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Cancer Survivors: What are Their Concerns and Quality of Life Across the Survivorship Trajectory?

Author(s): Gek Phin Chua, Quan Sing Ng, Hiang Khoon Tan, Whee Sze Ong

Purpose: Survivors of cancer deal with a myriad of acute, chronic, and late effects of cancer and its treatment which can linger on for decades and inadvertently affect their quality of life (QOL). The aim of this study is to determine the main concerns of survivors at various stages of the cancer survivorship, and to assess whether these concerns have any effect on their QOL.

Methods: A cross-sectional survey was conducted on cancer survivors diagnosed with colorectal, breast, lung, gynaecological, prostate or liver cancers (top 6 cancers in Singapore) who were seen at the National Cancer Centre Singapore between 11 April and 12 July 2017. Eligible study participants self-completed a questionnaire adapted from the Mayo Clinic Cancer Centre’s Cancer Survivors Survey of Needs. QOL was rated by participants on a scale of 0-10, with higher ratings denoting higher level of QOL.

Results: A total of 1107 cancer survivors filled in the questionnaire. The top 5 concerns among all survivors were cancer treatment and recurrence risk (51%), followed by long-term treatment effects (49%), fear of recurrence (47%), financial concerns (37%) and fatigue (37%). Cancer treatment and recurrence risk, long-term treatment effects and fear of recurrence were amongst the top concerns across the survivorship trajectory. Mean QOL was 7.3 on a scale of 0-10. Completed treatment patients had higher QOL score than the newly diagnosed and on treatment patients and the patients dealing with recurrence or second cancer patients. Predictors for QOL included the economic status and housing type of patients and whether patients were concerned with pain and fatigue.

Conclusion: This study reveals that cancer survivors in Singapore face multiple challenges and had various concerns at various stages of cancer survivorship, some of which negatively affect their QOL. It is critical to design patient care delivery systems that appropriately address their key concerns at different stages of their cancer trajectory so as to enhance their coping skills throughout their cancer journey.

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