Quality of Life

Quality of Life

Dramatic improvements in the management of side effects – including pain, nausea, and infection – have radically improved the quality of life for patients undergoing cancer treatment.

Major advances include the development of potent anti-nausea drugs, which enable most cancer patients to receive chemotherapy in an outpatient setting with minimal disruption to their daily routines. Pain management has also improved, along with recognition and treatment of emotional distress related to a patient's cancer diagnosis. Addressing quality of life issues is now considered an integral part of quality cancer care, as are support services for patients and families.

With record numbers of cancer survivors, programs have likewise been designed to ensure that medical monitoring and guidance needed to remain healthy are provided after treatment ends.
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2017

Reduced radiation dose for HPV-associated throat cancer reduces long-term complications

Reduced radiation dose for HPV-associated throat cancer reduces long-term complications

Two clinical trials show that lowering the standard radiation dose by 15% to 20% does not compromise survival for individuals with HPV-associated oropharyngeal cancer. Furthermore, one of the studies shows that those who receive the lower dose are far less likely to have difficulty swallowing solids or impaired nutrition a year after treatment. HPV-associated oropharyngeal cancers are increasing, and while they typically respond well to treatment, those diagnosed tend to be younger and can be affected by these treatment-related complications for decades – making reductions in long-term effects especially important.

More Information: 

J Clin Oncol 35:490-497, 2017
Lancet Oncol 18:803-811, 2017

2016

Olanzapine prevents chemotherapy-induced nausea and vomiting

Olanzapine prevents chemotherapy-induced nausea and vomiting

A large clinical trial finds that olanzapine (Zyprexa) prevents chemotherapy-induced nausea and vomiting more than standard anti-nausea treatments. In addition to being uncomfortable and debilitating, nausea and vomiting can prevent patients from completing their full course of chemotherapy, increasing the chance of recurrence, and shortening survival. These results add to previous research suggesting olanzapine’s benefit for patients receiving chemotherapy.

More Information: 

N Engl J Med. 2016; 375(2): 134-142
Olanzapine prevents chemotherapy-induced nausea and vomiting

Olanzapine prevents chemotherapy-induced nausea and vomiting

A large clinical trial finds that olanzapine (Zyprexa) prevents chemotherapy-induced nausea and vomiting more than standard anti-nausea treatments. In addition to being uncomfortable and debilitating, nausea and vomiting can prevent patients from completing their full course of chemotherapy, increasing the chance of recurrence, and shortening survival. These results add to previous research suggesting olanzapine’s benefit for patients receiving chemotherapy.

More Information: 

New England Journal of Medicine

2014

Early palliative care shows continued benefits

Early palliative care shows continued benefits

Building on previous data from smaller studies, a large study shows that integrating palliative care into standard care for patients with advanced cancer can help improve patients’ quality of life and their satisfaction with care.

Conducted in a range of cancer care settings, this study offers insights into how a more collaborative care model might be broadly implemented.

More Information: 

Lancet 2014; 383(9930): 1721–1730

2011

New tool helps physicians tailor chemotherapy treatment for older patients

New tool helps physicians tailor chemotherapy treatment for older patients

Researchers develop a new assessment tool that helps physicians identify older adults with cancer who will have difficulty tolerating and completing chemotherapy. The tool considers factors such as other illnesses, mental function, social support, and nutritional status to predict an elderly patient's risk of side effects. The model will help physicians tailor cancer treatment in a way that maximizes quality of life for the patients.

More Information: 

Journal of Clinical Oncology

2010

Adding palliative care to standard chemotherapy improves survival for advanced lung cancer patients

Adding palliative care to standard chemotherapy improves survival for advanced lung cancer patients

A head-to-head trial shows that patients who received standard chemotherapy along with palliative care (specialized treatment to address the symptoms of cancer, but not treat the disease) immediately after their diagnosis with advanced lung cancer lived three months longer and had a higher quality of life than patients who had chemotherapy alone. Patients who received the combination approach were also less likely to undergo aggressive therapy at the end of life, such as resuscitation. The results demonstrate the potential for palliative care to no only improve quality of life, but to extend patients' lives as well.

More Information: 

Cancer.Net; Lung Cancer - Non-Small Cell: Treatment Options
N Engl J Med 2010; 363: 733-42
Removing fewer lymph nodes for some breast cancer patients does not impair survival

Removing fewer lymph nodes for some breast cancer patients does not impair survival

Badge indicating that research was paid for using federal funds

Two large clinical trials confirm that less extensive lymph node surgery in women with early-stage disease does not reduce their likelihood of survival. Specifically, researchers find that removing additional underarm lymph nodes to look for breast cancer in women with limited or no disease spread in the "sentinel" node – where cancer is most likely to spread – does not make a significant difference in survival, compared to removing fewer nodes. Removing fewer nodes decreases the risk of side effects, such as pain and swelling in the affected arm.

More Information: 

JCO 2010; 28(Suppl 18): CRA504
JAMA 2011; 305(6): 569–575

2008

Minimally invasive surgery shown to be effective for cervical cancer

Minimally invasive surgery shown to be effective for cervical cancer

In a small study, researchers find that two minimally invasive techniques – laparoscopic and robotic radical hysterectomy (removal of the uterus) with radical pelvic lymphadenectomy (removal of surrounding pelvic lymph nodes) – are as effective as traditional radical hysterectomy and lymphadenectomy in women with cervical cancer. The procedures, which are performed through small incisions, are associated with less blood loss and shorter hospital stays than traditional, open surgery. While both of the new techniques had already been put into limited practice, this study provided evidence to support their widespread use.

More Information: 

Cancer.Net; Cervical Cancer: Treatment Options
Gynecologic Oncology 2008; 109(1): 86-91

2007

Psychosocial support becomes an integral part of cancer care

Psychosocial support becomes an integral part of cancer care

A growing body of research highlights the importance of providing "psychosocial" services to help patients address depression, anxiety and other emotional challenges after a cancer diagnosis. In 2007, the Institute of Medicine issues a report recommending that all cancer care providers make psychosocial services an integral part of patients' care, to improve their quality of life and help them adhere to their cancer treatment. Since then, ASCO and other medical and patient groups have developed additional guidance and information to help ensure that patients and their families receive the support they need to maintain their well-being.
Shorter course of radiation therapy is as effective as less frequent radiation therapy for early-stage breast cancer

Shorter course of radiation therapy is as effective as less frequent radiation therapy for early-stage breast cancer

Findings from the START Trial suggest that "hypofractionated" radiation therapy, which involves fewer but larger doses of radiation delivered over a shorter period of time, is as effective as conventional radiation for reducing the risk of cancer recurrence among women with early-stage breast cancer, and does not cause greater damage to healthy breast tissue. Since traditional radiation therapy for breast cancer can take five to six weeks to complete, this shorter course (as little as three weeks) is a more convenient option for some patients and makes it easier to complete all cycles of treatment.
Diet, exercise reduce risk of colon cancer recurrence

Diet, exercise reduce risk of colon cancer recurrence

Badge indicating that research was paid for using federal funds

Patients who follow a low-fat diet and exercise regularly are found to have a lower risk of colon cancer recurrence after surgery for early-stage disease, demonstrating that lifestyle factors can have a significant impact on cancer recurrence. The results provide patients with new tools for reducing the risk that their cancer will return.

More Information: 

JAMA 2007; 298(7): 754-764

2006

Many breast cancer survivors experience fatigue

Many breast cancer survivors experience fatigue

Badge indicating that research was paid for using federal funds

A large study shows more than one-third of long-term breast cancer survivors report elevated fatigue 5 to 10 years after their cancer diagnosis. Women in the study had completed all cancer therapies other than tamoxifen (Novaldex). The findings suggest that persistent fatigue may be common among breast cancer survivors, and heightens awareness of this symptom among healthcare providers and caregivers.

More Information: 

Cancer 2006; 106(4): 751-758
Treatment with new targeted drug cetuximab prolongs life

Treatment with new targeted drug cetuximab prolongs life

Badge indicating that research was paid for using federal funds

Important data emerge on the value of the targeted drug cetuximab (Erbitux), showing this therapy extends survival and improves quality of life for patients with head and neck cancers.

One large trial shows that adding cetuximab to standard radiation therapy significantly extends the lives of patients with head and neck cancer that has not spread beyond this region of the body. Notably, the addition of cetuximab does not carry significant added side effects. Soon after, the FDA approves cetuximab for this use and in patients with advanced disease who have not responded to previous chemotherapy. Since the value of cetuximab has not yet been confirmed by additional positive trials, however, many researchers remain cautious about the drug's benefits.

More Information: 

N Engl J Med 2006; 354: 567-578

2005

Drug approved to reduce oral sores caused by cancer treatment
Research sheds light on long-term health problems of cancer survivors

Research sheds light on long-term health problems of cancer survivors

Badge indicating that research was paid for using federal funds

In the 1990s, researchers begin a major study of the long-term effects of cancer and its treatment, focusing on survivors of childhood cancer. In 2005, the Childhood Cancer Survivors Study reports that survivors' risk of long-term health problems – including heart problems, second cancers and scarring of the lungs – was five times greater than that of their healthy siblings. Similar results have been found for survivors of other cancers with high cure rates, such as testicular cancer.

The results are helping oncologists and primary care providers monitor and better manage the long-term health of the millions of cancer survivors alive today.

More Information: 

Cancer.Net; Survivorship
NCI: Late Effects of Childhood Cancer
JNCI 2005; 97(18): 1354-65
Testicular cancer survivors face increased risk of second cancers, other health problems

Testicular cancer survivors face increased risk of second cancers, other health problems

A major study finds that survivors of testicular cancer – especially those who received radiation or chemotherapy – have double the risk of developing a second cancer three or more decades after their initial diagnosis. Other research identifies an increased risk of cardiovascular disease and chronically low testosterone. These findings highlight the need for doctors to continually monitor for long-term health effects among the growing number of cancer survivors.

More Information: 

Cancer.Net; Testicular Cancer: Follow-Up Care
JNCI 2005; 97(18): 1354-65
Journal of Clinical Oncology 2010; 28(30): 4649-57
Low-fat diet and regular exercise may reduce risk of breast cancer recurrence

Low-fat diet and regular exercise may reduce risk of breast cancer recurrence

Badge indicating that research was paid for using federal funds

Two large clinical trials suggest that lifestyle changes, including a low-fat diet and exercise, decrease the risk of breast cancer recurrence and death in women with early-stage breast cancer. The findings are among the first to demonstrate that healthy lifestyle changes can have a substantial impact on breast cancer outcomes.

More Information: 

JAMA 2005; 293(20): 2479-2486
Journal of the National Cancer Institute 2006; 98(24): 1767-1776

2004

Laparoscopic colon cancer surgery effective, better tolerated

Laparoscopic colon cancer surgery effective, better tolerated

Badge indicating that research was paid for using federal funds

A study by researchers at multiple cancer centers finds that laparoscopic surgery to remove colon tumors was as effective as conventional open abdominal surgery, and was associated with shorter hospital stays and less pain after surgery. Laparoscopic surgery involves removing the tumor through multiple small incisions and a telescoping camera device. This less-invasive approach is now widely used.

More Information: 

Cancer.Net; Colorectal Cancer: Treatment Options
N Engl J Med 2004; 350: 2050-2059
Chemotherapy and radiation before surgery reduce side effects for rectal cancer patients

Chemotherapy and radiation before surgery reduce side effects for rectal cancer patients

Results from a large clinical study show that giving chemotherapy and radiation therapy before, rather than after, rectal cancer surgery reduces the risk of local recurrence (cancer recurrence in the pelvis, near the original tumor). Survival was similar in both approaches, but because the pre-surgery treatment regimen was more tolerable, it is now the standard approach for treatment of rectal cancer.

More Information: 

Cancer.Net; Colorectal Cancer: Treatment Options
N Engl J Med 2004; 351: 1731-1740

2003

First oral chemotherapy drug helps simplify colon cancer treatment

First oral chemotherapy drug helps simplify colon cancer treatment

The FDA approves capecitabine (Xeloda) for patients with advanced (metastatic) colon cancer, and later for patients with stage III colon cancer (cancer with limited spread in the surrounding tissue) who have had surgery to remove the tumor. Capecitabine is a pill version of the widely used intravenous chemotherapy drug 5-fluorouracil that offers comparable effectiveness with a more convenient way for patients to receive their treatment. Recently, capecitabine has been combined with the drug oxaliplatin (Eloxatin) as an initial therapy for metastatic colon cancer and for early-stage colon cancer.

More Information: 

JCO 2004; 22(11): 2084-2091
N Engl J Med 2005; 352: 2696-2704
JCO 2011; 29(11): 1465-1471

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