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More care needed for cancer supportive care

21 November 2017 / by / no comments

More care needed for cancer supportive care

The recent ESMO Asia 2017 Con­gress reveals the psy­choso­cial impact on can­cer sur­vivors in Asia and their unmet needs.

The relent­less efforts devoted to improv­ing pre­ven­tion, early detec­tion, and treat­ment have resulted in more and more can­cer sur­vivors world­wide. In fact, there is a decrease in over­all can­cer mor­tal­ity rate of about one per­cent per year. How­ever, a cure or con­trol of can­cer does not nec­es­sar­ily mean a full restora­tion of health. Cancer-​related effects and the treat­ment itself can have a sig­nif­i­cant psy­choso­cial impact on can­cer survivors.

A recent study (STEP study) that assessed over 1,800 can­cer sur­vivors across 10 coun­tries in Asia Pacific was pre­sented at the recent ESMO Asia 2017 Con­gress. The study revealed that over a quar­ter of can­cer sur­vivors expe­ri­enced a poor qual­ity of life post-​treatment. In addi­tion, sig­nif­i­cant level of unmet needs was found among the sur­vivors in eight out of the 10 sur­veyed countries.

Treat­ment and cancer-​related effects can have a sig­nif­i­cant impact on the psy­choso­cial expe­ri­ences of can­cer sur­vivors,” said Prof Ray­mond Chan, Pro­fes­sor of Nurs­ing, Queens­land Uni­ver­sity of Tech­nol­ogy and Metro North Hos­pi­tal and Health Ser­vice. “How­ever, this phase of the can­cer tra­jec­tory has been rel­a­tively neglected, with post-​treatment follow-​up often focus­ing on sur­veil­lance for recur­rence and sec­ond cancers.”

The study exam­ined the unmet needs, qual­ity of life per­cep­tions and health sta­tus of can­cer sur­vivors, with a mean period of 62 months post-​treatment, in high-​income coun­tries (Aus­tralia, Japan, South Korea, Hong Kong and Sin­ga­pore) and low– and middle-​income coun­tries (Myan­mar, China, Thai­land, Philip­pines and India). Most sur­vivors had received chemother­apy. Thirty-​five unmet needs and the strength of needs were sur­veyed and 19 symp­toms were assessed to reflect the sur­vivors’ phys­i­cal well-​being. Fatigue, loss of strength, pain, sleep dis­tur­bance and weight changes are among the top five symp­toms present and were con­sis­tent in all coun­tries. The most com­mon unmet need across all patients was related to con­cerns about the can­cer com­ing back, fol­lowed by the need for local health­care ser­vices, best med­ical care, man­age health with team, and for doc­tors to talk to each other.

Patients from high-​income coun­tries reported sig­nif­i­cantly less unmet needs than low– and middle-​income coun­tries. How­ever, within the high-​income coun­tries, South Korean patients reported a high level of unmet need, sim­i­lar to that of some low– and middle-​income coun­tries. Sur­vivors in Aus­tralia, Hong Kong and Japan had reported a rel­a­tively low strength of unmet need. The strength of need is twice as strong in Thai­land, Sin­ga­pore and India, and three times as strong in South Korea, Myan­mar, Philip­pines and China. High strength of need is sig­nif­i­cantly related to lower qual­ity of life. Sur­vivors’ needs for infor­ma­tion, such as receiv­ing up-​to-​date and under­stand­able infor­ma­tion, and com­pre­hen­sive can­cer care were dou­ble or triple from that reported in sim­i­lar stud­ies from West­ern countries.

There is min­i­mal research to inform any national and inter­na­tional approaches to deliv­er­ing com­pre­hen­sive and coor­di­nated sur­vivor­ship care. As a result, some patients receive excel­lent follow-​up care, while oth­ers are left to man­age and seek resources as they are able,” Prof Chan added. “The study sug­gests that even high-​resource coun­tries with rel­a­tively well-​established health­care sys­tems may not have pri­ori­tised or organ­ised well can­cer sur­vivor­ship. It is clear that more effec­tive approaches to pro­vid­ing sur­vivor­ship care and meet­ing the needs of can­cer patients is required.”



The recent ESMO Asia 2017 Congress reveals the psychosocial impact on cancer survivors in Asia and their unmet needs.

 

The relentless efforts devoted to improving prevention, early detection, and treatment have resulted in more and more cancer survivors worldwide. In fact, there is a decrease in overall cancer mortality rate of about one percent per year. However, a cure or control of cancer does not necessarily mean a full restoration of health. Cancer-related effects and the treatment itself can have a significant psychosocial impact on cancer survivors.

A recent study (STEP study) that assessed over 1,800 cancer survivors across 10 countries in Asia Pacific was presented at the recent ESMO Asia 2017 Congress. The study revealed that over a quarter of cancer survivors experienced a poor quality of life post-treatment. In addition, significant level of unmet needs was found among the survivors in eight out of the 10 surveyed countries.

“Treatment and cancer-related effects can have a significant impact on the psychosocial experiences of cancer survivors,” said Prof Raymond Chan, Professor of Nursing, Queensland University of Technology and Metro North Hospital and Health Service. “However, this phase of the cancer trajectory has been relatively neglected, with post-treatment follow-up often focusing on surveillance for recurrence and second cancers.”

The study examined the unmet needs, quality of life perceptions and health status of cancer survivors, with a mean period of 62 months post-treatment, in high-income countries (Australia, Japan, South Korea, Hong Kong and Singapore) and low- and middle-income countries (Myanmar, China, Thailand, Philippines and India). Most survivors had received chemotherapy. Thirty-five unmet needs and the strength of needs were surveyed and 19 symptoms were assessed to reflect the survivors’ physical well-being. Fatigue, loss of strength, pain, sleep disturbance and weight changes are among the top five symptoms present and were consistent in all countries. The most common unmet need across all patients was related to concerns about the cancer coming back, followed by the need for local healthcare services, best medical care, manage health with team, and for doctors to talk to each other.

Patients from high-income countries reported significantly less unmet needs than low- and middle-income countries. However, within the high-income countries, South Korean patients reported a high level of unmet need, similar to that of some low- and middle-income countries. Survivors in Australia, Hong Kong and Japan had reported a relatively low strength of unmet need. The strength of need is twice as strong in Thailand, Singapore and India, and three times as strong in South Korea, Myanmar, Philippines and China. High strength of need is significantly related to lower quality of life. Survivors’ needs for information, such as receiving up-to-date and understandable information, and comprehensive cancer care were double or triple from that reported in similar studies from Western countries.

“There is minimal research to inform any national and international approaches to delivering comprehensive and coordinated survivorship care. As a result, some patients receive excellent follow-up care, while others are left to manage and seek resources as they are able,” Prof Chan added. “The study suggests that even high-resource countries with relatively well-established healthcare systems may not have prioritised or organised well cancer survivorship. It is clear that more effective approaches to providing survivorship care and meeting the needs of cancer patients is required.”

 


 

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