Quality of life in survivors of multiple primary cancers compared with cancer survivor controls

Abstract

BACKGROUND.Cancer survivors may develop additional cancers after their first diagnosis, but to the authors' knowledge the quality of life (QOL) consequences of a second cancer are not known. The current study assessed QOL and its correlates after a second cancer diagnosis.METHODS.QOL was compared between 487 survivors of second‐order and higher‐order primary cancer diagnoses, and a matched group of 589 survivors of a single cancer diagnosis. Outcome measures included standardized questionnaires that assessed depressive symptoms, perceived stress, vitality, post‐traumatic growth, existential well‐being, sexual adjustment, and global QOL.RESULTS.Survivors of multiple primary cancer diagnoses had significantly lower global QOL (t (792) = 5.42; P < .001), vitality (Student t test [t] (794) = 2.41; P < .01), and existential well‐being (t (775) = 2.78; P < .01), and higher intrusive stress symptoms (t (775) = −1.93; P < .05). Controlling for demographic, medical, and trait‐like psychosocial characteristics (eg, optimism and resilience), having multiple primary cancer diagnoses explained small, although significant, variances in global QOL (coefficient of determination [R2] = .04; P < .001), vitality (R2 = .01; P < .05), and existential well‐being (R2 = .01; P < .05), with patients in the multiple primary cancer group faring worse on all of these measures.CONCLUSIONS.The results of the current study suggest that the typical survivor of multiple primary cancers experiences modest but lasting QOL deficits. Cancer 2007. © 2007 American Cancer Society.

Physical and Mental Health Status and Health Behaviors of Survivors of Multiple Cancers: a National, Population-Based Study

“…Notably, the magnitude of group differences between survivors of multiple cancers and survivors of a single cancer either equaled or exceeded the magnitude of group differences between survivors of a single cancer and non-cancer controls for both categorical and continuous health status outcomes. While it is well known a single cancer diagnosis can negatively impact both physical and mental health status in both the short and long term (7–10, 23, 29, 30), our results extend previous research with survivors of multiple cancers (17) by suggesting additional cancer diagnoses beyond an initial cancer diagnosis have an additive impact on physical and mental health status.…”

“…Gotay and colleagues (17) found survivors of multiple cancers reported lower global quality of life, less vitality, greater cancer-specific distress, and poorer existential wellbeing than matched survivors of a single cancer, with effect sizes ranging from small to medium. While this initial study provides some indication of the mental health status of survivors of multiple cancers it does possess some significant limitations.…”

Disparities in mental health between rural and nonrural cancer survivors: a preliminary study

“…However, our accrual rate of 34% (conservatively defined as those who never responded to KCR recruitment efforts are included in the denominator) compares favorably to similar studies of psychosocial outcomes in cancer survivors which employed purposive sampling from population-based cancer registries. As examples, an accrual rate of 34% was achieved for survivors of six different cancer diagnoses [43], 41% for survivors of mixed, multiple primaries [44], 42% for breast, colorectal, and prostate cancer survivors [45], 46% for breast cancer survivors [46], and 54% for lymphoma survivors [47]. …”

Complementary and Alternative Medicine Use and Breast Cancer Prognosis: A Pooled Analysis of Four Population-Based Studies of Breast Cancer Survivors

“…We included in situ and invasive female breast cancer cases from four population-based studies of cancer survivors [28][29][30][31][32][33] ; the subjects were diagnosed during the years 1964-1999 in Hawaii. Subjects with missing data on CAM modality, education, tumor, node, metastasis (TNM) stage, surgery, chemotherapy, heart disease, or diabetes were excluded (n = 30), resulting in 1443 women for the analysis.…”

“…Table 1 summarizes the four studies and the types of CAM questions that were asked. The four studies were: (1) Quality of Life in Cancer Patients in Hawaii (QOL), the objective of which was to develop, validate, and pilot test an instrument appropriate to assess cancer-related quality of life among the culturally diverse cancer patient population in Hawaii, 28,[30][31][32] (2) Beating the Odds: A study of Patients Who Exceed Expected Survival Times (BTO), a study of individuals who were long-term survivors of cancers that are generally associated with poor survival, 33 (3) Quality of Life in Patients Who Develop Subsequent Primaries (SP), a study that described the psychologic impact among people experiencing more than one primary cancer, 29 and (4) Exploratory Study of Treatment Decision Making in Multiethnic Breast Cancer Patients (TDM), a study that focused on how patients make decisions about their breast cancer treatments. Two studies, BTO and SP, asked subjects: Which of the following remedies have you used for your cancer?…”