Skip to main content

Advertisement

SpringerLink
Log in

Impact of systemic cancer treatment on quality of life and mental well-being: a comparative analysis of patients with localized and advanced cancer

  • RESEARCH ARTICLE
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Introduction

This study investigated the impact of systemic cancer therapy on the quality of life, mental well-being, and life satisfaction of cancer patients.

Methods

This prospective study was promoted by the Spanish Society of Medical Oncology (SEOM) and enrolled patients with localized, resected, or unresectable advanced cancer from 15 Spanish medical oncology departments. Patients completed surveys on quality of life (EORTC-QoL-QLQ-C30), psychological distress (BSI-18) and life satisfaction (SWLS) before and after systemic cancer treatment.

Results

The study involved 1807 patients, 944 (52%) having resected, localized cancer, and 863 with unresectable advanced cancer. The mean age was 60 years, and 53% were female. The most common types of localized cancer were colorectal (43%) and breast (38%), while bronchopulmonary (32%), non-colorectal digestive (23%), and colorectal (15%) were the most frequent among those with advanced cancer. Before systemic treatment, patients with advanced cancer had poorer scores than those with localized cancer on physical, role, emotional, cognitive, social limitations, symptoms, psychological distress, and life satisfaction (all p < 0.001), but there were no differences in financial hardship. Patients with localized cancer had greater life satisfaction and better mental well-being than those with advanced cancer before systemic treatment (p < 0.001).

After treatment, patients with localized cancer experienced worsening of all scales, symptoms, and mental well-being (p < 0.001), while patients with advanced disease had a minor decline in quality of life. The impact on quality of life was greater on all dimensions except economic hardship and was independent of age, cancer location, and performance status in participants with resected disease after adjuvant chemotherapy.

Conclusion

In conclusion, our study highlights that systemic cancer treatment can improve quality of life in patients with advanced cancer, while adjuvant treatments for localized disease may have a negative impact on quality of life and psychological well-being. Therefore, treatment decisions should be carefully evaluated on an individual basis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of data and material

Statistical analyses were performed with Statistical Package for Social Sciences (SPSS) software, 25.0 version (IBM SPSS Statistics for Windows, Armonk, NY: IBM Corp). The code is available upon request to the authors.

Code availability

Patients are identified by an encrypted code known only to the local researcher. The code of the analyses is available upon request to the authors.

References

  1. Suarez-Almazor M, Pinnix C, Bhoo-Pathy N, Lu Q, Sedhom R, Parikh RB. Quality of life in cancer care. Med. 2021;2(8):885–8.

    Article  PubMed  Google Scholar 

  2. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209–49.

  3. Miller KD, Nogueira L, Devasia T, Mariotto AB, Yabroff KR, Jemal A, et al. Cancer treatment and survivorship statistics, 2022. CA Cancer J Clin. 2022;72(5):409–36.

    Article  PubMed  Google Scholar 

  4. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403–9.

  5. Leppert W, Zdun-Ryzewska A, Forycka M, Mess E, Majkowicz M. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center. Onco Targets Ther. 2014;687.

  6. Tamburini M, Gangeri L, Brunelli C, Beltrami E, Boeri P, Borreani C, et al. Assessment of hospitalised cancer patients’ needs by the Needs Evaluation Questionnaire. Ann Oncol. 2000;11(1):31–8.

    Article  CAS  PubMed  Google Scholar 

  7. van Roij J, Raijmakers N, Ham L, van den Beuken-van EM, van den Borne B, Creemers GJ, et al. Quality of life and quality of care as experienced by patients with advanced cancer and their relatives: a multicentre observational cohort study (eQuiPe). Eur J Cancer. 2022;165:125–35.

    Article  PubMed  Google Scholar 

  8. Lewandowska A, Rudzki G, Lewandowski T, Próchnicki M, Rudzki S, Laskowska B, et al. Quality of life of cancer patients treated with chemotherapy. Int J Environ Res Public Health. 2020;17(19):6938.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Rha SY, Lee J. Symptom clusters during palliative chemotherapy and their influence on functioning and quality of life. Support Care Cancer. 2017;25(5):1519–27.

    Article  PubMed  Google Scholar 

  10. Leinert E, Singer S, Janni W, Harbeck N, Weissenbacher T, Rack B, et al. The impact of age on quality of life in breast cancer patients receiving adjuvant chemotherapy: a comparative analysis from the prospective multicenter randomized ADEBAR trial. Clin Breast Cancer. 2017;17(2):100–6.

    Article  PubMed  Google Scholar 

  11. Nayak M, George A, Vidyasagar M, Mathew S, Nayak S, Nayak B, et al. Quality of life among cancer patients. Indian J Palliat Care. 2017;23(4):445.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Adamowicz K, Baczkowska-Waliszewska Z. Quality of life during chemotherapy, hormonotherapy or antiHER2 therapy of patients with advanced, metastatic breast cancer in clinical practice. Health Qual Life Outcomes. 2020;18(1):134.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Williams AM, Khan CP, Heckler CE, Barton DL, Ontko M, Geer J, et al. Fatigue, anxiety, and quality of life in breast cancer patients compared to non-cancer controls: a nationwide longitudinal analysis. Breast Cancer Res Treat. 2021;187(1):275–85.

    Article  CAS  PubMed Central  Google Scholar 

  14. Lu L, Gavin A, Drummond FJ, Sharp L. Cumulative financial stress as a potential risk factor for cancer-related fatigue among prostate cancer survivors. J Cancer Surviv. 2021;15(1):1–13.

    Article  PubMed  Google Scholar 

  15. Azad AD, Yilmaz M, Bozkurt S, Brooks JD, Blayney DW, Hernandez-Boussard T. Diverse patient trajectories during cytotoxic chemotherapy: capturing longitudinal patient-reported outcomes. Cancer Med. 2021;10(17):5783–93.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Annunziata MA, Muzzatti B, Flaiban C, Gipponi K, Carnaghi C, Tralongo P, et al. Long-term quality of life profile in oncology: a comparison between cancer survivors and the general population. Support Care Cancer. 2018;26(2):651–6.

    Article  PubMed  Google Scholar 

  17. Santin O, Mills M, Treanor C, Donnelly M. A comparative analysis of the health and well-being of cancer survivors to the general population. Support Care Cancer. 2012;20(10):2545–52.

    Article  PubMed  Google Scholar 

  18. Lee YJ, Suh SY, Choi YS, Shim JY, Seo AR, Choi SE, et al. EORTC QLQ-C15-PAL quality of life score as a prognostic indicator of survival in patients with far advanced cancer. Support Care Cancer. 2014;22(7):1941–8.

    Article  PubMed  Google Scholar 

  19. Mai TTX, Choi JH, Lee MK, Chang YJ, Jung SY, Cho H, et al. Prognostic value of post-diagnosis health-related quality of life for overall survival in breast cancer: findings from a 10-year prospective cohort in Korea. Cancer Res Treat. 2019;51(4):1600–11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Zamel ON, Inocian EP, Alshehry AS, Tumala RB, Patalagsa JG, Alsaleh KA. Quality of life among breast and colon cancer patients before and after first-cycle chemotherapy. J Holist Nurs. 2021;39(2):116–25.

    Article  PubMed  Google Scholar 

  21. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9.

    Article  Google Scholar 

  22. Mónaco E, Gil-Gómez J, Montoya-Castilla I. Emotional competences and subjective well-being: the mediating role of relationship satisfaction in young Spanish adults. Int J Psychol. 2021;56(6):908–16.

    Article  PubMed  Google Scholar 

  23. Calderon C, Ferrando PJ, Lorenzo-Seva U, Hernández R, Oporto-Alonso M, Jiménez-Fonseca P. Factor structure and measurement invariance of the Brief Symptom Inventory (BSI-18) in cancer patients. Int J Clin Health Psychol. 2020;20(1):71–80.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Calderon C, Ferrando PJ, Lorenzo-Seva U, Ferreira E, Lee EM, Oporto-Alonso M, et al. Psychometric properties of the spanish version of the european organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ-C30). Qual Life Res. 2021.

  25. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365–76.

    Article  CAS  PubMed  Google Scholar 

  26. Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess. 1985;49(1):71–5.

    Article  CAS  PubMed  Google Scholar 

  27. Lorenzo-Seva U, Calderon C, Ferrando PJ, del Mar MM, Beato C, Ghanem I, et al. Psychometric properties and factorial analysis of invariance of the Satisfaction with Life Scale (SWLS) in cancer patients. Qual Life Res. 2019;28(5):1255–64.

    Article  PubMed  Google Scholar 

  28. Derogatis LR, Melisaratos N. The brief symptom inventory: an introductory report. Psychol Med. 1983;13(3):595–605.

    Article  CAS  PubMed  Google Scholar 

  29. Fallowfield L. Quality of life: a new perspective for cancer patients. Nat Rev Cancer. 2002;2(11):873–9.

    Article  CAS  PubMed  Google Scholar 

  30. Secord AA, Coleman RL, Havrilesky LJ, Abernethy AP, Samsa GP, Cella D. Patient-reported outcomes as end points and outcome indicators in solid tumours. Nat Rev Clin Oncol. 2015;12(6):358–70.

    Article  PubMed  Google Scholar 

  31. Schütte K, Schulz C, Middelberg-Bisping K. Impact of gastric cancer treatment on quality of life of patients. Best Pract Res Clin Gastroenterol. 2021;50–51: 101727.

    Article  PubMed  Google Scholar 

  32. Kim JW, Kim JG, Kang BW, Chung IJ, Hong YS, Kim TY, et al. Treatment patterns and changes in quality of life during first-line palliative chemotherapy in korean patients with advanced gastric cancer. Cancer Res Treat. 2019;51(1):223–39.

    Article  CAS  PubMed  Google Scholar 

  33. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021;71(1):7–33.

    Article  PubMed  Google Scholar 

  34. Niell BL, Freer PE, Weinfurtner RJ, Arleo EK, Drukteinis JS. Screening for Breast Cancer. Radiol Clin North Am. 2017;55(6):1145–62.

    Article  PubMed  Google Scholar 

  35. Issa IA, Noureddine M. Colorectal cancer screening: an updated review of the available options. World J Gastroenterol. 2017;23(28):5086.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Wolthuis AM, Bislenghi G, Fieuws S, de Buck van Overstraeten A, Boeckxstaens G, D’Hoore A. Incidence of prolonged postoperative ileus after colorectal surgery: a systematic review and meta-analysis. Colorectal Disease. 2016;18(1):O1–9.

  37. Morrison EJ, Novotny PJ, Sloan JA, Yang P, Patten CA, Ruddy KJ, et al. Emotional problems, quality of life, and symptom burden in patients with lung cancer. Clin Lung Cancer. 2017;18(5):497–503.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Marques VA, Ferreira-Junior JB, Lemos TV., Moraes RF, Junior JR de S, Alves RR, et al. Effects of chemotherapy treatment on muscle strength, quality of life, fatigue, and anxiety in women with breast cancer. Int J Environ Res Public Health. 2020;17(19):7289.

  39. Post CCB, de Boer SM, Powell ME, Mileshkin L, Katsaros D, Bessette P, et al. Long-term toxicity and health-related quality of life after adjuvant chemoradiation therapy or radiation therapy alone for high-risk endometrial cancer in the randomized PORTEC-3 trial. Int J Radiat Oncol Biol Phys. 2021;109(4):975–86.

  40. Noordman BJ, Verdam MGE, Lagarde SM, Shapiro J, Hulshof MCCM, van Berge Henegouwen MI, et al. Impact of neoadjuvant chemoradiotherapy on health-related quality of life in long-term survivors of esophageal or junctional cancer: results from the randomized CROSS trial. Ann Oncol. 2018;29(2):445–51.

    Article  CAS  PubMed  Google Scholar 

  41. Lidington E, Giesinger JM, Janssen SHM, Tang S, Beardsworth S, Darlington AS, et al. Identifying health-related quality of life cut-off scores that indicate the need for supportive care in young adults with cancer. Qual Life Res. 2022;31(9):2717–27.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Giesinger JM, Loth FLC, Aaronson NK, Arraras JI, Caocci G, Efficace F, et al. Thresholds for clinical importance were defined for the European Organisation for Research and Treatment of Cancer Computer Adaptive Testing Core—an adaptive measure of core quality of life domains in oncology clinical practice and research. J Clin Epidemiol. 2020;117:117–25.

    Article  PubMed  Google Scholar 

  43. Giesinger JM, Aaronson NK, Arraras JI, Efficace F, Groenvold M, Kieffer JM, et al. A cross-cultural convergent parallel mixed methods study of what makes a cancer-related symptom or functional health problem clinically important. Psychooncology. 2018;27(2):548–55.

    Article  PubMed  Google Scholar 

  44. Giesinger JM, Loth FLC, Aaronson NK, Arraras JI, Caocci G, Efficace F, et al. Thresholds for clinical importance were established to improve interpretation of the EORTC QLQ-C30 in clinical practice and research. J Clin Epidemiol. 2020;118:1–8.

    Article  PubMed  Google Scholar 

  45. Laquente B, Macarulla T, Bugés C, Martín M, García C, Pericay C, et al. Quality of life of patients with metastatic pancreatic adenocarcinoma initiating first-line chemotherapy in routine practice. BMC Palliat Care. 2020;19(1):103.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the investigators of the NEOcoping and NEOetic study, the Bioethics Section, and the Continuing Care Group of the SEOM, Natalia Cateriano, Miguel Vaquero, and IRICOM S.A. for their support of the website registry.

Funding

This work is funded by the FSEOM (Spanish Society of Medical Oncology Foundation) grant for Projects of the Collaborative Groups in 2018 and by an Astra Zeneca grant. The sponsor of this research has not participated in data collection, analysis, or interpretation, in writing the report, or in the decision to submit this article for publication.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Hospital Universitario Central of Asturias, ISPA, Faculty of Medicine, University of Oviedo, Avenida de Roma S/N, Oviedo, Asturias, Spain

    Adán Rodríguez-Gonzalez, Oscar Alfredo Castillo-Trujillo, Emilio Esteban & Paula Jiménez-Fonseca

  2. Department of Medical Oncology, Hospital General Universitario Morales Meseguer, Murcia, Spain

    Alberto Carmona-Bayonas

  3. Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain

    Raquel Hernandez San Gil

  4. Department of Medical Oncology, Hospital Universitario la Paz, Madrid, Spain

    Patricia Cruz-Castellanos

  5. Department of Medical Oncology, Hospital Universitario Clínico San Carlos, Madrid, Spain

    Mónica Antoñanzas-Basa

  6. Department of Medical Oncology, Hospital Provincial de Castellón, Castellón, Spain

    David Lorente-Estelles

  7. Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain

    María Jose Corral & Caterina Calderon

  8. Department of Medical Oncology. Hospital QuironSalud, Seville, Spain

    Manuel González-Moya

Authors
  1. Adán Rodríguez-Gonzalez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alberto Carmona-Bayonas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Raquel Hernandez San Gil
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patricia Cruz-Castellanos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mónica Antoñanzas-Basa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David Lorente-Estelles
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. María Jose Corral
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Manuel González-Moya
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Oscar Alfredo Castillo-Trujillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Emilio Esteban
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Paula Jiménez-Fonseca
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Caterina Calderon
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

ACB, CC and PJF contributed to the study conception, design, and analysis. Material preparation and data collection were performed by ARG, ACB, RH, PCC, VV, MAB, DLE, MJC, MGM, ACT, PJF, EE, and CC. The first draft of the manuscript was written by ARG and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Paula Jiménez-Fonseca.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interest to disclose.

Ethics approval

This study was approved by the Research Ethics Committee of the Principality of Asturias (May 17, 2019) and by the AEMPS (May 8, 2019; number: D57DG38BFB). The studies have been performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments. This study is an observational, non-interventionist trial.

Consent to participate

Signed informed consent was obtained from all patients.

Consent for publish

Informed consent and approval by the national competent authorities includes permission for publication and diffusion of the data was obtained.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rodríguez-Gonzalez, A., Carmona-Bayonas, A., Hernandez San Gil, R. et al. Impact of systemic cancer treatment on quality of life and mental well-being: a comparative analysis of patients with localized and advanced cancer. Clin Transl Oncol 25, 3492–3500 (2023). https://doi.org/10.1007/s12094-023-03214-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-023-03214-5

Keywords

Search

Navigation