Cancer has a major impact on mental and physical wellbeing, researchers reported at the ESMO (European Society for Medical Oncology) Asia 2016 Congress held in Singapore last week from Dec 16 to 19.

Results from a Malaysian study of 1,362 patients found more than four in five survivors were suffering from anxiety and a similar number had depression a year after diagnosis.

Lead author Shridevi Subramaniam, a research officer at the Health Ministry’s National Clinical Research Centre, said: “We urgently need new ways of supporting cancer survivors and addressing wider aspects of wellbeing.

“Instead of just focusing on clinical outcomes, doctors must focus equally on quality of life for cancer patients, especially psychologically, financially and socially.”

The study included Malaysian patients from the Asean Cost in Oncology Study (Action), with a third being breast cancer patients.

The participants filled in questionnaires to assess health-related quality of life (HRQoL). Anxiety and depression levels were also included in the survey.

A patient’s satisfaction with their physical health and mental wellbeing – or HRQoL – is an important end result in cancer care.

But the study showed that patients’ mental and physical wellbeing was low overall 12 months after diagnosis.

The more advanced the cancer, the lower the HRQoL.

The type of cancer was also a factor because disease severity differs.

Women with reproductive system cancers, for example, had higher wellbeing scores than lymphoma patients.

This could be explained by the fact that lymphoma is often aggressive and progresses quickly, while reproductive system cancers, such as cervical cancer, can spread slowly over a number of years.

“The key message is to focus more on supporting patients throughout their whole cancer ‘journey’, especially in their lives after treatment,” said Shridevi.

When cancer strikes young

Cancer also has a significant impact on the lives and wellbeing of adolescents and young adults, as reported in a separate ongoing study from Singapore.

Researchers set out to identify the extent of wellbeing issues and other problems in this group who not only are at major milestones in their lives, but also do not expect to develop the disease.

The study included 56 patients who were newly diagnosed with cancer and had an average age of 28.

They completed a survey including questions on occupation and lifestyle, and were also asked about problems revolving around physical symptoms, mental wellbeing and financial issues.

Results showed that more than a third (37%) were suffering distress at diagnosis of cancer.

Nearly half identified the top cause as treatment decisions, followed by family health issues, sleep and worry.

Senior author Dr Alexandre Chan, National University of Singapore Department of Pharmacy associate professor and National Cancer Centre, Singapore, specialist pharmacist, said: “The young differ from older people because they don’t expect to be ill, and certainly not with cancer.

“They’re also at a stage when they’re facing many social responsibilities and family burdens.

“That’s why they need effective supportive care and help in managing the physical, psychological and emotional side-effects that come with both cancer diagnosis and treatment.”

More studies needed

Commenting on these studies, National Cancer Centre, Singapore, consultant medical oncologist and Duke-NUS Medical School assistant professor Dr Ravindran Kanesva-ran said: “There is a critical need to find ways of addressing the high levels of distress among cancer survivors in general, as highlighted by the Malaysian study.

“The psychosocial impact of cancer on adolescents and young adults also clearly needs further evaluation.

“This is to assess the impact on quality of life at the time of diagnosis, as well as throughout and after treatment.

“What’s required are specific interventions to meet the needs of this age group, as well as specially-tailored survivorship programmes and supportive care.

“While it’s not surprising that the young adult cancer population has a higher risk of suicide, conducting studies like this help us find new ways to address this issue effectively.”