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Psychological distress, quality of life, symptoms and unmet needs of colorectal cancer survivors near the end of treatment

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An Erratum to this article was published on 14 May 2015

Abstract

Purpose

This study investigated psychological morbidity, quality of life (QoL), colorectal cancer (CRC)-specific symptoms and supportive care needs in a CRC population at the end of treatment (EOT).

Methods

CRC survivors (n = 152) completed a post-treatment baseline questionnaire as part of a multisite supportive care randomised controlled trial (SurvivorCare). CRC survivors had completed treatment with curative intent within 0 to 6 months. Measures are as follows: Brief Symptom Inventory 18 (BSI-18) (psychological morbidity), EORTC QLQ-C30 and QLQ-CR29 (QoL and CRC-specific symptoms and problems) and Cancer Survivors’ Unmet Needs (CaSUN) measure with a simplified response format (unmet needs). Linear regression models were used to compare participants’ QoL with a general population sample. Correlation analysis examined associations between psychological morbidity, QoL and CRC-specific symptoms and problems.

Results

Average participant age was 64 years, and 51 % were male. The majority (68 %) had stage 3 disease. In comparison to population norms, CRC survivors had lower depression and anxiety scores (47.4 and 45.6, respectively) but higher somatisation, and lower role, cognitive and social functioning (p < 0.001). CRC survivors had higher fatigue, nausea/vomiting, appetite loss, diarrhoea and financial problems (all p < 0.001), as well as pain (p = 0.002) and constipation (p = 0.019). CRC-specific psychological scores were positively correlated with all three BSI domain scores, and pain and fatigue symptom scores on the QLQ-C30 while negatively correlated with all five functional scales of the QLQ-C30.

Conclusions

CRC survivors reported good mental health at EOT. Role and social functioning were impaired compared to population norms, possibly related to physical symptoms.

Implications for Cancer Survivors

Findings may help guide consultations with patients and inform the design of more tailored supportive care interventions.

Trial registration: ACTRN12610000207011

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Acknowledgments

The authors would like to thank all patients for volunteering their time to make this study possible. QLQ-C30 normative data were provided by Professor Madeleine King, The University of Sydney, on behalf of the MAUCa Consortium. Dr. Daniel Costa provided data management for the QLQ-C30 normative data. We also thank Lisa Demosthenous, Matthew Holmes, Anna Ugalde and Felicity Pendergast for their involvement with SurvivorCare.

Conflict of interest

This project was funded by the Victorian Cancer Agency: Grant number: EOI09_74 and Cancer Australia/Beyond Blue: Grant number: 628581. The funding bodies had no role in the design of the study nor in the collection, analysis and interpretation of data, or writing of the manuscript. Jane Young is supported by a Cancer Institute NSW Academic Leader in Cancer Epidemiology Award.

Lahiru Russell, Karla Gough, Allison Drosdowsky, Penelope Schofield, Sanchia Aranda, Phyllis N Butow, Jennifer A Westwood, Mei Krishnasamy, Jo Phipps-Nelson and Michael Jefford declare that they have no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, VIC, 3002, Australia

    Lahiru Russell, Karla Gough, Allison Drosdowsky, Penelope Schofield, Sanchia Aranda, Jennifer A. Westwood, Mei Krishnasamy, Jo Phipps-Nelson, Dorothy King & Michael Jefford

  2. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, 3010, Australia

    Penelope Schofield, Sanchia Aranda, Mei Krishnasamy & Michael Jefford

  3. Faculty of Medicine, Dentistry and Health Services, The University of Melbourne, Parkville, VIC, 3010, Australia

    Penelope Schofield, Sanchia Aranda, Mei Krishnasamy & Michael Jefford

  4. Surgical Outcomes Research Centre, University of Sydney and Sydney South West Area Health Service, Missenden Rd, PO Box M157, Sydney, NSW, 2050, Australia

    Phyllis N. Butow & Jane M. Young

  5. Centre for Medical Psychology and Evidence-based Decision Making (CeMPED), School of Psychology, University of Sydney, A18, Sydney, NSW, 2006, Australia

    Phyllis N. Butow

  6. School of Public Health, University of Sydney, A27, Sydney, NSW, 2006, Australia

    Jane M. Young

  7. Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Melbourne, VIC, 8006, Australia

    Michael Jefford

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  1. Lahiru Russell
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Correspondence to Michael Jefford.

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Russell, L., Gough, K., Drosdowsky, A. et al. Psychological distress, quality of life, symptoms and unmet needs of colorectal cancer survivors near the end of treatment. J Cancer Surviv 9, 462–470 (2015). https://doi.org/10.1007/s11764-014-0422-y

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  • DOI: https://doi.org/10.1007/s11764-014-0422-y

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