Comparison of breast and rectal cancer patients’ quality of life: results of a four year prospective field study
Corresponding Author
J. ENGEL MD , MPH
Munich Field Study, Munich Cancer Registry, Ludwig-Maximilians-University, Munich
address: Jutta Engel, Tumorregister München, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, Marchioninistraße 15, D-81377 München, Germany (e-mail: [email protected]).Search for more papers by this authorJ. KERR PHD , MSC
Munich Field Study, Munich Cancer Registry, Ludwig-Maximilians-University, Munich
Search for more papers by this authorA. SCHLESINGER-RAAB MPH
Munich Field Study, Munich Cancer Registry, Ludwig-Maximilians-University, Munich
Search for more papers by this authorR. ECKEL
Munich Field Study, Munich Cancer Registry, Ludwig-Maximilians-University, Munich
Search for more papers by this authorH. SAUER MD
Medical Clinic III, Klinikum Großhadern, Ludwig-Maximilians-University, Munich
Search for more papers by this authorD. HÖLZEL PHD
Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
Search for more papers by this authorCorresponding Author
J. ENGEL MD , MPH
Munich Field Study, Munich Cancer Registry, Ludwig-Maximilians-University, Munich
address: Jutta Engel, Tumorregister München, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, Marchioninistraße 15, D-81377 München, Germany (e-mail: [email protected]).Search for more papers by this authorJ. KERR PHD , MSC
Munich Field Study, Munich Cancer Registry, Ludwig-Maximilians-University, Munich
Search for more papers by this authorA. SCHLESINGER-RAAB MPH
Munich Field Study, Munich Cancer Registry, Ludwig-Maximilians-University, Munich
Search for more papers by this authorR. ECKEL
Munich Field Study, Munich Cancer Registry, Ludwig-Maximilians-University, Munich
Search for more papers by this authorH. SAUER MD
Medical Clinic III, Klinikum Großhadern, Ludwig-Maximilians-University, Munich
Search for more papers by this authorD. HÖLZEL PHD
Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
Search for more papers by this authorAbstract
This paper compares quality of life in breast and rectal cancer patients. The Munich Cancer Registry records clinical details of all cancer patients in the region. Over a 2-year period, cooperating clinicians recruited patients who were sent quality of life questionnaires, including the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – C30 over 4 years. Breast cancer patients were compared to both male and female rectal cancer patients. A total of 1315 patients returned questionnaires (988 breast cancer, 327 rectal cancer). More breast cancer patients were under 70 years old, received adjuvant therapy, had a good prognosis, took medication and rated psychological support as important. Breast cancer patients reported poorer quality of life than rectal cancer patients in more than half the variables. In particular, they suffered significantly worse emotional functioning, fatigue, pain and sleeplessness. Female rectal cancer patients did not suffer the same problems. Both age groups and those with or without adjuvant therapy indicated the same trend, with breast cancer patients reporting lower scores. Breast cancer patients, despite better prognoses, appear to suffer more psychological problems than rectal cancer patients. Gender, age and therapy did not seem to explain these differences. The negative public perception of breast cancer may play a role.
REFERENCES
- Aaronson N.K., Ahmedzai S., Bergman B., Bullinger M., Cull A., Duez N.J., Filiberti A., Flechtner H., Fleishman S.B., De Haes J.C., Kaasa S., Klee M., Osoba D., Razavi D., Rofe P.B., Schraub S., Sneeuw K., Sullivan M. & Takeda F. (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute 85, 365 – 376.
- Apolone G., Filiberti A., Cifani S., Ruggiata R. & Mosconi P. (1998) Evaluation of the EORTC QLQ-C30 questionnaire: a comparison with SF-36 Health Survey in a cohort of Italian long-survival cancer patients. Annals of Oncology 9, 549 – 557.
- Black W.C., Nease R.F. Jr & Tosteson A.N. (1995) Perceptions of breast cancer risk and screening effectiveness in women younger than 50 years of age. Journal of the National Cancer Institute 87, 720 – 731.
- Bull A.A., Meyerowitz B.E., Hart S., Mosconi P., Apolone G. & Liberati A. (1999) Quality of life in women with recurrent breast cancer. Breast Cancer Research and Treatment 54, 47 – 57.
- Burstein H.J., Gelber S., Guadagnoli E. & Weeks J.C. (1999) Use of alternative medicine by women with early-stage breast cancer. New England Journal of Medicine 340, 1733 – 1739.
- Camilleri-Brennan J. & Steele R.J. (2001) The impact of recurrent rectal cancer on quality of life. European Journal of Surgery Oncology 27, 349 – 353.
- Curran D., Aaronson N., Standaert B., Molenberghs G., Therasse P., Ramirez A., Koopmanschap M., Erder H. & Piccart M. (2000) Summary measures and statistics in the analysis of quality of life data: an example from an EORTC-NCIC-SAKK locally advanced breast cancer study. European Journal of Cancer 36, 834 – 844.
- EBCTCG (1998) Tamoxifen for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group. Lancet 351, 1451 – 1467.
- Fayers P., Aaronson N., Bjordal K., Curran D. & Groenvold M., on behalf of the EORTC Quality of Life Study Group (1995) EORTC QLQ-C30 Scoring Manual, 1st edn, Brussels.
- Fisher B., Dignam J., Tan-Chiu E., Anderson S., Fisher E.R., Wittliff J.L. & Wolmark N. (2001) Prognosis and treatment of patients with breast tumors of one centimeter or less and negative axillary lymph nodes. Journal of the National Cancer Institute 93, 112 – 120.
- Harter M., Reuter K., Aschenbrenner A., Schretzmann B., Marschner N., Hasenburg A. & Weis J. (2001) Psychiatric disorders and associated factors in cancer: results of an interview study with patients in inpatient, rehabilitation and outpatient treatment. European Journal of Cancer 37, 1385 – 1393.
- Hjermstad M.J., Fayers P.M., Bjordal K. & Kaasa S. (1998) Using reference data on quality of life – the importance of adjusting for age and gender, exemplified by the EORTC QLQ-C30 (+3). European Journal of Cancer 34, 1381 – 1389.
- Hölzel D., Klamert A. & Schmidt M. (1996) Krebs: Häufigkeiten, Befunde und Behandlungsergebnisse. Zuckschwerdt 1, 1 – 552.
- Jordhoy M.S., Fayers P., Loge J.H., Saltnes T., Ahlner-Elmqvist M. & Kaasa S. (2001) Quality of life in advanced cancer patients: the impact of sociodemographic and medical characteristics. British Journal of Cancer 85, 1478 – 1485.
- King M.T. (1996) The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Quality of Life Research 5, 555 – 567.
- Koller M. & Lorenz W. (1998) Quality of life research in patients with rectal cancer: traditional approaches versus a problem-solving oriented perspective. Langenbeck's Archives of Surgery 383, 427 – 436.
- Levine J. (1999) Risky business – communicating scientific findings to the public. Journal of the National Cancer Institute Monographs 25, 163 – 166.
- Lipkus I.M. & Hollands J.G. (1999) The visual communication of risk. Journal of the National Cancer Institute Monographs 25, 149 – 163.
- Lobb E.A., Butow P.N., Kenny D.T. & Tattersall M.H. (1999) Communicating prognosis in early breast cancer: do women understand the language used? Medical Journal of Australia 171, 290 – 294.
- Manning D.L. & Quigley P. (2002) Understanding the needs of people using a cancer information service in Northern Ireland. European Journal of Cancer Care (English) 11, 139 – 142.
- McLachlan S.A., Devins G.M. & Goodwin P.J. (1998) Validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) as a measure of psychosocial function in breast cancer patients. European Journal of Cancer 34, 510 – 517.
- Mor V., Malin M. & Allen S. (1994) Age differences in the psychosocial problems encountered by breast cancer patients. Journal of the National Cancer Institute Monographs 16, 191 – 197.
- Osoba D. (1999) What has been learned from measuring health-related quality of life in clinical oncology. European Journal of Cancer 35, 1565 – 1570.
- Osoba D., Aaronson N., Zee B., Sprangers M. & Te Velde A. (1997) Modification of the EORTC QLQ-C30 (version 2.0) based on content validity and reliability testing in large samples of patients with cancer. The Study Group on Quality of Life of the EORTC and the Symptom Control and Quality of Life Committees of the NCI of Canada Clinical Trials Group. Quality of Life Research 6, 103 – 108.
- Ries L., Eisner M., Kosary C., Hankey B., Miller B., Clegg L. & Edwards B.K., eds (2002) SEER Cancer Statistics Review, 1973–1999. National Cancer Institute, Bethesda, MD. Available at http:seer.cancer.govcsr19731999
-
Rimer B. (1999) The cancer risk communication meeting in perspective.
Journal of the National Cancer Institute Monographs
25, 3.
10.1093/oxfordjournals.jncimonographs.a024204 Google Scholar
- Rimer I. (1984) The mass media and the cancer patient – some views. Health Education Quarterly 10 (Suppl.), 95 – 101.
- Rodgers J.E. (1999) Introduction of section: overarching considerations in risk communications: romancing the message. Journal of the National Cancer Institute Monographs 25, 21 – 22.
- Rustoen T., Moum T., Wiklund I. & Hanestad B.R. (1999) Quality of life in newly diagnosed cancer patients. Journal of Advanced Nursing 29, 490 – 498.
- Rustoen T., Wahl A. & Burchardt C. (2000) Changes in the importance of quality of life domains after cancer diagnosis. Scandinavian Journal of Caring Science 14, 224 – 231.
-
Sanson-Fisher R.,
Girgis A.,
Boyes A.,
Bonevski B.,
Burton L. &
Cook P. (2000) The unmet supportive care needs of patients with cancer. Supportive Care Review Group.
Cancer
88, 226
–
237.
10.1002/(SICI)1097-0142(20000101)88:1<226::AID-CNCR30>3.0.CO;2-P CAS PubMed Web of Science® Google Scholar
- Shiel E. (1999) Don’t Ask for an Opinion – Ask for the Scalpel; Print Media Coverage of Breast Cancer in Australia in 1995. NHMRC National Breast Cancer Centre, NSW, Australia.
- Sprangers M.A.G. (1999) Quality-of-life assessment in colorectal cancer patients: evaluation of cancer therapies. Seminars in Oncology 26, 691 – 696.