Skip to main content

Advertisement

SpringerLink
Log in

Role of supportive care in improving the quality of life and reducing unscheduled hospital care in patients with metastatic breast cancer

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Background

Metastatic breast cancer (MBC) patients experience long survival and report poorer quality of life than localized breast cancer patients. Comprehensive supportive care (CSC) has been shown to improve the quality of life (QoL) of MBC. The respective part of each support care has not been fully examined, and little is known about whether meeting patients’ needs is accompanied by decreased unscheduled hospital care (UHC).

Methods

This prospective monocentric study included women who started a new treatment line for MBC between January 2018 and December 2018. The endpoints were factors associated with UHC and QoL (SF36) at month 12.

Results

100 patients were offered CSC, 78 were included (21 refusals, 1 no MBC). CSC was provided to 60 patients: pain (43%), psychological (37%), kinesitherapy (30%), social assistance (22%), esthetic (18%), nutrition (18%), massage (13%), and none (10%). CSC rate was not statistically different among patients with (58%) and without UHD (49%). Factors associated with a decrease of UHC were age > 65 years (p = 0.01), no previous treatment for MBC (p = 0.0001) with a trend for the lack of CSC (p = 0.054). Among the 8 domains of the SF36 scale, only health change perception was improved (p = 0.01) and its predictive factors were treatment carried out as planned (p = 0.0004), pain care (p = 0.003), and lack of MBC progression (p = 0.0035).

Conclusion

CSC can improve QoL in MBC. Painful patients might benefit more from CSC. UHC did not decrease for patients receiving CSC as expected possibly because of their important needs for clinical care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. WHO 2018. http://gco.iarc.fr/today/home

  2. Caswell-Jin JL, Plevritis SK, Tian L et al (2018) Change in survival in metastatic breast cancer with treatment advances: meta-analysis and systematic review. JNCI Cancer Spectr 2(4):pky062

    Article  Google Scholar 

  3. Mariotto AB, Etzioni R, Hurlbert M et al (2017) Estimation of the number of women living with metastatic breast cancer in the United States. Cancer Epidemiol Biomark Prev 26(6):809–815

    Article  Google Scholar 

  4. Oh S, Heflin L, Meyerowitz BE et al (2004) Quality of life of breast cancer survivors after a recurrence: a follow-up study. Breast Cancer Res Treat 87(1):45–57

    Article  Google Scholar 

  5. Wang T, Molassiotis A, Chung BPM et al (2018) Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review. BMC Palliat Care 17(1):96

    Article  Google Scholar 

  6. Cardoso F, Senkus E, Costa A et al (2018) 4th ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4). Ann Oncol 29(8):1634–1657

    Article  CAS  Google Scholar 

  7. National Institute for Clinical Excellence (NICE): Guidance on cancer services: improving supportive and palliative care for adults with cancer: the manual. London, NICE, 2004. www.nice.org.uk/ guidance/csgsp, Access on December, 2019.

  8. Uchida M, Akechi T, Okuyama T et al (2011) Patients’ supportive care needs and psychological distress in advanced breast cancer patients in Japan. Jpn J Clin Oncol 41(4):530–536

    Article  Google Scholar 

  9. Zdenkowski N, Tesson S, Lombard J et al (2016) Supportive care of women with breast cancer: key concerns and practical solutions. Med J Aust 205(10):471–475

    Article  Google Scholar 

  10. Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483

    Article  Google Scholar 

  11. Kuligowski J, Pérez-Guaita D, Quintás G (2016) Application of discriminant analysis and cross-validation on proteomics data. Methods Mol Biol 1362:175–184

    Article  CAS  Google Scholar 

  12. Boele F, Harley C, Pini S, et al. Cancer as a chronic illness: support needs and experiences. BMJ Supportive & Palliative Care Published Online First: 19 September 2019. https://doi.org/10.1136/bmjspcare-2019-001882.

  13. Mustafa M, Carson-Stevens A, Gillespie D et al (2013) Psychological interventions for women with metastatic breast cancer. Cochrane Database Syst Rev 6:CD004253

    Google Scholar 

  14. Kim HJ, McGuire DB, Tulman L et al (2005) Symptom clusters: concept analysis and clinical implications for cancer nursing. Cancer Nurs 28(4):270–282

    Article  Google Scholar 

  15. Parker KP, Kimble LP, Dunbar SB et al (2005) Symptom interactions as mechanisms underlying symptom pairs and clusters. J Nurs Scholarsh 37(3):209–215

    Article  Google Scholar 

  16. Delaney A, Fleetwood-Walker SM, Colvin LA et al (2008) Translational medicine: cancer pain mechanisms and management. Br J Anaesth 101(1):87–94

    Article  CAS  Google Scholar 

  17. Hamash KI, Umberger W, Aktas A et al (2018) The effect of the pain symptom cluster on performance in women diagnosed with advanced breast cancer: the mediating role of the psychoneurological symptom cluster. Pain Manag Nurs 19(6):627–636

    Article  Google Scholar 

  18. Van den Beuken-Van Everdingen MH, De Rijke JM, Kessels AG et al (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 18(9):1437–1449

    Article  Google Scholar 

  19. Costa WA, Monteiro MN, Queiroz JF et al (2017) Pain and quality of life in breast cancer patients. Clinics (Sao Paulo) 72(12):758–763

    Article  Google Scholar 

  20. NCTN 2015. https://www.cancer.gov/about-nci/organization/ccct/steering-committees/strategic-priorities.pdf

  21. Cleary J, Ddungu H, Distelhorst SR et al (2013) Supportive and palliative care for metastatic breast cancer: resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement. Breast 22(5):616–627

    Article  Google Scholar 

  22. Girgis A, Breen S, Stacey F, et al. Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients with nonlocalized breast and colorectal cancers. J Clin Oncol.2009;20;27(36):6180-6190.

  23. Reiser V, Rosenzweig M, Welsh A et al (2019) The Support, Education, and Advocacy (SEA) program of care for women with metastatic breast cancer: a nurse-led palliative care demonstration program. Am J Hosp Palliat Care 36(10):864–870

    Article  Google Scholar 

  24. Sprangers MA, Groenvold M, Arraras JI et al (1996) The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol 14(10):2756–2768

    Article  CAS  Google Scholar 

  25. Apolone G, Filiberti A, Cifani S et al (1998) Evaluation of the EORTC QLQ-C30 questionnaire: a comparison with SF-36 Health Survey in a cohort of Italian long-survival cancer patients. Ann Oncol 9(5):549–557

    Article  CAS  Google Scholar 

  26. Yip WK, Mordiffi SZ, Anq E (2012) Reliability, validity and feasibility of quality of life instruments for adult patients with cancer undergoing chemotherapy: result from a systematic review. Int J Evid Based Healthc 10(1):27–52

    Article  Google Scholar 

  27. Oostendorp LJ, Stalmeier PF, Donders AR et al (2011) Efficacy and safety of palliative chemotherapy for patients with advanced breast cancer pretreated with anthracyclines and taxanes: a systematic review. Lancet Oncol 12(11):1053–1061

    Article  CAS  Google Scholar 

  28. Earle CC, Neville BA, Landrum MB et al (2005) Evaluating claims-based indicators of the intensity of end-of-life cancer care. Int J Qual Health Care 17(6):505–509

    Article  Google Scholar 

  29. WHO SP https://www.who.int/cancer/palliative/definition/en/

  30. Lemieux J, Topp A, Chappell H et al (2006) Economic analysis of psychosocial group therapy in women with metastatic breast cancer. Breast Cancer Res Treat 100(2):183–190

    Article  Google Scholar 

  31. Trumper M, Ross PJ, Cunningham D et al (2006) Efficacy and tolerability of chemotherapy in elderly patients with advanced oesophago-gastric cancer: a pooled analysis of three clinical trials. Eur J Cancer 42:827–834

    Article  CAS  Google Scholar 

  32. Repetto L (2003) Greater risks of chemotherapy toxicity in elderly patients with cancer. J Support Oncol 14(Suppl 2):18–24

    Google Scholar 

Download references

Acknowledgments

The authors thank all the investigators who participated in the study.

Author information

Authors and Affiliations

  1. Institut Sainte Catherine, 250 chemin de baigne-pieds, 84918, Avignon, France

    Antoine Arnaud, Julien Grenier, Rania Boustany, Sylvie Kirscher, Alice Mege, Gaëtan de Rauglaudre, Léa Vazquez & Philippe Debourdeau

Authors
  1. Antoine Arnaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julien Grenier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rania Boustany
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sylvie Kirscher
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alice Mege
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gaëtan de Rauglaudre
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Léa Vazquez
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Philippe Debourdeau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Léa Vazquez.

Ethics declarations

Competing interests

PD has received research grants and conferences invitation from Pfizer Company.

Funding

The study was funded by the Pfizer, France.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arnaud, A., Grenier, J., Boustany, R. et al. Role of supportive care in improving the quality of life and reducing unscheduled hospital care in patients with metastatic breast cancer. Support Care Cancer 29, 3735–3742 (2021). https://doi.org/10.1007/s00520-020-05877-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-020-05877-0

Keywords

Search

Navigation