tract cancer between non-small cell and small cell lung cancer (P > 0.05). However, the incidence of squamous cell lung cancer with upper aerodigestive tract cancer was higher than that of non-squamous cell lung cancer (P < 0.05). With regard to the location of lung cancer, the right lung was more commonly affected than the left (P < 0.001). The locations of upper aerodigestive tract cancers in these lung cancer patients were as follows: larynx 24, nasopharynx 11, esophagus 10, hypopharynx 4, pharyngeal tonsils 2, oral cavity 5. Most upper aerodigestive tract cancers were diagnosed before lung cancer (36/56, 64%), and lung cancer was diagnosed within 3 years in more than half of cases after the diagnosis of upper aerodigestive tract cancer (58.3%). Most lung cancers that preceded upper aerodigestive tract cancer were at an early stage at diagnosis (stage I 4, stage Illa 1), whereas the others, appearing either synchronously or after the diagnosis of upper aerodigestive tract cancer, were mostly at the late stage. There was no difference in survival between lung cancer patients with upper aerodigestive tract cancer and those without (P > 0.05).      

Proportion of lung cancers in males, due to occupation, in different areas of the USA

Occupational data from 5 case-control studies in the United States involving 2,973 male cases and 3,210 controls were analyzed to estimate the percentage of lung cancer attributable to well-known and suspected lung carcinogens. The studies were conducted in areas heterogeneous in terms of industrial activities. The percentage of lung cancers attributable to occupations entailing potential exposure to well-recognized carcinogens ranged, by study area, from 3 to 17%. The further inclusion of occupational groups with suspect carcinogenic exposures changed these estimates very little. Exclusion of data derived from next-of-kin interviews influenced the estimates of attributable risks, but not in a systematic fashion. The estimates also varied according to ethnic group, smoking status and birth cohort, with higher values in non-whites, non-smokers and among members of more recent birth cohorts. Possible errors in exposure classification, which may make these estimates conservative, are discussed.     

绍兴市区1996年～2000年居民恶性肿瘤发病分析

[目的]了解绍兴市区1996年—2000年恶性肿瘤发病情况，为防治工作提供依据。[方法]调查人员经培训后，对市区居民展开全面调查登记，根据ICD-9进行恶性肿瘤分类统计，计算发病率、标化发病率。[结果]绍兴市区恶性肿瘤年平均发病率213．92／10万，标化发病率为153．7／10万。男性标化发病率居前5位的是：肺癌、胃癌、肝癌、大肠癌、食管癌；女性标化发病率居前5位的是：肺癌、乳腺癌、胃癌、大肠癌、肝癌，总标化发病率居前5位的是：肺癌、胃癌、大肠癌、肝癌、乳腺癌。[结论]绍兴市区恶性肿瘤以肺癌和消化系统肿瘤为主，应作为防治重点。     

Mortality of Major Cancers in Guangxi,China: Sex,Age and Geographical Differences from 1971 and 2005

The incidence and mortality rates of liver and nasopharyngeal cancer in Guangxi province of China havealways been among the highest in the world, and cancer is one of the major diseases that pose a threat to thehealth of residents in Guangxi. However, no systematic study has been performed to evaluate the time trendsin the structure of cancer-related deaths and cancer mortality. In this study, we reveal sex, age and geographydifferences of cancers mortality between three death surveys (1971 to 1973, 1990 to 1992, and 2004 to 2005). Theresults show that the standardized mortality rate of cancer in Guangxi residents has risen from 43.3/100,000to 84.2/100,000, the share of cancer deaths in all-cause deaths has increased from 13.3% to 20.7%, and cancerhas become the second most common cause of death. The five major cancers, liver cancer, lung cancer, gastriccancer, nasopharyngeal cancer and colorectal cancer, account for 60% of all the cancer deaths. Cancers withgrowing mortality rates over the past 30 years include lung cancer, colorectal cancer, liver cancer and femalebreast cancer, of which lung cancer is associated with the sharpest rise in mortality, with a more than 600% risein both men and women. Cancer death in Guangxi residents occurs mainly in the elderly population above 45years of age, especially in people over the age of 65. The areas with the highest mortality rates for liver cancerand nasopharyngeal cancer, which feature regional high incidences, include Chongzuo and Wuzhou. Therefore,for major cancers such as liver cancer, lung cancer, gastric cancer, nasopharyngeal cancer and female breastcancer in Guangxi, we can select high-risk age groups as the target population for cancer prevention and controlefforts in high-prevalence areas in a bid to achieve the ultimate goal of lowering cancer mortality in Guangxi.     

Familial upper aerodigestive tract cancers: incidence trends,familial clustering and subsequent cancers

Familial risks in upper aerodigestive tract cancer have been assessed mainly through case-control studies based on reported but not medically verified cancers in family members. The nationwide Swedish Family-Cancer Database was used to describe the incidence trends for all subsites of upper aerodigestive tract cancer and to calculate standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for the cancer in 0-66-year-old offspring by cancers in family members. Additionally, SIRs for second primary cancer after upper aerodigestive tract cancers were analysed. SIRs in offspring for all upper aerodigestive tract cancer were not significant when a parent presented with concordant cancer. The population attributable fraction of familial upper aerodigestive tract cancer was 0.43%. Risk for subsequent cancers in men and women after upper aerodigestive tract cancer were increased in smoking, alcohol and other life-style related sites and in skin cancer and non-Hodgkin's lymphoma.     

Cancer mortality in East and Southeast Asian migrants to New South Wales, Australia, 1975-1995

Routinely collected data for New South Wales were used to analyse cancer mortality in migrants born in East or Southeast Asia according to duration of residence in Australia. A case-control approach compared deaths from cancer at particular sites with deaths from all other cancers, adjusting for age, sex and calendar period. Compared with the Australian-born, these Asian migrants had a 30-fold higher risk of dying from nasopharyngeal cancer in the first 2 decades of residence, falling to ninefold after 30 years, and for deaths from liver cancer, a 12-fold risk in the first 2 decades, falling to threefold after 30 years. The initial lower risk from colorectal, breast or prostate cancers later converged towards the Australian-born level, the change being apparent in the third decade after migration. The relative risk of dying from lung cancer among these Asian migrants was above unity for each category of duration of stay for women, but at or below unity for men, with no trend in risk over time. An environmental or lifestyle influence for nasopharyngeal and liver cancers is suggested as well as for cancers of colon/rectum, breast and prostate.     

Health-related quality of life after chemotherapy cycle in breast cancer in Iran

The aim of this study was to compare the differences between the level of whole quality of life and its subscales after receiving two common treatment of breast cancer in women with early stage of breast cancer. A double-blinded cohort study was done in 100 breast cancer patients with node positive that used fluorouracil, doxorubicin, cyclophosphamide (FAC) and docetaxel, doxorubicin and cyclophosphamide (TAC) regimen as adjuvant therapy. Patients were followed for 4 months since the end of chemotherapy. Health-related quality of life was assessed using questionnaire (QLQ-C30) from European Organization for Research and Treatment of Cancer (EORTC). Independent t-test analysis was used at the significant level of 0.05 for analyzing the results. The mean of age was 48.49 ± 10.63 in these patients. QoL scores were 64 and 68 in TAC and FAC groups, respectively (P < 0.001). After 4 months, patients in TAC and FAC groups experienced 11.45 and 7.14 units of improvement in QoL scores, respectively (P = 0.02). Although, TAC had a more negative impact on QoL during chemotherapy, it created a higher improvement than FAC during 4 months since the end of treatment. These effects on quality of life should be considered in making decision for providing and financing cancer treatments in Iran.     

Physical performance, toxicity, and quality of life as assessed by the physician and the patient

The aim of this study was to study the relationship between physician-assessed quality of life parameters, i.e., toxicity and physical performance, and patients' self-reports of their quality of life (QoL). QoL was assessed at baseline and before each treatment, using the EORTC QLQ-C30. The WHO performance score (PS) and toxicity were assessed in physician interviews. The correlations between the WHO PS and the QLQ-C30 functioning scale scores varied from weak to moderate, depending on the scale. Strongest associations were found in physical-, social-, and role functioning, and in the global QoL. The QLQ-C30 nausea/vomiting and diarrhea scales correlated moderately to corresponding WHO scores. A multiple linear regression analysis was used to analyze the contribution of WHO PS and toxicity variables to the global QoL. The best model explained only 16% of the variance of the global QoL score. The present findings highlight the importance of independent QoL assessments focused on those aspects of QoL not captured in clinical interviews with the physician.     

Polymorphic variation in hOGG1 and risk of cancer: a review of the functional and epidemiologic literature

The gene encoding human 8-oxoguanine glycosylase 1 (hOGG1) is involved in DNA base excision repair. The encoded DNA glycosylase excises 7,8-dihydro-8-oxoguanine (8-OHdG), a highly mutagenic base produced in DNA as a result of exposure to reactive oxygen species (ROS). Polymorphisms in this gene may alter glycosylase function and an individual's ability to repair damaged DNA, possibly resulting in genetic instability that can foster carcinogenesis. In order to elucidate the possible impact of polymorphisms in hOGG1, we performed a literature review of both functional and epidemiologic studies that assessed the effects of these polymorphisms on repair function, levels of oxidative DNA damage, or associations with cancer risk. Fourteen functional studies and 19 epidemiologic studies of breast, colon, esophageal, head and neck, lung, nasopharyngeal, orolaryngeal, prostate, squamous cell carcinoma of the head and neck (SCCHN), and stomach cancers were identified. Although the larger functional studies suggest reduced repair function with variant alleles in hOGG1, the evidence is generally inconclusive. There is some epidemiologic evidence that risk for esophageal, lung, nasopharyngeal, orolaryngeal, and prostate is related to hOGG1 genotype, whereas risk of breast cancer does not appear related. In studies that explored potential interactions with environmental factors, cancer risk for hOGG1 genotypes differed depending on exposure, especially for colon cancer. In summary, there is limited evidence that polymorphisms in hOGG1 affect repair function and carcinogenesis. Larger, well-designed functional and epidemiologic studies are needed to clarify these relationships, especially with respect to interactions with other DNA repair enzymes and interactions with environmental factors that increase carcinogenic load.