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Recent progress in improving quality of life in cancer patients

  • Peter Harper
Original Article

Summary

The importance of assessing and maintaining quality of life (QOL) in cancer patients is now well appreciated. The development of standardized instruments, such as the measurement system from the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, the Functional Assessment of Chronic Illness Therapy (FACIT) scale and the various anaemia-specific questionnaires for quantifying patients’ QOL, has led to the emergence of QOL measures in clinical studies to aid in assessing new treatments. Recommendations for appropriate management of common cancer-related symptoms, such as pain, depression, fatigue, and nausea and vomiting, are described in this paper. Depression may be difficult to diagnose due to the overlap of symptoms from the cancer as well as cancer therapy, but it does respond well to treatment. However, the single most important cause of QOL deficit in cancer patients is fatigue. This is clearly multifactorial, but we are now able to assess the component associated with anaemia and its relief can lead to improvements in QOL in cancer patients. There are many potential causes of QOL deficit in cancer patients and it is prudent that clinicians frequently monitor QOL during the course of the disease and treatment, while actively preventing and treating the relevant symptoms.

Keywords

cancer quality of life depression fatigue anaemia 

References

  1. 1.
    Cherny NI, Foley KM. Nonopioid and opioid analgesic pharmacotherapy of cancer pain. Otolaryngol Clin North Am 1997; 30:279–306.PubMedGoogle Scholar
  2. 2.
    Serlin RC, Mendoza TR, Nakamura Y, Edwards KR, Cleeland CS. When is cancer pain mild, moderate, or severe? Grading pain severity by its interference with function. Pain 1995; 61:277–84.PubMedCrossRefGoogle Scholar
  3. 3.
    Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, Blum RH, Stewart JA, et al. Pain and its treatment in outpatients with metastatic cancer N Engl J Med 1994; 330:592–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Ahmedzai S, Brooks D. Transdermal fentanyl versus sustainedrelease oral morphine in cancer pain: preference, efficacy, and quality of life. The TTS-Fentanyl Comparative Trial Group. J Pain Symptom Manage 1997; 13:254–61.PubMedCrossRefGoogle Scholar
  5. 5.
    Holland JC, Romano SJ, Heiligenstein JH, Tepner RG, Wilson MG. A controlled trial of fluoxetine and desipramine in depressed women with advanced cancer. Psychooncology 1998; 7:291–300.PubMedCrossRefGoogle Scholar
  6. 6.
    Greer S, Moorey S, Baruch JD, Watson M, Robertson BM, Mason A, et al. Adjuvant psychological therapy for patients with cancer: a prospective randomised trial. BMJ 1992; 304:675–80.PubMedCrossRefGoogle Scholar
  7. 7.
    Curt GA, Breitbart W, Cella DF, Groopman JE, Horning SJ, Itri L, et al. Impact of cancer-related fatigue on the lives of patients. J Clin Oncol 1999; 18:573.Google Scholar
  8. 8.
    Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ, et al. Patient, caregiver, and oncologist perceptions of cancerrelated fatigue: results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol 1997; 34(3 Suppl 2):4–12.PubMedGoogle Scholar
  9. 9.
    Coiffier B. Retrospective analysis of hematological parameters and transfusion requirements in non-platinum chemotherapy-treated patients. J Clin Oncol 1998; 17:90A.Google Scholar
  10. 10.
    Dalton JD, Bailey NP, Barrett-Lee PJ, O’Brien MER. Multicenter UK Audit of Anaemia in Patients Receiving Cytotoxic Chemotherapy. J Clin Oncol 1998; 17:418a.Google Scholar
  11. 11.
    Hainsworth JD. Nausea and Vomiting. In: Abeloff MD, Armitage JO, Lichter AS, Niederhuber JE, editors. Clinical Oncology. New York: Churchill Livingston; 1995. pp. 727–40.Google Scholar
  12. 12.
    Clavel M, Bonneterre J, d’Allens H, Paillarse JM. Oral ondansetron in the prevention of chemotherapy-induced emesis in breast cancer patients. French Ondansetron Study Group. Eur J Cancer 1995; 1:15–19.CrossRefGoogle Scholar

Copyright information

© Lippincott Williams & Wilkins 2000

Authors and Affiliations

  • Peter Harper
    • 1
  1. 1.Department of OncologyGuy’s HospitalLondonUK

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