More care needed for cancer supportive care
The recent ESMO Asia 2017 Congress reveals the psychosocial impact on cancer survivors in Asia and their unmet needs.
The relentless efforts devoted to improving prevention, early detection, and treatment have resulted in more and more cancer survivors worldwide. In fact, there is a decrease in overall cancer mortality rate of about one percent per year. However, a cure or control of cancer does not necessarily mean a full restoration of health. Cancer-related effects and the treatment itself can have a significant psychosocial impact on cancer survivors.
A recent study (STEP study) that assessed over 1,800 cancer survivors across 10 countries in Asia Pacific was presented at the recent ESMO Asia 2017 Congress. The study revealed that over a quarter of cancer survivors experienced a poor quality of life post-treatment. In addition, significant level of unmet needs was found among the survivors in eight out of the 10 surveyed countries.
“Treatment and cancer-related effects can have a significant impact on the psychosocial experiences of cancer survivors,” said Prof Raymond Chan, Professor of Nursing, Queensland University of Technology and Metro North Hospital and Health Service. “However, this phase of the cancer trajectory has been relatively neglected, with post-treatment follow-up often focusing on surveillance for recurrence and second cancers.”
The study examined the unmet needs, quality of life perceptions and health status of cancer survivors, with a mean period of 62 months post-treatment, in high-income countries (Australia, Japan, South Korea, Hong Kong and Singapore) and low- and middle-income countries (Myanmar, China, Thailand, Philippines and India). Most survivors had received chemotherapy. Thirty-five unmet needs and the strength of needs were surveyed and 19 symptoms were assessed to reflect the survivors’ physical well-being. Fatigue, loss of strength, pain, sleep disturbance and weight changes are among the top five symptoms present and were consistent in all countries. The most common unmet need across all patients was related to concerns about the cancer coming back, followed by the need for local healthcare services, best medical care, manage health with team, and for doctors to talk to each other.
Patients from high-income countries reported significantly less unmet needs than low- and middle-income countries. However, within the high-income countries, South Korean patients reported a high level of unmet need, similar to that of some low- and middle-income countries. Survivors in Australia, Hong Kong and Japan had reported a relatively low strength of unmet need. The strength of need is twice as strong in Thailand, Singapore and India, and three times as strong in South Korea, Myanmar, Philippines and China. High strength of need is significantly related to lower quality of life. Survivors’ needs for information, such as receiving up-to-date and understandable information, and comprehensive cancer care were double or triple from that reported in similar studies from Western countries.
“There is minimal research to inform any national and international approaches to delivering comprehensive and coordinated survivorship care. As a result, some patients receive excellent follow-up care, while others are left to manage and seek resources as they are able,” Prof Chan added. “The study suggests that even high-resource countries with relatively well-established healthcare systems may not have prioritised or organised well cancer survivorship. It is clear that more effective approaches to providing survivorship care and meeting the needs of cancer patients is required.”