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

ArticleinAnnals of Hematology 82(1):14-8 · February 2003with5 Reads
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.
    • "In contrast, the longitudinal design of our current study allows the evaluation of the trajectory of QoL of the same group of long-term HL survivors over time. The finding of a deterioration in the physical component of QoL in our cohort may be partly related to advancing age [10, 18, 21, 22], but the decline is also clearly associated with development of new cardiopulmonary complications. Hjermstad et al. [14] reported longitudinal survey results of 280 HL survivors using the Fatigue Questionnaire. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Long-term Hodgkin lymphoma (HL) survivors are known to have diminished quality of life (QoL). However, limited data are available on temporal changes in QoL and factors associated with the changes.Methods In 2010, we conducted a follow-up questionnaire study on 273 HL survivors who participated in a 2003 questionnaire study on late effects after HL. The questionnaire items were limited to new late complications and reassessment of QoL and fatigue level, using the Short Form 36 (SF-36) and the Functional Assessment of Chronic Illness Therapy-Fatigue instruments, respectively. We compared the results from the 2003 and the 2010 questionnaires, and QoL score changes between survivors with and without new late complications during the 7-year period.ResultsThere was a significant decline in the SF-36 Physical Component Summary score (median change, -1.8; P < 0.0001) over the time period. The decline was significantly greater among survivors with a new cardiac (P = 0.005) or pulmonary (P < 0.0001) complication, compared with those without any new complications. The survivors reporting new cardiac complications also experienced significantly greater worsening of fatigue scores (P = 0.004).Conclusion The significant association between the development of new cardiopulmonary complications and decline in QoL and energy level of HL survivors provides further support for current efforts to reduce treatment to limit late effects.
    Full-text · Article · Aug 2012
    • "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] . Two sectional studies reported that more advanced disease stage or recurrences were associated with reduced HRQoL; however, no information about clinically important differences could be obtained [15, 32]. "
    [Show abstract] [Hide abstract] 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.
    Full-text · Article · Jun 2011
    • "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 ). "
    Full-text · Article · Jun 2006
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