Saturday, November 3, 2007

Quality of life is key to cancer survival

Having someone who cares may be more important than medical factors

Having someone to drive you to cancer treatments or make sure you are eating may be even more important than tumor size or other medical factors in predicting cancer survival, U.S. researchers said on Tuesday.
They found patients with a below-average quality of life before getting treatment for lung cancer — those in poor health or with inadequate support networks — had nearly a 70 percent higher death rate than those with a better one.
"It's intuitive that someone who is in better physical shape and has a support system will do better than someone who comes in already debilitated and doesn't really have anyone to help them go through treatment," said Dr. Nicos Nicolaou of Fox Chase Cancer Center in Philadelphia in a telephone interview.

"We have now shown this," said Nicolaou, whose study was presented on Tuesday at the American Society of Therapeutic Radiology and Oncology meeting in Los Angeles.
Doctors routinely consider factors such as tumor size, stage of the disease and other measures to predict how long a patient with cancer will survive.
But factors that make up a patient's quality of life — overall health, mobility, emotional stability, social support and financial resources — may make the most difference, Nicolaou and colleagues found.
"If you have someone to help you with your meals, transportation, give you your medications and take care of your daily needs, both physical and emotional, you will be able to get through the treatment better," he said.
Researchers at Fox Chase and Henry Ford Hospital in Detroit studied 239 patients with lung cancer enrolled in a treatment trial involving both radiation and chemotherapy.
The study was designed to evaluate the role of quality of life as a prediction for survival. Questions included things like: "Do you have trouble taking a long walk?" or, "In the past week, did you feel irritable? Did you feel depressed?"

The researchers also analyzed classic predictors of survival such as gender, race, age, marital status, state of disease and tumor location.
Some 91 percent of patients completed a standardized quality of life survey before treatment. All patients were followed for at least 17 months.
What they found is quality of life emerged as the most significant predictor of overall patient survival.
"We conducted two different statistical analyses including all the usual prognostic factors and either way, quality of life remained the strongest predictor of overall survival," Dr. Benjamin Movsas of Henry Ford Hospital said in a statement.
"What's more, if a patient's quality of life increased over time, we saw a corresponding increase in survival," he said.
People who were single, divorced or widowed had significantly lower quality of life scores, and fared far worse in the study.
For these patients, doctors may need to take a more active role in ensuring that support services are in place before a patient undergoes cancer treatment, Nicolaou said.
"It is incumbent on the treatment team to make sure the patient's needs are met and the patient gets the support he needs to get through the treatment," he said. "It has to be an integral part of decision-making."

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