Cancer patients often experience a reduction in quality of life (QOL) during and after cancer treatment. Many experience pain, nausea, fatigue, sleep, and distress, among others. Family members caring for these patients often experience a lower QOL. Many studies have tested approaches to improve psychosocial functioning, but most have focused on only one aspect of psychosocial functioning. QOL is comprehensive and consists of five domains: cognitive, physical, emotional, social, and spiritual well-being.
Testing a New Intervention for Patients Receiving Radiation
In a study published in Cancer, my colleagues and I conducted a randomized trial in which we sought to help patients with advanced cancer receiving radiation therapy. Family members were also included in the study. While half of the participants stayed with their usual care during treatment, the other half participated in a multidisciplinary program of six, 90-minute sessions that formally addressed the five aforementioned domains of QOL. Each session included:
• Physical therapy exercises to improve fatigue.
• Discussions of topics like coping strategies or spiritual concerns.
• Deep breathing or guided imagery to reduce stress.
Our results demonstrated that the multidisciplinary intervention was effective in maintaining the QOL of patient participants. Conversely, patients who stayed with their standard routines showed a decline in QOL measures. Much of our program’s success was attributable to active engagement from patients. They also received support and encouragement to continue to practice the coping strategies, such as physical activity, spirituality—and relaxation—when cancer treatment was completed.
More to Come: Maintaining Improved QOL
Our study showed that our intervention can maintain QOL during cancer treatment, but unfortunately, our follow-up conducted 6 months after treatment failed to show any long-term effect associated with our intervention. Thus, while the intervention was helpful at a critical time, it didn’t have a lasting, continuous enhancing effect.
In addition, the program did not impact the QOL for caregivers. We were hopeful that the program would also improve caregiver QOL, but it’s clear that we still need to find ways to help cancer caregivers. These individuals also experience a significant symptom burden that warrants recognition and care.
In the future, our aim is to develop strategies to help people and their caregivers maintain and improve their QOL throughout cancer survivorship. The QOL and symptom burden for these patients is striking, making it important to identify effective strategies that can be implemented in conjunction with cancer care.
Readings & Resources (click to view)
Clark MM, Rummans TA, Atherton PJ, et al. Randomized controlled trial of maintaining quality of life during radiotherapy for advanced cancer. Cancer. 2013;119:880-887. Available at: http://onlinelibrary.wiley.com/doi/10.1002/cncr.27776/abstract.
Rummans TA, Clark MM, Sloan JA, et al. Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: a randomized controlled trial. J Clin Oncol. 2006; 24:635-642.
Frost MH, Novotny PJ, Johnson ME, Clark MM, Sloan JA, Yang P. Spiritual well-being in lung cancer survivors. Support Care Cancer. 2013 Feb 19. [Epub ahead of print].
Solberg Nes L, Liu H, Patten CA, et al. Physical activity level and quality of life in long term lung cancer survivors. Lung Cancer. 2012;77:611-616.
Brown P, Clark MM, Atherton P, et al. Will improvement in quality of life (QOL) impact fatigue in patients receiving radiation therapy for advanced cancer? Am J Clin Oncol. 2006; 29:52-58.