Study Identifies Factors Affecting QOL in Older Cancer Patients

A new study published in Cancer has shown several ways that the health-related quality of life (HRQOL) in cancer patients older than 65 years could be improved. Among the older individuals in the southeastern United States studied, quality comorbidity and supportive care and leisure-time physical activity interventions could help to address persistent symptoms experienced, such as pain, fatigue, and disturbed sleep.

“Quality-of-life studies tend to focus on one cancer at the time, on the period during treatment, and on specific cancer drugs or treatments; however, as people live longer after a cancer diagnosis, it is important to understand the contribution of other factors to quality of life regardless of cancer type or treatment,” said Maria Pisu, PhD, associate professor in the division of preventive medicine at the University of Alabama at Birmingham.

In this study, Pisu and colleagues sought to understand the most important factors that contribute to improving or maintaining good quality of life beyond the initial treatment period. According to the researchers, this knowledge could help identify survivors who are most vulnerable and at risk for poor health outcomes.

The study included 1,457 older adults with cancer who participated in a telephone survey. Participants were surveyed using several forms and the results were used to identify factors in the physical, psychological, social, and spiritual domains. The participants were a median of 19 months from their cancer diagnosis and more than one-quarter were still receiving treatment.

“Cancer type and treatment received were not among the most important factors affecting quality of life in our group of survivors,” Pisu said.

Instead, the most relevant factors associated with physical outcomes were symptom severity, comorbidity scores, leisure-time physical activity, and having physical support needs. The most relevant mental factors were having emotional support needs, symptom severity score, and the number of financial hardship events.

Dr. Pisu noted that the contribution of financial hardship to the mental component of quality of life was somewhat unexpected. “Financial and economic hardships have usually been found to be less concerning for older adults,” she said.

The study’s results have implications for the care of older cancer survivors.

“The approach to care for this population has to be one of comprehensive health promotion that includes appropriate management of symptoms and comorbid conditions and the promotion of healthy lifestyles,” Pisu said. “Moreover, their care should recognize the importance of older survivors’ social contexts and the support needs that they may have, including those related to financial challenges.”