This information may help physicians better assist their patients in making decisions about systemic adjuvant therapy, conclude Patricia A. Ganz, M.D., of the University of California at Los Angeles Jonsson Comprehensive Cancer Center, and colleagues. Their findings appear in the Jan. 2 issue of the Journal of the National Cancer Institute.
Women who survive breast cancer account for nearly half of all female cancer survivors. Previous studies have shown that these women maintain a healthy quality of life during the first several years after their primary treatment has ended. Few studies have looked at how these women fare years later.
In the new study, researchers resurveyed 763 breast cancer-free women who had participated in an earlier cross-sectional study looking at quality of life during the first 5 years after diagnosis. The follow-up re-evaluated these women, focusing on their quality of life between 5 and 9.5 years after diagnosis. Quality-of-life assessments included measures of general health, physical functioning, and emotional well-being.
Overall, the women in the follow-up study reported high levels of health, physical functioning, and emotional well-being. Their energy level and social functioning remained the same as in the initial survey. The researchers also found that the social support that the survivors received seemed to predict how they assessed their current quality of life.
In the follow-up study, the women also reported less frequent hot flashes, night sweats, vaginal discharge, and breast sensitivity than they reported in the initial study. But they experienced more vaginal dryness and loss of urinary control. Women in the follow-up study also reported a decline in sexual activity. The researchers note that these symptoms and sexual problems increased modestly and that the increase may be related to the normal aging process.
Studies have suggested that systemic adjuvant therapy could improve the likelihood of disease-free and overall survival in women with breast cancer. In separate analyses, the authors looked at the late effects of adjuvant systemic therapy (chemotherapy, tamoxifen, or a combination of both) on quality of life and reported a statistically significant decrease in physical functioning associated with adjuvant therapy, even many years after the therapy ended. “These findings suggest that there may be … effects from treatment that do not appear until many years later,” the authors conclude.
The authors note that the study was limited to only women from Washington, D.C., and Los Angeles, Calif., and that the response rate was only 61%, but they maintain that their findings may help patients and physicians make more informed decisions about adjuvant therapy.
Contact: Kim Irwin, UCLA Jonsson Comprehensive Cancer Center, (310) 206-2805, fax: (310) 206-5553, kirwin@mednet.ucla.edu.
Ganz PA, Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR. Quality of life in long-term disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst 2002;94:39–49.
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