Lung cancer

Certain cancers have worse disability and quality of life for survivors

People living with certain cancers have higher levels of disability, psychological distress and lower levels of quality of life than those with other cancers, a new Australian report shows

Lung cancer, multiple myeloma, non-Hodgkin lymphoma and certain less common cancers were associated with the worst physical and mental health-related outcomes, according to a study of 22,000 cancer survivors conducted by researchers at he Australian National University, Canberra.

In contrast, people with melanoma, breast, prostate, and bowel cancers rated their quality of life almost as highly as those who never had cancer, according to study lead author Professor Emily Banks, of the National Centre for Epidemiology and Population Health.

The potential reasons for poor outcomes for some cancers included lower cure rate for some such as lung cancer (and thus ongoing symptoms related to cancer and its treatment), higher toxicity of treatment (such as bone marrow transplant commonly used in myeloma) and higher prevalence of comorbid disease (as in lung cancer and myeloma).

The poor outcomes seen in people with rarer cancers may be linked to a lack of proven treatment protocols, said Professor Banks, as well as the wide variability in prognoses and treatments, including some which are intense and toxic.

Published in BMC Medicine, the data from the 45 and Up Study showed that cancer survivors were more likely to report lower levels of physical functioning, self-rated health and quality of life and slightly higher psychological distress than people without cancer, with considerable variation across cancer types, time since diagnosis, treatments and stages.

According to Professor Banks, a key finding was the importance of physical disability as a driver of a person’s mental health and quality of life, and thus the need to support physical functioning, including by focusing on non-cancer morbidity in cancer survivors.

“In addition to routine screening for psychological distress, management of physical functioning and other symptoms is important in cancer survivorship,” the authors wrote.

But the overall message was that with average five year cancer survival rates of 68%, patients can be helped to adapt to the “new normal” said Professor Banks

“Overall, we found that once patients with the most common cancers were through the initial period of diagnosis and treatment, their quality of life and levels of psychological distress were similar to people in the community without cancer,” she said.

“These findings should shift the general mindset about cancer. It is good for people to know they may not have to quit their job and may continue to have a good quality life.”

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