Quality of life tied to lung cancer survival

The way lung cancer patients feel around the time they’re diagnosed may be related to how long they survive - even after taking into account objective measures of the disease, a new study suggests.

Researchers found that newly-diagnosed lung cancer patients who rated their quality of life higher generally lived longer with the disease: typically surviving nearly six years, versus less than two years among patients who’d reported a poor quality of life.

And objective measures - like age, the stage and aggressiveness of the cancer and other health conditions - did not fully explain the connection.

Quality of life is a “complex construct” that includes a person’s feelings of physical, mental and emotional well-being, said Jeff A. Sloan, a professor of oncology and biostatistics at the Mayo Clinic in Rochester, Minnesota, who led the new study.

But doctors can begin to get at the issue by basically asking, “How are you doing?” Sloan said in an interview.

“That can start a conversation,” he said.

Blood work and other lab tests are one way of seeing how a patient is doing, according to Sloan. But, he said, doctors have long been aware that two patients can look the same as far as objective cancer-related measures go, yet fare differently.

Lung cancer survival rates

Lung cancer has one of the lowest survival outcomes of any cancer because over two-thirds of patients are diagnosed at a late stage when curative treatment is not possible.  Earlier diagnosis and referral to specialist teams would make a significant difference to survival rates.

Many of the patients are elderly with co-existing co-morbid problems making them unfit for radical treatment but new surgical techniques may enable more patients with complex medical problems to benefit from surgery.

In England and Wales the latest figures show around 27% of male and 30% of female lung cancer patients are alive one year after diagnosis falling to 7% and 9% respectively at five years.


References for lung cancer survival
  The Information Centre for Health and Social Care and RCP. National Lung Cancer Audit, Report for the audit period 2005 December 2006
  Martin-Ucar AE, et al A case-matched study of anatomical segmentectomy versus lobectomy for stage 1 lung cancer in high tosk patients Eur J Cardiothorac Surg 2005 27(4):675-9
Coleman, M., P. Babb, and P. Damiecki, Cancer Survival Trends in England and Wales, 1971-1995: Deprivation and NHS Region. Vol. 1999: TSO.
Rachet, B., et al., Population-based cancer survival trends in England and Wales up to 2007:an assessment of the NHS cancer plan for England. The Lancet Oncology (2009). Standardised figures were provided by the author on request.
Office for National Statistics (ONS), Survival Rates in England, patients diagnosed 2001-2006 followed up to 2007

A number of studies have now shown that quality of life seems to affect the long-term picture for cancer patients, Sloan said.

So doctors at Mayo have begun routinely assessing cancer patients’ quality of life, and some other cancer centers are starting to do the same, he added.

A Scottish analysis reported that 50% of lung cancer patients are dead within four months of diagnosis. One-year lung cancer survival rates in England and Wales have risen from 15% to 27% for men and 13% to 30% for women diagnosed between 1971-75 and 2004-06.

Five-year survival rates over the same period have doubled but still remain low at around 8%. For lung cancer patients diagnosed in Scotland in 2004-2006, one-year survival rates were 26% for men and 28.8% for women. Five-year survival rates were 7% and 7.8% respectively. In Northern Ireland, five-year lung cancer survival rates were around 9% for patients diagnosed in 1997-2000.

The current study, published in the Journal of Clinical Oncology, included 2,442 patients treated for lung cancer at Mayo over 11 years.

Around the time of their diagnoses, patients rated their overall quality of life on a standard scale of zero to 100. The researchers found that 21 percent had a “deficit” in quality of life - or a score of 50 or lower.

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