Quality of life and psychological well-being in Spanish long-term survivors of Hodgkin's disease: Results of a controlled pilot study

Complutense University of Madrid, Madrid, Madrid, Spain
Annals of Hematology (Impact Factor: 2.63). 02/2003; 82(1):14-8. DOI: 10.1007/s00277-002-0582-0
Source: PubMed


Nowadays, the chemoradiotherapeutic protocols for Hodgkin's disease (HD) achieve high curability rates. Hemato-oncologists focus on both avoiding medical and psychological sequelae of the treatment and returning patients to a normal life. The quality of life and psychological well-being of Spanish patients who are long-term survivors of HD were studied and compared to the results obtained from healthy controls. Questionnaires on quality of life [European Organization for Research and Treatment of Cancer (EORTC) QLQ30] and psychological status [hospital anxiety and depression (HAD) scale] were mailed to HD patients without active disease and free of second malignancies and were also given to healthy controls. Of 67 selected patients (68.6%), 46 were included in this study. The median follow-up for these 46 patients was of 7.6 years (0.8-22.1) after being diagnosed. Although there were no differences between patients and controls with regard to their global state of health and quality of life (72.9+/-22.7 vs 79.3+/-18.7; p=0.22), patients presented a lower physical function (88.2+/-18.1 vs 96.5+/-9.7; p=0.05) and a worse social operation scale (81.5+/-25.4 vs 96.3+/-13.1; p= 0.0015) together with higher symptoms of dyspnea (8.6+/-14.7 vs 0+/-0; p=0.03) and higher economic difficulties (23.1+/-38.3 vs 0.7+/-4.9; p=0.017) when compared with healthy controls. However, we did not find differences in the scores and the proportion of cases of anxiety and depression between the two groups. The quality of life questionnaire disclosed differences between patients and controls in some functional and symptomatic scales. These differences can be read as a consequence of either the disease itself or the treatment received. However, the results of this controlled pilot study should be confirmed in a larger series of Spanish HD survivors. In the future, these results could be a reference when new therapeutic protocols are designed to reduce the impact on the quality of life of the patients. Socioeconomic support to the patients should also be provided in order to improve their medical care.

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    • "Three cross-sectional and one prospective study observed that older patients reported clinically important worse outcomes [9, 16, 24, 27]. Six studies reported contradicting differences in HRQoL according to gender [9, 15, 16, 24, 27, 29], three studies found clinically important worse scores for women [9, 24, 27], one found only statistically worse scores for women [16], one found worse scores for men [29] and one found no differences [15]. "
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    ABSTRACT: Cancer survivors are at risk of experiencing adverse physical and psychosocial effects of their cancer and its treatment. Both Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL) survivors face problems that can affect their health-related quality of life (HRQoL). The authors systematically reviewed the literature on HRQoL among HL and NHL survivors. A PubMed and PsychINFO literature search for original articles published until May 2011 was performed. Twenty-four articles, which met the predefined inclusion criteria, were subjected to a quality checklist. HL survivors showed the most problems in (role) physical, social and cognitive functioning, general health, fatigue and financial problems. In addition, HL survivors treated with a combination of therapies, with older age and female sex reported worse HRQoL. NHL survivors showed the most problems in physical functioning, appetite loss, vitality and financial problems. Having had chemotherapy was negatively associated with HRQoL, but no differences in chemotherapy regimens were found. Furthermore, in NHL survivors not meeting public exercise guidelines, HRQoL is low but can be improved with more exercise. More research on the longitudinal comparison between HL and NHL survivors and healthy controls should be performed in order to better understand the long-term (side) effects of treatment on HRQoL and possibilities to alleviate these.
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    • "Additionally, the ethnicity profi le of survivors will change as American society grows into a more heterogeneous cultural mix. Attention to ethnicity profi le is imperative as culturally prescribed norms may affect health-seeking behavior, symptom verbalization, self-care practices, and the provision of family support (Ashing-Giwa, Padilla, Tejero, & Kim, 2004; Dirksen & Erickson, 2002; Farmer & Smith, 2002; Gil-Fernandez et al., 2003). A paucity of studies have addressed cultural diversity within the construct of cancer survivorship (Aziz & Rowland, 2002; Gotay, Holup, & Pagano, 2002). "

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