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Women with lung cancer: impact on quality of life

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Abstract

The purpose of this study was to describe disruptions in quality of life (QOL) in women suffering from lung cancer, the leading cause of cancer-related death in the United States. QOL was measured with the CARES-SF. Symptom distress was measured with the modified Symptom Distress Scale, and functional status was measured with the Karnofsky Performance Status Scale. Sixty-nine women with lung cancer participated in a one-time data collection. The typical subject was under 65 years of age, married, has had primary or recurrent non-small cell lung cancer for over 12 months, had limited disease, and was not currently receiving treatment. Subjects had greater disruptions in global QOL and its dimensions compared to a normative heterogeneous female cancer sample. The most prevalent serious disruptions were fatigue, difficulty with household chores, worry about ability to care for self, and worry about cancer progression. The global CARES-SF score was moderately correlated to functional status (r=0.69,p=<0.001), and to symptom distress (r=0.72,p=<0.001). Symptom distress was associated strongly with the physical subscale of QOL (r=0.80,p=0.001) and significantly but less strongly with all other dimensions of QOL. Significantly greater differences in disruptions of quality of life occurred in women younger than 65 years (p=0.04), women with recurrent disease (p=0.003), and women with low income (p=0.008). In stepwise regression, symptom distress predicted 53% of the variance followed by functional status (59%) and recurrence (63%) when QOL was the outcome variable.

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References

  1. LoewenGM, RomanoCF. Lung cancer in women.J Psychoactive Drugs 1989;21: 319–21.

    Google Scholar 

  2. GarfinkelL, SilverbergE. Lung cancer and smoking trends in the United States over the past 25 years.CA 1991;41: 137–145.

    Google Scholar 

  3. BoringCC, SquiresTS, TongT. Cancer statistics, 1992.CA 1992;42: 19–38.

    Google Scholar 

  4. American Cancer Society.Cancer Facts and Figures 1992. Atlanta, GA: American Cancer Society.

    Google Scholar 

  5. ShoplandDR, HarmonJE, PechacekTP. Smoking-attributable cancer mortality in 1991: Is lung cancer now the leading cause of death among smokers in the United States?J Natl Cancer Inst 1991;83: 1142–1147.

    Google Scholar 

  6. GanzPA, SchagCAC, ChengHL. Assessing the quality of life—a study in newly-diagnosed breast cancer patients.J Clin Epidemiol 1990;43: 75–86.

    Google Scholar 

  7. GanzPA, RofessartJ, PolinskyML, SchagCC, HeinrichRL. A comprehensive approach to the assessment of cancer patients' rehabilitation needs.J Psychosoc Oncol 1986;4: 27–42.

    Google Scholar 

  8. McCorkleR. The measurement of symptom distress.Semin Oncol Nurs 1987;3: 234–256.

    Google Scholar 

  9. FeldR. Quality of life in patients with non-small cell lung cancer treated with chemotherapy.Eur J Cancer Clin Oncol 1986;23: 357–359.

    Google Scholar 

  10. BernhardJ, GanzPA, Psychosocial issues in lung cancer patients (part 1).Chest 1991;99: 216–223.

    Google Scholar 

  11. BernhardJ, GanzPA. Psychosocial issues in lung cancer patients (part 2).Chest 1991;99: 480–455.

    Google Scholar 

  12. FergussonRJ, CullA. Quality of life measurement for patients undergoing treatment for lung cancer.Thorax 1991;46 671–675.

    Google Scholar 

  13. SplinterTAW. Chemotherapy in advanced non-small cell lung cancer.Eur J Cancer 1990;26: 1093–1099.

    Google Scholar 

  14. HumphreyEW. Lung Cancer. In: SteeleJGD, WinchesterDP, MenckHR, MurphyGP, eds.National Cancer Data Base. Atlanta, Georgia: The American Cancer Society, Inc., 1992: 19–28.

    Google Scholar 

  15. ScheinokPA, EnglerPE, RobertsonPD, HutterRV, HensonDE. Lung cancer. Difference in age at diagnosis between men and women.N Engl J Med 1989;86: 951–957.

    Google Scholar 

  16. McDuffieHH, KlaassenDJ, DosmanJA. Men, women and primary lung cancer—a Saskatchewan personal interview study.J Clin Epidemiol 1991;44: 537–544.

    Google Scholar 

  17. SchagCAC, HeinrichRL.Cancer Rehabilitation Evaluation System: CARES Manual. Los Angeles, CARES Consultants 1988.

    Google Scholar 

  18. SchagCCC, HeinrichRL, GanzPA. Cancer inventory of problem situation: an instrument for assessing cancer patients' rehabilitation needs.J Psychosoc Oncol 1983;1: 11–25.

    Google Scholar 

  19. HeinrichRL, SchagCAC, GanzPA. Living with cancer: The cancer inventory of problem situations.J Clin Psychol 1984;40: 972–980.

    Google Scholar 

  20. McCorkleR, YoungK. Development of a Symptom Distress Scale.Cancer Nurs 1978;1: 373–378.

    Google Scholar 

  21. McCorkle R, Benoliel JQ:Cancer patient responses to psychosocial variables. Final Report of project supported by Grant No. Nu 00730, DHHS, University of Washington, 1981.

  22. KarnofskyDA, BurchenalJH. Clinical evaluation of chemotherapeutic agents in cancer. In: MacLeodCM, ed.,Evaluation of Chemotherapeutic Agents. New York: Columbia Press, 1949: 191–205.

    Google Scholar 

  23. GriecoA, LongC. Investigation of the Karnofsky Performance Status as a measure of quality of life.Health Psychol 1984;3: 129–142.

    Google Scholar 

  24. HutchinsonTA, BoydNF, FeinsteinAR, GondA, HolssombyD, RowaB. Scientific problems in clinical scales, as demonstrated in the Karnofsky Performance Status Index.J Chronic Dis 1979;32: 661–666.

    Google Scholar 

  25. SchagCAC, HeinrichRL, GanzPA. Karnofsky performance status revisited: reliability, validity, and guidelines.J Clin Oncol 1984;2: 187–193.

    Google Scholar 

  26. YatesJW, ChalmerB, McKegneyFP. Evaluation of patients with advanced cancer using the Karnofsky Performance Status.Cancer 1980;40: 2220–2224.

    Google Scholar 

  27. Sarna L. Correlates of symptom distress in women with lung cancer.Cancer Practice 1993; In press.

  28. BrownCC, KesslerLG. Projections of lung cancer mortality in the United States: 1985–2025.J Natl Cancer Inst 1988;80: 43–51.

    Google Scholar 

  29. GanzPA, SchagCAC, HeinrichRL. The psychosocial impact of cancer on the elderly: a comparison with younger patients.J Am Geriatr Soc 1985;33: 429–435.

    Google Scholar 

  30. MorV. QOL measurement scales for cancer patients: Differentiating effects of age from effects of illness.Oncology 1992;6: 146–152.

    Google Scholar 

  31. GotayCC, KornEL, McCabeMS, MooreTD, ChesonBD. Quality-of-life assessment in cancer treatment protocols: Research issues in protocol development.J Natl Cancer Inst 1992;84: 575–579.

    Google Scholar 

  32. McCorkleR, BenolielJQ. Symptom distress, current concerns and mood disturbance after diagnosis of life-threatening disease.Soc Sci Med 1983;17: 431–438.

    Google Scholar 

  33. BenedictS. The suffering associated with lung cancer.Cancer Nurs 1989;12: 34–40.

    Google Scholar 

  34. BleehanMN, FayersPM, GirlingDJ, StephensRJ. Survival adverse reactions and quality of life during combination chemotherapy compared with selective palliative treatment for small-cell lung cancer.Respir Med 1989;83: 51–58.

    Google Scholar 

  35. GailMH, EaganRT, FeldR, et al. Prognostic factors in patients with resected Stage I non-small cell lung cancer.Cancer 1984;54: 1802–1813.

    Google Scholar 

  36. GanzPA, LeeJJ, SiauJ. Quality of life assessment: An independent prognostic variable for survival in lung cancer.Cancer 1991;67: 3131–3135.

    Google Scholar 

  37. HydeL, WolfJ, McCrackenS, YesnerR. Natural course of inoperable lung cancer.Chest 1973;64: 309–312.

    Google Scholar 

  38. KaasaS, MastekaasaA, LungE. Prognostic factors for patients with inoperable non-small cell lung cancer, limited disease. The importance of patients' subjective experience of disease and psychosocial well being.Radiother Oncol 1989;15: 235–242.

    Google Scholar 

  39. KukullWA, McCorkleR, DrieverM. Symptom distress psychosocial variable and lung cancer survival.J Psychosoc Oncol 1986;4: 91–104.

    Google Scholar 

  40. GanzPA, FiglinRA, HaskellCM, LaSotoN, SiauJ. Supportive care versus supportive care and combination chemotherapy in metastatic non-smali cell lung cancer. Does chemotherapy make a difference?Cancer 1989;63: 1271–1278.

    Google Scholar 

  41. MinetP, BartschP, ChevalierP, et al. Quality of life of inoperable non-small cell lung carcinoma. A randomized phase II clinical study comparing radiotherapy alone and combined radio-chemotherapy.Radiother Oncol 1987;8: 217–230.

    Google Scholar 

  42. KaasaS, MastekaasaA, ThorudE. Toxicity, physical function and everyday activity reported by patients with inoperable non-small cell lung cancer in a randomized trial (chemotherapy versus radiotherapy).Acta Oncol 1988;27 343–349.

    Google Scholar 

  43. JaakkimainenL, GoodwinPJ, PaterJ, WardeP, MurrayN, EdnaR. Counting the costs of chemotherapy in a National Cancer Institute of Canada randomized trial in non small-cell lung cancer.J Clin Oncol 1990;8: 1301–1309.

    Google Scholar 

  44. McCorkleR, BenolielJQ, DonaldsonG, GeorgiadouF, MoinpourC, GoodellB. A randomized clinical trial of home nursing care for lung cancer patients.Cancer 1989;64: 199–206.

    Google Scholar 

  45. CellaDF, OrofiammaB, HollandJC, et al. The relationship of psychological distress, extent of disease, and performance status in patients with lung cancer.Cancer 1987;60: 1661–1667.

    Google Scholar 

  46. GoldbergRJ, WoolMS, GlicksmanA, TullR. Relationship of the social environment and patients' physical status to depression in lung cancer patients and their spouses.J Psychosoc Oncol 1985;2: 73–80.

    Google Scholar 

  47. HopwoodP, ThatcherN. Preliminary experience with quality of life evaluation in patients with lung cancer.Oncol Williston Park 1990;4: 158–162.

    Google Scholar 

  48. Hughes JE. Depressive illness and lung cancer. I. Depression before diagnosis.Eur J Surg Oncol;11: 15–20.

  49. Hughes JE. Depressive illness and lung cancer. II. Follow-up of inoperable patients.Eur J Surg Oncol;11: 21–4.

  50. WeismanAD, WordenJW.Coping and Vulnerability in Cancer Patients, Boston: Project Omega, Harvard Medical School, 1977.

    Google Scholar 

  51. MountainCF. Value of the new TNM staging system for lung cancer.Chest 1989;96: 47s-51s.

    Google Scholar 

  52. BergmanS, SorensonS. Smoking and effects of chemotherapy in small cell lung cancer.Eur Respir J 1988;1: 932–937.

    Google Scholar 

  53. MacdonaldN. Research—a neglected area of palliative care.J Palliative Care 1992;8: 54–58.

    Google Scholar 

  54. McCorkle R, Wilkerson K.Home care needs of cancer patients and their caregivers. Final Report. National Center for Nusing Research, #NR01914 1991.

  55. GeddesDM, DonesL, HillE, et al. Quality of life during chemotherapy for small cell lung cancer: Assessment and use of a daily diary card in a randomized trial.Eur J Cancer 1990;26: 484–492.

    Google Scholar 

  56. BergmanB, SullivanM, SorensonS. Quality of life during chemotherapy for small cell lung cancer: I. An evaluation with generic health measures.Acta Oncol 1991;30: 947–957.

    Google Scholar 

  57. BergmanB, SullivanM, SorensonS. Quality of life during chemotherapy for small cell lung cancer: II. A longitudinal study of the EORTC Core Quality of Life Questionnaire and comparison with the Sickness Impact Profile.Acta Oncol 1992;31: 19–28.

    Google Scholar 

  58. FerrelBR, WisdomC, WenzlC, SchneiderC. Quality of life as an outcome variable in pain research.Cancer 1989;63: 2321–2327.

    Google Scholar 

  59. CrawfordJ, O'RourkeMA, CohenHJ. Age factors in the management of lung cancer. In: YancikR, YatesJW, eds,Cancer in the Elderly: Approaches to Early Detection and Treatment. New York: Springer Verlag, 1989: 177–203.

    Google Scholar 

  60. OlofsenJ, SkooghBE, BakeB, SvardsuddK. Mortality related to smoking habits, respiratory symptoms and lung function.Eur J Respir Dis 1987;71: 69–76.

    Google Scholar 

  61. FellettiR, SouhamiRL, SpiroSG. et al. Social consequences of brain or liver relapse in small cell carcinoma of the bronchus.Radiother Oncol 1985;4: 335–339.

    Google Scholar 

  62. MorV, GuadagnoliE, WoolM. An examination of the concrete service needs of advanced cancer patients.J Psychosoc Oncol 1987;5: 1–17.

    Google Scholar 

  63. GreenCP. Changes in responsibility in women's families after the diagnosis of cancer.Health Care Women Int 1986;7: 221–239.

    Google Scholar 

  64. LewisFM, EllisonES, WoodsNF. The impact of breast cancer on the family.Semin Oncol Nurs 1985;1: 106–213.

    Google Scholar 

  65. McCorkleR. Women and cancer. In: TiffanyR, ed.Oncology for Nurses and Health Care Professionals. London: Harper and Row, 1988.

    Google Scholar 

  66. Weisman AD, Worden JW. The existential plight in cancer: significance of the first 100 days.Int J Psychiatry Med 76–77;7: 1–15.

  67. EdgarL, RosbergerZ, NowlisD. Coping with cancer during the first year after diagnosis: Assessment and intervention.Cancer 1992;69: 817–828.

    Google Scholar 

  68. CowardDD. Self-transcendence and emotional wellbeing in women with advanced breast cancer.Oncol Nurs Forum 1991;18: 857–863.

    Google Scholar 

  69. FreemanHP. Cancer in the socioeconomically disadvantaged.CA 1989;39: 266–287.

    Google Scholar 

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Supported in part by Gamma Tau: Sigma Theta Tau, Academic Senate, University of California, Los Angeles, the UCLA School of Nursing, and the American Cancer Society, California Division

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Sarna, L. Women with lung cancer: impact on quality of life. Qual Life Res 2, 13–22 (1993). https://doi.org/10.1007/BF00642885

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