Abstract
BackgroundRecent epidemiological studies indicate the rate of gastrointestinal (GI) malignancies among younger patients is increasing, mainly due to colorectal cancer. There is a paucity of data regarding the magnitude of treatment-related symptoms, psychosocial issues and potential unmet needs in this population. We aimed to characterize the needs of this population to evaluate whether unmet needs could be targeted by potential intervention.MethodsFemale and male patients diagnosed with cancer of the gastrointestinal tract <40y retrospectively completed a questionnaire to evaluate symptoms, daily function and unmet needs at pre-treatment, during and post-treatment. Comparisons were made by gender, disease stage and treatment modality. Multiple linear regression models evaluated effects of demographics, symptoms and needs on multiple domains of health-related-quality-of-life (using Short-Form Health Survey-12 and CARES).ResultsFifty patients were enrolled (52 % female) to a pilot study. Median age at diagnosis was 35.5y (range, 21-40y). The symptoms that significantly increased from baseline to during and post-treatment were: diarrhea (37 %), sleeping disorder (32 %) and sexual dysfunction (40 %). Patients also reported significant deterioration in occupational activities and coping with children compared with baseline. Female patients reported significant unmet need for nutritional counseling and psychosocial support compared to male patients (p < 0.05). Patients treated with multimodality-treatment presented higher rates of unmet needs (p = 0.03).ConclusionsYoung patients with GI cancers represent a group with unique characteristics and needs compared with published evidence on other young-onset malignancies. The distinctive symptoms and areas of treatment-related functional impairments indicate there are unmet needs, especially in the area of psychosocial support and nutritional counseling.
Highlights
Recent epidemiological studies indicate the rate of gastrointestinal (GI) malignancies among younger patients is increasing, mainly due to colorectal cancer
Fifty percent of participants were diagnosed with colon cancer (n = 25), 30 % with rectal cancer (n = 15) and 8 % percent with gastric cancer (n = 4)
The results indicate that following treatment young GI cancer patients experience symptoms that significantly worsen their quality of life (QOL) and interfere with daily activities as diarrhea, sleeping disorder and sexual dysfunction
Summary
Recent epidemiological studies indicate the rate of gastrointestinal (GI) malignancies among younger patients is increasing, mainly due to colorectal cancer. While overall gastric cancer incidence has steadily declined in many countries over the past 50 years, gastroesophageal rates are generally increasing in the western world among YA populations. A recent study demonstrated that the incidence rate for noncardia gastric cancer declined among all race and age groups except for whites aged 25 to 39 years, for whom it had increased [4]. Recent studies characterizing YA patients with early-onset gastrointestinal malignancies have indicated that younger patients experience worse adverse effects of therapy (e.g., nausea and vomiting) compared with older patients [5, 6]. The magnitude of symptoms in the population of YAs with GI malignancies remains to be elucidated
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