Prognostic Value of Knowledge of Cancer and Used Unconventional Therapy Methods on Quality of Life in Advanced, Metastatic Colorectal Cancer in Clinical Practice

Abstract

Colorectal cancer (CRC) is the third most common malignancy in the world and the second cause of cancer-related deaths. Despite the search for new therapeutic agents, there are still many doubts concerning the quality of life (QOL) improvement in palliative patients. In this study, we assessed the impact of oncology knowledge on QOL and the relationship between QOL and various environmental factors and unconventional treatment methods in patients with CRC treated with chemotherapy and targeted therapy. The results of first-line palliative chemotherapy in 330 patients with colorectal cancer treated between January 2010 and December 2016 in two centers were analyzed. The average age of patients was 66 ± 11.7 years. Median survival time was 25 months. In multivariate analysis, the performance status and response to treatment had a significant effect on survival time. A trend towards shorter survival was also observed in patients receiving 5-FU monotherapy, in elderly patients and in patients with less oncology knowledge. A relationship between general quality of life and performance status (PS 0 vs. PS > 0), response to treatment and oncology knowledge was found. Patients with limited oncology knowledge more often used unconventional therapy methods in parallel with the treatment. In patients over 70 years of age and in patients with worse overall condition, 5-FU monotherapy was more commonly used (p < 0.01). The level of oncology knowledge of the treated patients observed in everyday clinical practice may be related to some parameters of treatment effectiveness assessment, such as QOL and may be related to the use of unconventional treatment methods. Those, in turn may have an impact on the QOL of the treated patients.

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

Abbreviations

CRC:

colorectal cancer

QOL:

quality of life

HBI:

questionnaire Health Behavior Inventory by prof. Z. Juczyński

References

  1. 1.

    Ferlay J, Soerjomataram I, Ervik M i wsp. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. http://globocan.iarc.fr

  2. 2.

    Wojciechowska U, Didkowska J, Zatoński W (2012) Nowotwory złośliwe w Polsce. Centrum Onkologii Instytut, Warszawa

    Google Scholar 

  3. 3.

    De Angelis R, Sant M, wsp CMP i (2014) Cancer survival in europe 1999-2007 by country and age: results of EUROCARE–5-a population-based study. Lancet Oncol 15:23–34

    Article  Google Scholar 

  4. 4.

    Cunningam D, Pyrhonen S (1998) James RD i wsp. Randomised trial of irinotecan plus supportive care versus supportive care alone after flurouracil failure for patients with metastatic colorectal cancer. Lancet 352:1407–1412

    Article  Google Scholar 

  5. 5.

    Aranda E, Valladares M (2009) Martinez-Villacampa M i wsp. Randomized study of weekly irinotecan plus high-dose 5-fluorouracil (FUIRI) versus biweekly irinotecan plus 5-fluorouracil/leucovorin (FOLFIRI) as first-line chemotherapy for patients with metastatic colorectal cancer: a Spanish Cooperative Group for the Treatment of Digestive Tumors Study. Ann Oncol 20:251–257

    CAS  Article  Google Scholar 

  6. 6.

    Kohne CH, Wils J, wsp LM i (2003) Randomized phase III study of high-dose fluorouracil given as a weekly 24-hour infusion with or without leucovorin versus bolus fluorouracil plus leucovorin in advanced colorectal cancer: European Organization of Research and Treatment of Cancer Gastrointestinal Group Study 40952. J Clin Oncol 21:3721–3728

    Article  Google Scholar 

  7. 7.

    Tournigand C, André T, wsp AE i (2004) FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 22:229–237

    CAS  Article  Google Scholar 

  8. 8.

    Douillard JY, Cunningham D, Roth AD i wsp(2000) Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 355(erratum in Lancet 355: 1372):1041–1047

    CAS  Article  Google Scholar 

  9. 9.

    de Gramont A, Figer A, Seymour M i wsp(2000) Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18:2938–2947

    Article  Google Scholar 

  10. 10.

    Saltz LB, Cox JV, Blanke C i wsp(2000) Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 343:905–914

    CAS  Article  Google Scholar 

  11. 11.

    The World Health Organization Quality of Life assessment (1995) (WHOQOL): position paper from the World Health Organization. Soc Sci Med 41:1403–1409

    Article  Google Scholar 

  12. 12.

    Adamowicz K, Zalewska M, Majkowicz M, Zaucha JM (2015) Evaluation of the impact of different types of health education on the adoption and preservation of prohealth attitudes in preventing cancer in juveniles younger than 18 years. J Cancer Educ 30:432–438

    Article  Google Scholar 

  13. 13.

    Adamowicz K, Zaucha JM, Majkowicz M (2011) Assessment of the state of knowledge regarding cancer prevention among patients of the breast cancer prevention clinic Nowotwory. J Oncol 61:449–456

    Google Scholar 

  14. 14.

    Saad ED, Adamowicz K, Katz A, Jassem J (2012) Assessment of quality of life in advanced non-small-cell lung cancer: an overview of recent randomized trials. Cancer Treat Rev 38:807–814

    Article  Google Scholar 

  15. 15.

    Adamowicz K, Jassem J, Katz A, Saad ED (2012) Assessment of quality of life in advanced breast cancer. An overview of randomized phase III trials. Cancer Treat Rev 38:554–558

    Article  Google Scholar 

  16. 16.

    Hoon LS, Chi Sally CW, Hong-Gu H (2013) Effect of psychosocial interventions on outcomes of patients with colorectal cancer: a review of the literature. Eur J Oncol Nurs 17:883–891

    Article  Google Scholar 

  17. 17.

    Alacacioglu A, Binicier O, Gungor O i wsp(2010) Quality of life, anxiety, and depression in Turkish colorectal cancer patients. Support Care Cancer 18:417–421

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Krzysztof Adamowicz.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

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

Verify currency and authenticity via CrossMark

Cite this article

Adamowicz, K., Baczkowska-Waliszewska, Z. Prognostic Value of Knowledge of Cancer and Used Unconventional Therapy Methods on Quality of Life in Advanced, Metastatic Colorectal Cancer in Clinical Practice. J Canc Educ 35, 151–158 (2020). https://doi.org/10.1007/s13187-018-1454-1

Download citation

Keywords

  • Colorectal cancer
  • Chemotherapy
  • Treatment outcomes
  • Quality of life
  • Knowledge of cancer