Quality of Life Assessment across the Cancer Continuum: Understanding the Role of an Exercise Rehabilitation Programme

Authors: Bernat-Carles Serdà Ferrer, Arantza Del Valle Gómez

Abstract:

The Quality of Life (QoL) paradigm is multidimensional, dynamic and modular and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness. This research aims to obtain a valid and sensitive assessment of QoL change over the continuum disease, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities. The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4). Results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups prove the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL. Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of watchful waiting on patients’ QoL until their complete recovery in daily life.

Keywords: Prostate cancer, quality of life, rehabilitation programme, response shift.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1316163

References:

[1] Cella, D. F. & Tulsky, D. S. (1993). Quality of life in cancer: definition, purpose, and method of measurement. Cancer Investigation, 11, 327-336.
[2] Díaz Veiga, P., Facal, J. & Yanguas Leazón JJ. (2010). Funcionamiento psicológico y envejecimiento. Aprendizajes a partir de estudios longitudinales. Revista Española de Geriatría y Gerontología, 45, 350-357. doi:10.1016/j.regg.2010.09.001.
[3] Megari K. Quality of Life in Chronic Disease Patients. Health Psychology Research. 2013;1(3). doi:10.4081/hpr.2013.e27.
[4] Menichetti, J., Villa, S., Magnani, T., Avuzzi, B., Bosetti, D., Marenghi, C., Morlino, S., Rancati, T., Van Poppel, H., Salvioni, R., Valdagni, R., Bellardita, L. (2016). Lifestyle interventions to improve the quality of life of men with prostate cancer: A systematic review of randomized controlled trials. Critical Reviews in Oncology / Hematology. 108:13-22 doi: http://dx.doi.org/10.1016/j.critrevonc.2016.10.007.
[5] Barocas, D., Alvarez J., Resnick, M. J., Koyama, T., Hoffman, K., Tyson, M., et al. (2017). Association between radiation therapy surgery or observation for localised prostate cancer and patient-reported outcomes after 3 years. JAMA, 317(11):1126-1140. doi: 10.1001/jama.2017.1704.
[6] Van Tol-Geerdink JJ, Leer JWH, van Oort IM, et al. Quality of life after prostate cancer treatments in patients comparable at baseline. British Journal of Cancer. 2013;108(9):1784-1789. doi:10.1038/bjc.2013.181.
[7] Eisemann N, Nolte S, Schnoor M, Katalinic A, Rohde V, Waldmann A. The ProCaSP study: quality of life outcomes of prostate cancer patients after radiotherapy or radical prostatectomy in a cohort study. BMC Urology. 2015; 15:28. doi:10.1186/s12894-015-0025-6.
[8] Korfage, I. J., de Koning, H. J. & Essink-Bot, M. L. (2007). Response shift due to diagnosis and primary treatment of localized prostate cancer: a then-test and a vignette study. Quality of Life Research, 16, 1627-1634. doi: 10.1007/s11136-007-9265-6.
[9] Serdà, BC., Valle A., Marcos-Gragera R. (2014). Prostate Cancer and Quality of Life: Analysis of Response Shift Using Triangulation Between Methods. J Gerontol Nurs. 40(6) 32-41. doi: 10.3928/00989134-20140211-01.
[10] Serdà. BC. (2009). Avaluació dels efectes d'un programa d'exercici físic individualitzat sobre la Qualitat de Vida (QdV), la incontinència urinària, la fatiga i la resistència muscular amb malalts de càncer de pròstata. (Thesis, Universitat de Girona). Recovered from http://www.tdx.cat/bitstream/handle/10803/7948/tbsf.pdf;jsessionid=CCB456608D6667FB8B98308CC01AB3E7.tdx2?sequence=5.
[11] Segal, R. J., Reid, R. D., Courneya, K. S., Malone, S. C., Parliament, M. B., Scott, C. G. et al. (2003). Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. Journal of Clinical Oncology, 21, 1653-1659.
[12] Kvam, A. K., Wisloff, F. & Fayers, P. M. (2010). Minimal important differences and response shift in health-related quality of life; a longitudinal study in patients with multiple myeloma. Health and Quality of Life Outcomes, 8, 79. doi: 10.1186/1477-7525-8-79.
[13] Schwartz, C. E. & Sprangers, M. A. (2010). Guidelines for improving the stringency of response shift research using the then-test. Quality of Life Research, 19, 455-464.
[14] Schwartz, C. E., Bode, R., Repucci, N., Becker, J., Sprangers, M. A. & Fayers, P. M. (2006). The clinical significance of adaptation to changing health: a meta-analysis of response shift. Quality of Life Research, 15, 1533-1550.
[15] Dabakuyo, T.S., Guillemin, F., Conroy, T., Velten, M., Jolly, D., Mercier, M., Canseret, S., Cuisenier, J., Graesslin, O. & Bonnetain, F. (2013). Response shift effects on measuring post-operative quality of life among breast cancer patients: a multicenter cohort study. Quality of Life Research, 22, 1-11.doi:10.1007/s11136-012-0135-5.
[16] Calman, K. C. (1984). Quality of life in cancer patients--an hypothesis. Journal of Medical Ethics, 10, 124-127.
[17] Schwartz, C. & Sprangers, M. A. (2000). Adaptation to changing health: Response Shift in Quality-of-Life Research. Washington: American Psychological Association.
[18] Sweegers, MG., Altenburg, M., Chinipaw, M., Kalter, J., Verdonck-de Leeuw, Courneya, K., newton, R., Aaronson, N., Jacobsen, P., Brug, J., Buffart, L., (2017). Which exercise prescriptions improve quality of life and physical function in patients with cancer during and following treatment? A systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 2017;0:1–1. http://dx.doi.org/10.1136/bjsports-2017-097891.
[19] Mottet, N., Bellmuntm J., Biers, E., van den Bergh RCN, Bolla, M., van casteren NJ., Cornford, P., Culine, S., Joniau, S., Lam, T. et al. Guidelines on prostate cancer in: European Association of urology, 2015.
[20] Moyer VA., Screening for prostate cancer: US: Preventive Services task Force recommendation statement. Ann intern Med. 2012; 15(2):120-34.