Original ResarchCervical Cancer Survivorship: Long-term Quality of Life and Social Support
Introduction
As the fourth most common cancer among women, cervical cancer is diagnosed in 528,000 women annually and results in 266,000 deaths.1 In the United States, 12,360 new diagnoses and 4,020 cervical cancer−related deaths are expected in 2014.2 Thankfully, there continue to be improvements in outcomes from surgery, radiotherapy, and chemotherapy in terms of progression-free and overall survival.3 However, treatment-related effects, including urinary, gastrointestinal, sexual, and neurologic side effects, can disrupt long-term quality of life (QOL). Because treatment is curative for 85% to 90% of patients with stage I cervical cancer, it is important not to lose focus on the impact of long-term QOL and the interventions that can improve QOL. In addition, cervical cancer patients have been found to have worse QOL scores, not only when compared with the general population, but also when compared with other gynecologic cancer survivors.3
Presently, there are 245,022 cervical cancer survivors living in the United States, each with their own set of victories and challenges as they continue their lives without cancer.4 The goal of this article is to review the key literature regarding QOL among long-term cervical cancer survivors (at least 5 years); delineate the most common challenges to QOL; and identify, where available, both primary treatment modifications that improve long-term QOL and forms of treatment for the long-term sequelae that affect QOL.
Section snippets
Methods
Relevant articles and abstracts published between 1993 and 2014 were identified through searches of PubMed using the following search terms: cervical cancer, long-term effects, survivorship, quality of life, radiation proctitis, bladder dysfunction, bowel dysfunction, sexual dysfunction, lymphedema, and psychosocial support. Data regarding QOL, social support, and coping were abstracted from a focus group of cervical cancer survivors. Themes emerging from group interviews were extracted from
Conclusions
Although data are mixed, concerns remain that during the time of re-entry into survivorship, cervical cancer survivors’ QOL is not that of baseline controls.30 For the 245,022 cervical cancer survivors living in the United States, that has significant ramifications not only on QOL but productivity in life.4 In this review, we have identified the most common long-term sequelae of treatments for cervical cancer that affect the QOL of cervical cancer survivors, whether treatment was surgical,
Conflicts of Interest
The authors have indicated that they have no conflicts of interest regarding the content of this article.
Acknowledgments
This study was supported by RO1 CA118136-05 (Lari Wenzel), P30 CA-62203-14 (Lari Wenzel), and P20 CA174292-01 (Lari Wenzel and Mindy Mechanic).
The authors would like to thank the student researchers who participated in data abstraction from the focus group of cervical cancer survivors.
References (52)
- et al.
Quality of life and emotional distress in early stage and locally advanced cervical cancer patients: a prospective, longitudinal study
Gynecol Oncol
(2012) - et al.
Time course and incidence of late complications in patients treated with radiation therapy for FIGO stage IB carcinoma of the uterine cervix
Int J Radiat Oncol Biol Phys
(1995) - et al.
Patient reported late effects of gynecological cancer treatment
Gynecol Oncol
(2012) - et al.
Class II versus class III radical hysterectomy in stage IB-IIA cervical cancer: a prospective randomized study
Gynecol Oncol
(2001) - et al.
Quality of life in long-term cervical cancer survivors: a population-based study
Gynecol Oncol
(2013) - et al.
Management of early-stage cervical carcinoma by modified (Type II) radical hysterectomy
Gynecol Oncol
(2002) - et al.
Quality of life (QOL) in women treated for gynecologic malignancies with radiation therapy: a literature review of patient-reported outcomes
Gynecol Oncol
(2014) - et al.
Post radical hysterectomy urinary incontinence: a prospective study of transurethral bulking agents injection
Gynecol Oncol
(2009) Gastrointestinal symptoms after pelvic radiotherapy: a new understanding to improve management of symptomatic patients
Lancet Oncol
(2007)- et al.
Severe late toxicities following concomitant chemoradiotherapy compared to radiotherapy alone in cervical cancer: an inter-era analysis
Int J Radiat Oncol Biol Phys
(2012)
Sexual function after modified radical hysterectomy (Piver II/Type B) vs. classic radical hysterectomy (Piver III/Type C2) for early stage cervical cancer. A prospective study
J Sex Med
A critical review of patient-rated quality of life studies of long-term survivors of cervical cancer
Gynecol Oncol
Quality of life in long-term cervical cancer survivors
Gynecol Oncol
Complications of lymphadenectomy for gynecologic cancer
Eur J Surg Oncol
Posttraumatic stress disorder after high-dose-rate brachytherapy for cervical cancer with 2 fractions in 1 application under spinal/epidural anesthesia: incidence and risk factors
Int J Radiat Oncol Biol Phys
Life after radiotherapy: the psychological and social effects experienced by women treated for advanced stages of cervical cancer
Gynecol Oncol
Estimation of potential gain in quality of life from early detection of cervical cancer
Value Health
Health-related quality of life in cervical cancer survivors: a population-based survey
Int J Radiat Oncol Biol Phys
Quality of life characteristics inpatients with cervical cancer
Eur J Cancer
Factors associated with poor quality of life among cervical cancer survivors: Implications for clinical care and clinical trials
Gynecol Oncol
The quality of life of women treated for cervical cancer
Eur J Oncol Nurs
Sexual satisfaction in the elderly female population: A special focus on women with gynecologic pathology
Maturitas
Psychological morbidity and female urinary incontinence. Best practice & research
Clinical obstetrics & gynaecology
Quality of life and sexual function of patients following radical hysterectomy and vaginal extension
J Sex Med
Pneumatic compression device treatment of lower extremity lymphedema elicits improved limb volume and patient-reported outcomes
Eur J Vasc Endovasc Surg
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