Effect of Cancer On Quality of Life

David Osoba

• Éditeur: CRC Press
• Année: 2021
• ISBN:
  9781000142037
• Édition: 1
• Sujet: Medicine
• Sous-sujet: Medical Theory, Practice & Reference

This book is comprised of extensive reviews and instructional chapters that discuss the quality of life in several aspects of cancer. The first six chapters deal with conceptual issues relating to measuring quality of life in adult and pediatric populations with cancer. The next five chapters provide practical information on how to select quality-of-life measures, the statistical analysis of trials, economic evaluations to be considered, and some possible abuses of quality-of-life measures. Five chapters review the results of studies using selected quality-of-life measures and provide recent information on their performance. These are followed by three chapters dealing with specific issues relating to nausea and vomiting associated with cancer therapy. Three chapters are devoted to the problems of assessing and controlling pain in patients who have cancer. There are also two chapters that deal with the quality of life in palliative care. Effect of Cancer on Quality of Life is intended for all who have an interest in measuring the quality of life in patients with cancer. This includes investigators who are just entering the field and can benefit from instructions on how to conduct quality-of-life research, as well as those who are experienced in conducting this kind of research.

Chapter 1

PERSPECTIVES ON QUALITY OF LIFE AND THE GLOBAL CANCER PROBLEM

Jan Stjernswärd and Noreen Teoh

TABLE OF CONTENTS

I.	Introduction
II.	Current Perspectives in Controlling Cancer
III.	Strategies and Priorities of the World Health Organization (WHO)
IV.	Challenges
V.	Conclusions
References

I. INTRODUCTION

Cancer is one of the three leading causes of death for the productive age group 15 to

55 years in both developed and developing countries. The other two leading causes of death are accidents and cardiovascular diseases. Cancer is recognized as a major health problem in the developed regions of the world. However, the prevalence of communicable diseases often hides the fact that cancer is also becoming a serious problem in developing countries.

Cancer rates in developing countries are progressively approaching those in the industrialized countries, mainly because of an increase in the average age of the population, continued improvement in the control of other major health problems, and a continued increase in tobacco use. Counter measures should therefore be adopted without delay.

At present, an estimated 7,000,000 new cancer patients are diagnosed annually, of which slightly more than one half are in the developing countries. Cancer is a Third World problem too. Every year, about 5,000,000 cancer patients die of their disease.

In general, there are three approaches available for controlling a cancer: prevention, early detection, and curative therapy. In reviewing the eight most common tumors globally, it is evident that not all approaches are effective for most tumors (Table 1).

Even though about one third of cancers today are preventable, few effective national prevention programs have been implemented. Similarly, one third of today’s tumors could be cured if they were diagnosed early; but again, only a limited number of countries have established both the early-detection and treatment services necessary to take advantage of the progress in medical science.²

II. CURRENT PERSPECTIVES IN CONTROLLING CANCER

In most countries, if one were to ask what is the national goal in cancer, the response would be “to find a cure”. Indeed, the overwhelming majority of resources for cancer are allocated to precisely that — finding a cure. However, it may be that a better response to the question would be “to prevent cancer” or “to detect cancer early and cure it”.

Currently, aggressive therapeutic attempts to achieve a minor prolongation of life or the act of uncomfortable dying predominate over concerns for quality of life and dignity in death in a familiar environment.²

Although for most cancer patients, pain relief and relief of other common symptoms is the only realistic option, few of the cancer control resources go to palliative care and generally, there is little or no training of health care professions in this type of care.

Quality of life and comfort before death could be considerably improved through the application of current knowledge for relieving cancer pain and implementing existing knowledge in palliative care. All too often, palliative care is ignored or seen as something that comes at the very end of the list of treatment options, a type of “waste-paper basket” alternative (Figure 1).

The size of the problem is big. In developed countries, 67% of male and 60% of female cancer patients will die of their disease. In developing countries, the figure is much higher. Instead, palliative care needs to be seen as an integral part of cancer care in both developed and developing countries (Figures 2 and 3). Curative care and palliative care are not mutually exclusive. For most cancer patients, however, no curative treatment exists. The quality of life in these patients would be better if they had access to palliative care from the start.¹

III. STRATEGIES AND PRIORITIES OF THE WORLD HEALTH ORGANIZATION (WHO)

The WHO global cancer control program is based on the concept that enough knowledge exists today about cancer to take effective action that will significantly reduce cancer morbidity and mortality worldwide, if properly implemented.

TABLE 1
Availability of Effective Strategies for the Control of the Eight Most Common Cancers Worldwide¹

Tumor^a	No. of cases^b	Primary prevention	Early diagnosis	Curative therapy^c	Palliative care
Stomach	670	+^d	−	−	+ +
Lung	660	+ +	−	−	+ +
Breast	572	−	+ +	+ +	+ +
Colon/rectum	572	+	+	+	+ +
Cervix	466	+	+ +	+ +	+ +
Mouth/pharynx	379	+ +	+ +	+ +	+ +
Esophagus	310	−	−	−	+ +
Liver	251	+ +		−	+ +

^a Listed in order of the eight most common tumors globally.

^b Per year, in thousands.

^c Curative for majority of cases with a realistic opportunity of finding them early.

^d + + = effective, + = partly effective, − = not effective.

FIGURE 1. Present allocation of cancer resources.¹

FIGURE 2. Proposed allocation of cancer resources in developed countries.¹

FIGURE 3. Proposed allocation of cancer...

Table des matières

• Cover
• Title Page
• Copyright Page
• Preface
• Acknowledgments
• The Editor
• Contributors
• Table of Contents
• Chapter 1 Perspectives on Quality of Life and the Global Cancer Problem
• Chapter 2 Measuring Functioning, Well-Being, and Other Generic Health Concepts
• Chapter 3 Measuring the Effect of Cancer on Quality of Life
• Chapter 4 Prediction of Psychosocial Distress in Patients with Cancer
• Chapter 5 N of 1 Randomized Controlled Trials for Investigation of Quality of Life in Cancer
• Chapter 6 Quality of Life of the Treatment Process in Pediatric Oncology: An Approach to Measurement
• Chapter 7 A Practical Guide for Selecting Quality-of-Life Measures in Clinical Trials and Practice
• Chapter 8 Incorporation of Quality-of-Life Assessment into Clinical Trials
• Chapter 9 Statistical Analysis of Trials Assessing Quality of Life
• Chapter 10 Economic Evaluations of Cancer Care — Incorporating Quality-of-Life Issues
• Chapter 11 Uses (and Some Possible Abuses) of Quality-of-Life Measures
• Chapter 12 Cancer Patients’ Unmet Support Needs as a Quality-of-Life Indicator
• Chapter 13 The Spitzer Quality-of-Life Index: Its Performance as a Measure
• Chapter 14 The EORTC Core Quality-of-Life Questionnaire: Interim Results of an International Field Study
• Chapter 15 Quality of Life in Breast Cancer
• Chapter 16 Women’s Sexuality Following Breast Cancer
• Chapter 17 Methodological Issues in Anti-Emetic Studies
• Chapter 18 Anticipatory Nausea and Vomiting Side Effects Experienced by Cancer Patients Undergoing Chemotherapy Treatment
• Chapter 19 Selective 5-HT3, Receptor Antagonists: A Novel Class of Antiemetics
• Chapter 20 Pain and Quality of Life: Theoretical Aspects
• Chapter 21 Pain Assessment in Cancer
• Chapter 22 Clinical Trials in Pain Control
• Chapter 23 Quality-of-Life Research in the European Palliative Care Setting
• Chapter 24 Quality-of-Life Research in Hospice Care
• Index