Health-Related Quality of Life in Adolescent and Young Adult Patients With Cancer: A Longitudinal Study

Abstract

Purpose To examine changes in health-related quality of life (HRQoL) and its predictors during the first 2 years after initial cancer diagnosis in adolescent and young adult (AYA) patients with cancer. Patients and Methods A multicenter, longitudinal, prospective study was conducted among a diverse sample of AYA patients with cancer ages 15 to 39 years. One hundred seventy-six patients (75% response) completed a self-report measure of HRQoL (Short Form-36 [SF-36]) within the first 4 months after diagnosis and again 12 and 24 months later. Linear mixed models with random intercepts and slopes estimated changes in QoL. Results Recently diagnosed AYA patients with cancer had significantly worse physical component scale (PCS) scores (38.7 v 52.8; P < .001) and mental component scale (MCS) scores (42.9 v 48.9; P < .001) when compared with population norms. Significant improvements in PCS and MCS scores from baseline to 24-month follow-up were observed; however, these increases were largest during the first 12 months. At the 24-month follow-up, AYA patients still had significantly lower PCS scores (48.0 v 52.8; P < .001) and MCS scores (45.8 v 48.9; P = .002) when compared with population norms. Multivariable analyses revealed that improvements in PCS and MCS scores were primarily a function of being off-treatment and being involved in school or work. PCS but not MCS scores were worse for AYA patients diagnosed with cancers with poorer prognoses. Conclusion Although HRQoL improved over time, it was still compromised 24 months after primary diagnosis. Given relatively little observed improvement in HRQoL during the 12- to 24-month period after diagnosis, AYA patients may benefit from supportive care interventions administered during the second year after diagnosis.

Health‐related quality of life, psychosocial functioning, and unmet health needs in patients with sarcoma: A systematic review

“…Patients with sarcoma were reported to have lower outcomes at all disease phases compared with the general population, despite showing improvements in HRQoL during follow‐up. This is similar to results noted for other malignancies . Patients treated for sarcoma typically reported issues with their role and social functioning, as well as fatigue, insomnia, pain, loss of appetite, anxiety, and depression.…”

Prevalence of mental disorders and psychosocial distress in German adolescent and young adult cancer patients (AYA)

“…The majority of the few studies who examine psychological distress of AYAs with cancer have found that every fourth patient exceeds distress cutoff values during and after medical treatment . Furthermore, AYAs with cancer who have completed medical treatment are more distressed than age‐matched healthy controls . As far as sociodemographic (eg, gender, age at diagnosis) and medical (eg, treatment status) correlates of psychosocial distress are concerned, current research findings have, to date, been inconsistent…”

Life satisfaction in young adults with cancer and the role of sociodemographic, medical, and psychosocial factors: Results of a longitudinal study

“…6,7 Being sick with cancer during this sensitive time often results in multiple physical, psychological, and psychosocial limitations such as infertility, 8 changes in physical appearance, 9 fatigue, 10 and disruptions in social life and career. 12,13 Cancer November 15, 2018 QOL is a broad multidimensional concept that usually includes subjective evaluations of both positive and negative aspects of life. Because psychological symptoms such as anxiety and distress develop differently after cancer and are highly interconnected with psychosocial factors, we believe it is safe to assume that QOL also is quite likely to change over time.…”

“…[17][18][19] LS refers to a subjective appraisal of one's personal life in an number of life domains. 20 These frequently lack some important and unique concerns of AYA patients with cancer such as employment challenges, fertility and family planning, or body image, 13,20,21 yet all these domains are likely to be affected by illness, especially in AYA patients. It can be considered as an indicator of QOL because it reflects how satisfied one is with one's life as a whole.…”