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Health concerns of cancer survivors after primary anti-cancer treatment

Abstract

Purpose

Cancer survivors experience significant health concerns compared to the general population. Sydney Survivorship Clinic (SSC) is a multi-disciplinary clinic aiming to help survivors treated with curative intent manage side effects, and establish a healthy lifestyle. Here, we determine the health concerns of survivors post-primary treatment.

Methods

Survivors completed questionnaires assessing symptoms, quality of life (QOL), distress, diet, and exercise before attending SSC, and a satisfaction survey after. Body mass index (BMI), clinical findings and recommendations were reviewed. Descriptive statistical methods were used.

Results

Overall, 410 new patients attended SSC between September 2013 and April 2018, with 385 survivors included in analysis: median age 57 years (range 18–86); 69% female; 43% breast, 31% colorectal and 19% haematological cancers. Median time from diagnosis, 12 months. Common symptoms of at least moderate severity: fatigue (45%), insomnia (37%), pain (34%), anxiety (31%) and with 56% having > 5 moderate-severe symptoms. Overall, 45% scored distress ≥ 4/10 and 62% were rated by clinical psychologist as having ‘fear of cancer recurrence’. Compared to population mean of 50, mean global QOL T-score was 47.2, with physical and emotional well-being domains most affected. Average BMI was 28.2 kg/m2 (range 17.0–59.1); 61% overweight/obese. Only 31% met aerobic exercise guidelines. Overall, 98% ‘agreed’/‘completely agreed’ attending the SSC was worthwhile, and 99% would recommend it to others.

Conclusion

Distress, fear of cancer recurrence, fatigue, obesity and sedentary lifestyle are common in cancer survivors attending SSC and may best be addressed in a multi-disciplinary Survivorship Clinic to minimise longer-term effects. This model is well-rated by survivors.

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Acknowledgements

We would like to thank Erika Jungfer, Loraine Fong and Mashaal Hamayun for their assistance with data entry.

Funding

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

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Correspondence to Janette L. Vardy.

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All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflicts of interest.

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Tan, S.Y., Turner, J., Kerin-Ayres, K. et al. Health concerns of cancer survivors after primary anti-cancer treatment. Support Care Cancer 27, 3739–3747 (2019). https://doi.org/10.1007/s00520-019-04664-w

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Keywords

  • Survivorship
  • Quality of life
  • Distress
  • Fear of cancer recurrence
  • Survivorship care plan