Background : Maximizing quality of life (QOL) is an important aspect of care for cancer survivors. In 2006, the Institute of Medicine (IOM) highlighted the need to conduct clinical research in survivors’ attitudes regarding care, especially as it may impact access to supportive services.
Patients and Methods : In 2009, we developed a community oriented cancer survivorship program at HealthPartners (St. Paul, MN). All patients were asked to complete the previously validated City of Hope QOL instrument (COH-QOL) which incorporates assessment of the four main QOL domains on a 1 to 10 scale (http://prc.coh.org/pdf/QOL%20Breast%20Cancer%20Pt.pdf). Various supportive services were utilized based on the self-reported survey.
Results : So far 40 breast cancer survivors, 90% representing early stage (0-III) disease, have participated. Median time from diagnosis was 1 year (range 0-10 years). The median level of distress at diagnosis was 10, fell to 8 during
treatment and 3 after completion of cancer treatment. Overall quality of life was rated highly by the respondents, with a median score of 9. Women expressed low levels of depression and anxiety (median score 3 and 2 respectively). Many survivors reported a change in spiritual life as a result of cancer (median score 7), a positive change in life caused by cancer (median 7.5), and a sense of purpose in life (median score 8). There was no statistical correlation between spiritual activity and overall quality of life (Pearson R = -0.282).
Conclusion : Breast cancer survivors face the highest degree of distress at the time of diagnosis, which may be under appreciated by the patient at that time. Therefore, screening tools and appropriate triage should be developed early on in the treatment phase to gather psychological support. Overall quality of life was high in this population. Breast cancer caused several positive changes in lives of the survivors in this study.