Assessing patients’ quality of life during treatment

This study evaluated the quality of life of patients with lung cancer undergoing different chemotherapy regimens.

Chemotherapy uses one or multiple drugs to kill rapidly dividing cancer cells and is a common treatment for patients with lung cancer, since some lung cancers cannot be surgically removed and most lung cancers are diagnosed in an advanced stage. Chemotherapy may have a curative effect on its own, by killing all cancer cells, it may shrink the tumor in order to be easily removed through surgery, or it may be given to alleviate the disease symptoms as palliative care and slow the progression of the disease. On the basis of clinical evidence and the status of the patient, the physician chooses the appropriate chemotherapy for the patient. However, most chemotherapy drugs have side effects that may affect the quality of life (QOL) of these patients. This study aimed to assess patient’s symptoms, functioning, and overall well-being under different chemotherapy regimens for lung cancer. 

187 patients with lung cancer that were treated with chemotherapy participated in the study. Patients received chemotherapy either before or after surgery, as only treatment or as palliative care. Within each treatment visit, patients received a computed QOL questionnaire which evaluated their social, emotional, physical and cognitive (involving conscious mental activities such as thinking, reasoning, learning and remembering) functioning, financial difficulties, symptoms such as pain, nausea, vomiting, fatigue, sleep disturbances, as well as general well being.

Based on the questionnaires, there was a significant worsening in patient’s cognitive function, fatigue and pain in patients receiving second or third line chemotherapy (chemotherapy given as the second or third treatment after previous treatments for lung cancer have failed) compared to patients receiving chemotherapy before surgery (neoadjuvant) or first line (main treatment for cancer) chemotherapy. However, there was no significant difference between chemotherapy lines regarding side effects such as nausea, vomiting, diarrhea and sleeping disturbances. A substantial deterioration in appetite loss and physical functioning was seen between the second and third chemotherapy lines for older patients (70 year old and above), while in younger patients (below the age of 70) this deterioration was more prominent between the first and second lines. Overall, the quality of life remained stable within each chemotherapy line.

In summary, this study showed that patients’ QOL remained unchanged during each chemotherapy line. Worse QOL was found for the latter lines, which may not be related to the treatment itself, but to the progression of the disease. 

Talk to your physician about methods to improve your quality of life during or after treatment.