Quality of Life and Real-Time Patient Experience During Neoadjuvant Therapy

Abstract

Background: Neoadjuvant therapy (NT) is increasingly used for patients with localized gastrointestinal (GI) cancers. There is little data assessing patient experience and quality of life (QOL) during NT for GI cancers. Objective: To use a customized smartphone application to prospectively measure QOL and the real-time patient experience during NT. Methods: Patients with GI cancers receiving NT were instructed on using a customized smartphone application through which the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, a validated measure of health-related (HR) QOL, was administered at baseline, every 30 days, and at completion of NT. Participants also tracked their mood, symptoms, and used free-text journaling functionalities in the application. Mean overall and sub-section HRQOL scores were calculated during NT. Results: Among 104 enrolled patients, mean age was 60.5±11.5 years and 55% were male. Common cancer diagnoses were colorectal (40%), pancreatic (37%), and esophageal (15%). Mean overall FACT-G scores did not change during NT (P=0.987). While functional wellbeing scores were consistently the lowest and social wellbeing scores the highest, FACT subscores similarly did not change during NT (all P>0.01). The most common symptoms reported during NT were fatigue, insomnia, and anxiety (39.3%, 34.5%, and 28.3% of patient entries, respectively). Qualitative analysis of free-text journaling entries identified anxiety, fear, and frustration as the most common themes, but also the importance of social support systems and confidence in health care providers. Conclusions: While patient symptom burden remains high, results of this prospective cohort study suggest QOL is maintained during NT for localized GI cancers.

Patient Perceptions of Care Coordination during Neoadjuvant Therapy for Gastrointestinal Cancers: A Mixed Methods Analysis

“…This study is part of a prospective longitudinal cohort study evaluating the patient experience during NT using a customized smartphone application. The complete protocol of this prospective study has previously been reported [ 14 , 15 ]. In brief, enrolled patients with esophageal, gastric, pancreatic, hepatobiliary, colorectal, or bladder cancer between 2020 and 2021 were instructed on how to use the application in order to document real-time symptoms and also receive monthly quality of life surveys directly through their application.…”

Evaluating the caregiver experience during neoadjuvant therapy for pancreatic ductal adenocarcinoma

“…[4][5][6][7] Although recent research has highlighted the significant treatment burden associated with NT, little research has focused on the patients' primary caregivers. [8][9][10] Caregivers serve an important role by providing emotional and physical support to patients throughout cancer treatment. 11 These individuals often take on the role of coordinating healthcare appointments, transporting patients to appointments, helping with activities of daily living (e.g., showering and cooking), and are the main point of contact for the wider support network of family members and friends.…”