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What happens to cancer survivors attending a structured cancer survivorship clinic? Symptoms, quality of life and lifestyle changes over the first year at the Sydney Cancer Survivorship Centre clinic

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Abstract

Background

Sydney Cancer Survivorship Centre (SCSC) clinic provides multidisciplinary care after primary adjuvant treatment, with ~ 40% of attendees continuing follow-up with SCSC.

Methods

SCSC survivors completed measures of symptoms, quality-of-life and lifestyle factors at initial visit (T1), first follow-up (T2) and 1 year (T3). Analyses used mixed effect models, adjusted for age, sex and tumour type.

Results

Data from 206 survivors (2013–2019) were included: 51% male; median age 63 years; tumour types colorectal 68%, breast 12%, upper gastrointestinal 12%, other 8%. Mean time from: T1 to T2, 3.6 months; T1 to T3, 11.8 months. Mean weight remained stable, but 45% (35/77) of overweight/obese survivors lost weight from T1 to T3. Moderately-intense aerobic exercise increased by 63 mins/week at T2, and 68 mins/week T3. Proportion meeting aerobic exercise guidelines increased from 20 to 41%. Resistance exercise increased by 26 mins/week at T2. Global quality-of-life was unchanged from T1 to T2, improving slightly by T3 (3.7-point increase), mainly in males. Mean distress scores were stable, but at T3 the proportion scoring 4+/10 had declined from 41 to 33%. At T3, improvements were seen in pain, fatigue and energy, but > 20% reported moderate–severe fatigue, pain or sleep disturbance. Proportion reporting 5+ moderate–severe symptoms declined from 35% at T1 to 26% at T3, remaining higher in women.

Conclusions

Survivors attending SCSC increased exercise by 3 months, and sustained it at 1 year. Most overweight/obese survivors avoided further weight gain. Survivors had relatively good quality-of-life, with improvement in many symptoms and lifestyle factors at 1 year.

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References

  1. Hewitt ME, Ganz PA, Institute of Medicine (US), American Society of Clinical Oncology (US) (2006) From cancer patient to cancer survivor: lost in transition : an American Society of Clinical Oncology and Institute of Medicine Symposium. National Academies Press, Washington, DC

    Google Scholar 

  2. Kline RM, Arora NK, Bradley CJ, Brauer ER, Graves DL, Lunsford NB, McCabe MS, Nasso SF, Nekhlyudov L, Rowland JH et al (2018) Long-term survivorship care after cancer treatment - summary of a 2017 National Cancer Policy Forum Workshop. J Natl Cancer Inst 110(12):1300–1310

    Article  Google Scholar 

  3. Welfare AIoH (2019) Cancer data in Australia. In. Canberra, AIHW

    Google Scholar 

  4. Eakin EG, Youlden DR, Baade PD, Lawler SP, Reeves MM, Heyworth JS, Fritschi L (2006) Health status of long-term cancer survivors: results from an Australian population-based sample. Cancer Epidemiol Biomark Prev 15(10):1969–1976

    Article  Google Scholar 

  5. (2004) Cancer survivorship--United States, 1971–2001, MMWR Morb Mortal Wkly Rep. 53(24):526–529

  6. Brown JC, Meyerhardt JA (2016) Obesity and energy balance in GI Cancer. J Clin Oncol 34(35):4217–4224

    Article  Google Scholar 

  7. Demark-Wahnefried W, Schmitz KH, Alfano CM, Bail JR, Goodwin PJ, Thomson CA, Bradley DW, Courneya KS, Befort CA, Denlinger CS, Ligibel JA, Dietz WH, Stolley MR, Irwin ML, Bamman MM, Apovian CM, Pinto BM, Wolin KY, Ballard RM, Dannenberg AJ, Eakin EG, Longjohn MM, Raffa SD, Adams-Campbell LL, Buzaglo JS, Nass SJ, Massetti GM, Balogh EP, Kraft ES, Parekh AK, Sanghavi DM, Morris GS, Basen-Engquist K (2018) Weight management and physical activity throughout the cancer care continuum. CA Cancer J Clin 68(1):64–89

    Article  Google Scholar 

  8. Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH et al (2019) Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc 51(11):2375–2390

    Article  Google Scholar 

  9. Vardy JL, Tan C, Turner JD, Dhillon H (2017) Health status and needs of cancer survivors attending the Sydney Survivorship Centre clinics and programmes: a protocol for longitudinal evaluation of the centre's services. BMJ Open 7(5):e014803

    Article  Google Scholar 

  10. Tan SY, Turner J, Kerin-Ayres K, Butler S, Deguchi C, Khatri S, Mo C, Warby A, Cunningham I, Malalasekera A, Dhillon HM, Vardy JL (2019) Health concerns of cancer survivors after primary anti-cancer treatment. Support Care Cancer 27(10):3739–3747

    Article  CAS  Google Scholar 

  11. Cormie P, Atkinson M, Bucci L, Cust A, Eakin E, Hayes S, McCarthy S, Murnane A, Patchell S, Adams D (2018) Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust 209(4):184–187

    Article  Google Scholar 

  12. Amireault S, Godin G, Lacombe J, Sabiston CM (2015) The use of the Godin-Shephard leisure-time physical activity questionnaire in oncology research: a systematic review. BMC Med Res Methodol 15:60

    Article  Google Scholar 

  13. Tuinman MA, Gazendam-Donofrio SM, Hoekstra-Weebers JE (2008) Screening and referral for psychosocial distress in oncologic practice: use of the distress thermometer. Cancer 113(4):870–878

    Article  Google Scholar 

  14. Cella D, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11(3):10

    Article  Google Scholar 

  15. Stockler MR, O'Connell R, Nowak AK, Goldstein D, Turner J, Wilcken NR, Wyld D, Abdi EA, Glasgow A, Beale PJ, Jefford M, Dhillon H, Heritier S, Carter C, Hickie IB, Simes RJ, Zoloft’s Effects on Symptoms and survival Time Trial Group (2007) Effect of sertraline on symptoms and survival in patients with advanced cancer, but without major depression: a placebo-controlled double-blind randomised trial. Lancet Oncol 8(7):603–612

    Article  CAS  Google Scholar 

  16. Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O'Neal L, McLeod L, Delacqua G, Delacqua F, Kirby J et al (2019) The REDCap consortium: building an international community of software platform partners. J Biomed Inform 95:103208

    Article  Google Scholar 

  17. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381

    Article  Google Scholar 

  18. Janda M, DiSipio T, Hurst C, Cella D, Newman B (2009) The Queensland Cancer risk study: general population norms for the Functional Assessment of Cancer Therapy-General (FACT-G). Psychooncology 18(6):606–614

    Article  Google Scholar 

  19. StataCorp.: Stata Statistical Software: Release 13. In., Release 13 edn. College Station, Texas: StataCorp LP; 2013

  20. Williamson DA, Bray GA, Ryan DH (2015) Is 5% weight loss a satisfactory criterion to define clinically significant weight loss? Obesity (Silver Spring) 23(12):2319–2320

    Article  Google Scholar 

  21. Jacobsen PB, Donovan KA, Trask PC, Fleishman SB, Zabora J, Baker F, Holland JC (2005) Screening for psychologic distress in ambulatory cancer patients. Cancer 103(7):1494–1502

    Article  Google Scholar 

  22. Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL, Winters-Stone K, Gerber LH, George SM, Fulton JE et al (2019) American College of Sports Medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Med Sci Sports Exerc 51(11):2391–2402

    Article  Google Scholar 

  23. Eakin EG, Youlden DR, Baade PD, Lawler SP, Reeves MM, Heyworth JS, Fritschi L (2007) Health behaviors of cancer survivors: data from an Australian population-based survey. Cancer Causes Control 18(8):881–894

    Article  Google Scholar 

  24. Short CE, James EL, Girgis A, D'Souza MI, Plotnikoff RC (2015) Main outcomes of the Move More for Life Trial: a randomised controlled trial examining the effects of tailored-print and targeted-print materials for promoting physical activity among post-treatment breast cancer survivors. Psychooncology 24(7):771–778

    Article  Google Scholar 

  25. Galvao DA, Newton RU, Gardiner RA, Girgis A, Lepore SJ, Stiller A, Occhipinti S, Chambers SK (2015) Compliance to exercise-oncology guidelines in prostate cancer survivors and associations with psychological distress, unmet supportive care needs, and quality of life. Psychooncology 24(10):1241–1249

    Article  Google Scholar 

  26. Hawkins ML, Buys SS, Gren LH, Simonsen SE, Kirchhoff AC, Hashibe M (2017) Do cancer survivors develop healthier lifestyle behaviors than the cancer-free population in the PLCO study? J Cancer Surviv 11(2):233–245

    Article  Google Scholar 

  27. Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera EV, Hamilton KK, Grant B, McCullough M et al (2012) Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 62(4):243–274

    Article  Google Scholar 

  28. Vagenas D, DiSipio T, Battistutta D, Demark-Wahnefried W, Rye S, Bashford J, Pyke C, Saunders C, Hayes SC (2015) Weight and weight change following breast cancer: evidence from a prospective, population-based, breast cancer cohort study. BMC Cancer 15:28

    Article  Google Scholar 

  29. Vance V, Mourtzakis M, McCargar L, Hanning R (2011) Weight gain in breast cancer survivors: prevalence, pattern and health consequences. Obes Rev 12(4):282–294

    Article  CAS  Google Scholar 

  30. Ligibel JA, Alfano CM, Courneya KS, Demark-Wahnefried W, Burger RA, Chlebowski RT, Fabian CJ, Gucalp A, Hershman DL, Hudson MM, Jones LW, Kakarala M, Ness KK, Merrill JK, Wollins DS, Hudis CA (2014) American Society of Clinical Oncology position statement on obesity and cancer. J Clin Oncol 32(31):3568–3574

    Article  Google Scholar 

  31. World Cancer Research Fund (2019) Be a healthy weight. Accessed 19 November 2019

  32. Courneya KS, Vardy JL, O'Callaghan CJ, Friedenreich CM, Campbell KL, Prapavessis H, Crawford JJ, O’Brien P, Dhillon HM, Jonker DJ, Chua NS, Lupichuk S, Sanatani MS, Gill S, Meyer RM, Begbie S, Bonaventura T, Burge ME, Turner J, Tu D, Booth CM (2016) Effects of a structured exercise program on physical activity and fitness in colon cancer survivors: one year feasibility results from the CHALLENGE trial. Cancer Epidemiol Biomark Prev 25(6):969–977

    Article  Google Scholar 

  33. Haidinger R, Bauerfeind I (2019) Long-term side effects of adjuvant therapy in primary breast cancer patients: results of a web-based survey. Breast Care (Basel) 14(2):111–116

    Article  Google Scholar 

  34. Molassiotis A, Yates P, Li Q, So WKW, Pongthavornkamol K, Pittayapan P, Komatsu H, Thandar M, Yi M, Titus Chacko S et al (2018) Mapping unmet supportive care needs, quality-of-life perceptions and current symptoms in cancer survivors across the Asia-Pacific region: results from the international STEP study. Ann Oncol

  35. Jefford M, Ward AC, Lisy K, Lacey K, Emery JD, Glaser AW, Cross H, Krishnasamy M, McLachlan SA, Bishop J (2017) Patient-reported outcomes in cancer survivors: a population-wide cross-sectional study. Support Care Cancer 25(10):3171–3179

    Article  Google Scholar 

  36. Mitchell AJ, Ferguson DW, Gill J, Paul J, Symonds P (2013) Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis. Lancet Oncol 14(8):721–732

    Article  Google Scholar 

  37. Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H (2004) Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. J Clin Oncol 22(23):4829–4836

    Article  Google Scholar 

  38. Schmidt CE, Bestmann B, Kuchler T, Longo WE, Rohde V, Kremer B (2005) Gender differences in quality of life of patients with rectal cancer. A five-year prospective study. World J Surg 29(12):1630–1641

    Article  Google Scholar 

  39. King MT, Stockler MR, Cella DF, Osoba D, Eton DT, Thompson J, Eisenstein AR (2010) Meta-analysis provides evidence-based effect sizes for a cancer-specific quality-of-life questionnaire, the FACT-G. J Clin Epidemiol 63(3):270–281

    Article  Google Scholar 

  40. Tan SY, Turner J, Kerin-Ayres K, Butler S, Deguchi C, Khatri S, Mo C, Warby A, Cunningham I, Malalasekera A, Dhillon HM, Vardy JL (2019) Health concerns of cancer survivors after primary anti-cancer treatment. Support Care Cancer 27:3739–3747

    Article  CAS  Google Scholar 

  41. Butow PN, Aldridge L, Bell ML, Sze M, Eisenbruch M, Jefford M, Schofield P, Girgis A, King M, Duggal-Beri P, McGrane J, Goldstein D (2013) Inferior health-related quality of life and psychological well-being in immigrant cancer survivors: a population-based study. Eur J Cancer 49(8):1948–1956

    Article  Google Scholar 

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Acknowledgements

We would like to thank Anne Warby for her assistance with creating the database and Erika Jungfer, Anne Warby and Loraine Fong for their assistance with data entry.

Funding

Dr. Janette Vardy was supported by a Practitioner Fellowship from the National Breast Cancer Foundation, Australia.

Author information

Authors and Affiliations

  1. Concord Cancer Centre, Concord Repatriation General Hospital, Hospital Rd, Concord, NSW, 2139, Australia

    J. L. Vardy, J. Turner, K. Kerin-Ayres, S. Butler, C. Deguchi, S. Khatri, C. Wildbore, A. Malalasekera & S. Y. Tan

  2. Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia

    J. L. Vardy, A. Liew, C. Mo, M. Hamayun & A. Malalasekera

  3. Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Sydney, NSW, 2006, Australia

    J. L. Vardy, J. Turner, C. Mo & H. M. Dhillon

  4. Psychology Department, Concord Hospital, Hospital Rd, Concord, NSW, 2139, Australia

    S. Butler

  5. Nursing Services, Concord Hospital, Hospital Rd, Concord, NSW, 2139, Australia

    K. Kerin-Ayres, C. Deguchi, S. Khatri, C. Wildbore & S. Y. Tan

  6. Nutrition and Dietetics Department, Concord Hospital, Hospital Rd, Concord, NSW, 2139, Australia

    K. Kerin-Ayres & S. Y. Tan

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  1. J. L. Vardy
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Vardy, J.L., Liew, A., Turner, J. et al. What happens to cancer survivors attending a structured cancer survivorship clinic? Symptoms, quality of life and lifestyle changes over the first year at the Sydney Cancer Survivorship Centre clinic. Support Care Cancer 29, 1337–1345 (2021). https://doi.org/10.1007/s00520-020-05614-7

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