DOI: 10.1097/01.COT.0000398799.78063.69
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Issn Print: 0276-2234
Publication Date: 2011/05/25
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Excerpt
“Exactly why patients maintain emotional well-being while getting treatment is still something we are trying to elucidate,” said Bethany Samuelson, a fourth-year doctoral candidate at Oregon Health & Science University School of Medicine, speaking at her poster presentation.
Of the measures of quality of life examined, patients actually reported a 1.44-point improvement in emotional well-being. At baseline, the scores on this part of the assessment were 17.42, which by the end of treatment had increased to 18.86, a statistically significant difference. There was also a minimal improvement on social/family well-being of 0.21 points.
On the other hand, there was a marked 4.21-point decrease in physical well-being and a 1.33-point decrease in functional well-being. The overall score declined 3.89 points from the start of radiation therapy.
“The findings in this study are very consistent with other reports,” said Christopher Willett, MD, Chair of the Department of Radiation Oncology at Duke University Medical Center, who commented on the study. “There is always a capacity among patients for hope, and since most of these patients are receiving definitive treatment, what is being observed is a belief that the treatment may be having a positive impact.”
Samuelson noted that therapy for GI malignancies has long been known to have a marked impact on quality of life, yet this relationship remains poorly understood.” The aim in performing that particular study was to evaluate the impact of radiation therapy on patients with pancreatic and hepatobiliary malignancies.
To perform the retrospective analysis, the researchers received institutional review board approval to scrutinize the charts of 722 patients in the hospital's database, including patients who completed patient-related outcome questionnaires or who undergone interviews or completed questionnaires from January 2006 through December 2008.
The 722 patients (53%) included anyone who had been given a diagnosis of any form of cancer. They were assessed prior to undergoing radiotherapy and after having completed the treatment regimen.
When Samuelson culled the charts for patients diagnosed with gastrointestinal cancers, 73 were identified, and 20 of those patients were being treated for pancreatic or hepatobiliary disease and represented the patients in her study. The average age of these individuals was 63. Twelve were men and 8 were women. Twelve of these patients were being given definitive treatment.
The emotional well-being part of the quality-of-life assessment involved six questions, and even though the patients were deteriorating physically and functionally, the score on these questions generally showed improvements.
“This improvement was largely due to a decrease in positive response to the statements ‘I feel nervous’ and ‘I worry my condition will get worse,’” she said.
The baseline score on the question of ‘I feel nervous’ was 1.30, but after radiation therapy the score was 0.70, a difference that achieved statistical significance. The baseline score on the question ‘I worry my condition will get worse’ was 1.60 at baseline but fell to 1.20 after therapy.
Although the differences in scores on the other questions failed to reach statistical significance, on the question ‘I am satisfied with how I am coping with my illness’ the patients' scores rose from 2.70 to 3.05. Patients also showed a decrease in scores on the question ‘I feel sad,’ which decreased from 1.20 to 0.95. There also was no significant difference in scores on the question ‘I am losing hope in the fight against my illness (an increase from 0.26 at baseline to 0.
