Abstract
PurposeIn breast cancer patients, treatment-related health symptoms can occur that may affect their health-related quality of life (HRQoL). This study aimed to determine the impact of health symptoms on HRQoL in breast cancer patients up to 5 years after diagnosis.MethodsFemales surgically treated for early-stage breast cancer diagnosed between 2012 and 2016 (n = 876) were selected from the Netherlands Cancer Registry and invited for a survey about current health symptoms (‘Symptoms and Perceptions questionnaire’, SaP) and HRQoL (‘EORTC-QLQ-C30’). From the latter, functioning and global health were included. Mean scores were compared to norm population scores (T test). Multivariable linear regression analyses were performed to determine the association between health symptoms and global health and functioning.Results404 patients (46%) responded. The median age was 62.2 ± 10.9 years. Respondents had significantly lower mean scores for role, cognitive, emotional, and social functioning than the general population. The most frequently reported health symptoms were musculoskeletal (including pain/complaints in lower/upper extremities/back/neck; 71%) and central nervous system symptoms (including concentration impairment, dizziness, neuralgia; 66%), and fatigue (63%). While most symptoms affected functioning, irrespective of time since diagnosis, especially fatigue, musculoskeletal, central nervous system, and gastrointestinal symptoms were significantly associated (p < 0.05) with lower functioning.ConclusionsThe majority of health symptoms that occur after breast cancer treatment were associated with lower functioning of patients in daily life. This paper urges healthcare providers to support breast cancer patients in alleviating or coping with health symptoms, even years after end of treatment, to improve their functioning.
Highlights
For early-stage breast cancer, five-year survival rates are relatively high and have been increasing over the recent years [1, 2], with current rates in Europe and North America exceeding 85% [1, 3]
Even though survivorship care has become an increasingly important part of care, there are concerns that benefits in treatment of breast cancer do not lead to similar benefits in psychosocial, functional, and sexual wellbeing [21]
Residual treatment-related health symptoms were associated with lower QoL [27, 31], disability, and increased healthcare use [27]
Summary
For early-stage breast cancer, five-year survival rates are relatively high and have been increasing over the recent years [1, 2], with current rates in Europe and North America exceeding 85% [1, 3]. Even though survivorship care has become an increasingly important part of care, there are concerns that benefits in treatment of breast cancer do not lead to similar benefits in psychosocial, functional, and sexual wellbeing [21] Both detection and management of late and side effects of breast cancer and its treatment are widely addressed as a research priority for the recent future [22, 23]. Large unmet needs were found for information, detection, and management of physical impairments [9, 12], cognitive impairments [9], sexual functioning and enjoyment [9, 28], menopausal disorders [9], and antihormonal treatment effects as hot flashes [9, 29, 30] These unmet needs often mediate a lower HRQoL, and were associated with worse perceived physical and mental health [27, 31]. Residual treatment-related health symptoms were associated with lower QoL [27, 31], disability, and increased healthcare use [27]
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