Factors Affecting The Quality of Life in Cancer Survivors

survivor

Cancer survivors face unique short-term and long-term challenges to physical and mental health, family functioning, and maintenance of a healthy lifestyle [1, 2].  Long-term and late effects of cancer treatment may arise during or after treatment and may persist throughout a patient’s lifetime. Survivors may also need ongoing monitoring for cancer recurrence and the development of new cancers. Thus cancer can be perceived as a chronic condition, and recommendations are emerging for long-term survivorship care. Cancer survivors who have other chronic conditions or health risk factors at the time of diagnosis may face additional challenges during cancer treatment and follow-up care. [3]

Factors Affecting Quality of Life in Cancer Survivors

Studies of quality of life in cancer survivors have examined both the physical and mental health consequences of cancer and its treatments.

Physical Symptoms

After cancer treatment, some people recover quickly with few side effects. However, it is also common for others to experience a variety of physical symptoms that can take weeks, months or even years to fully overcome. Physical symptoms vary across cancer types and treatment modalities but commonly include fatigue; weight gain and weight loss; hormonal changes, such as loss of fertility or menopause; sexual difficulties; memory problems or difficulty concentrating, sometimes called ‘chemo brain’; sleep disturbances; pain; neuropathy; swelling of a leg or arm (lymphoedema). How these symptoms impact quality of life varies depending on a number of factors, including the type and stage of cancer at diagnosis, the patient’s prognosis, the type of treatments received, the patient’s age, and comorbidities (both before and after the cancer diagnosis).

Many physical symptoms persist long beyond the initial treatment period and may influence survivors’ quality of life throughout the remainder of their lives. In addition, conditions such as cardiotoxicity and accompanying symptoms can develop 10 years or more after treatment, indicating the need for long-term surveillance of and specialized care for cancer survivors. Even long after diagnosis, cancer survivors are significantly more likely than adults without cancer to be in poor health and to have multiple chronic medical conditions and functional and employment limitations [4]

Mental Health and Well-Being

For many people, one of the hardest things about life after cancer treatment is dealing with a confusing whirlwind of different emotions. Feelings of isolation, resentment and anxiety are common and perfectly normal, as are a loss of confidence or fear of cancer returning.  For cancer survivors, as for individuals without a history of cancer, physical health directly influences mental health status and overall quality of life. Physical symptoms are more likely to be detected and treated by health care providers, as the mental health and social consequences of illness are less well recognized.

Cancer diagnosis and treatment may be accompanied by profound physical, emotional, social, occupational, and financial stressors, as well as associated increases in anxiety and depressive symptoms. The first 1–3 years after treatment are a critical period during which to monitor the mental health of cancer survivors. Challenges during the early post-treatment period may include fear of recurrence, resumption or alteration of life roles, late and long-term effects of treatment (which can be physical and/or psychological), perceived loss of support from providers, and diminished support from family and friends [5]. Long-term survivors may face psychological challenges associated with cancer recurrence or second cancers, as well as continuation of mental health symptoms that first occurred during diagnosis and treatment.

References

1. Hewitt M, Greenfield S, Stovall E, eds; Institute of Medicine; National Research Council. From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, DC: National Academies Press; 2006.

2. Aziz NM. Cancer survivorship research: state of knowledge, challenges and opportunities. Acta Oncol. 2007;46(4):417-432.

3. Naughton M, Weaver K; Physical and Mental Health Among Cancer Survivors: Considerations for Long-Term Care and Quality of Life. NCMJ vol. 75, no. 4.

4. Ibid

5. Stanton AL. What happens now? Psychosocial care for cancer survivors after medical treatment completion. J Clin Oncol. 2012;30(11):1215-1220