For better quality of life, older cancer patients need more than just medicine

(Reuters Health) - For elderly patients with cancer - who often focus on making the most of the time they have left - financial stability, leisure pursuits and physical activity may have large influences on quality of life, a U.S. study suggests.

Almost two-thirds of the 15 million people living with cancer nationwide are at least 65 years old, researchers note in the journal Cancer.

For these patients, “many issues that frequently go unnoticed, such as financial hardship, lack of social support, and unaddressed symptoms can have a tremendous impact on how patients do and affect their quality of life,” said lead study author Maria Pisu, a researcher at the University of Alabama at Birmingham.

“Patients that lack sufficient emotional support often have more difficulty adjusting and coping with a cancer diagnosis, and cancer treatments and frequent physician visits can cause undue financial burden: all of these have a strong impact on a patient’s sense of well-being,” Pisu said by email.

To see what makes the biggest difference in quality of life, researchers surveyed 1,457 older cancer patients about a wide range of physical, psychological, and social factors.

Participants were 74 years old on average, although they ranged in age from 65 to 99.

Half had been diagnosed with cancer at least 19 months ago. The most common malignancies were breast and prostate tumors. About 28 percent of the patients were receiving active treatment at the time of the survey.

Most of the participants were retired, and roughly 62 percent had a spouse or partner and at least some college education.

The most important factors associated with worse physical quality of life included more severe symptoms of pain, fatigue, and disturbed sleep in the week leading up to the survey, as well as other medical conditions that patients had besides cancer, the study found.

Being physically active also appeared to be an important contributor to better physical quality of life, as did having support with physical activities during periods of fatigue.

When it came to poor mental quality of life, the main culprits were the severity of symptoms like fatigue and disturbed sleep, as well as a lack of emotional support or financial security.

The study wasn’t a controlled experiment designed to prove whether or how any given symptom or circumstance might influence quality of life for older cancer patients. Researchers also lacked data on spiritual factors that might influence quality of life.

Even so, the findings add to the evidence that cancer patients may need emotional, social or financial support, said Dr. Preeti Malani, a researcher at the University of Michigan in Ann Arbor who wasn’t involved in the study. The study also highlights one aspect of quality of life that may be overlooked, Malani said by email.

“The authors note the importance of leisure time physical activity, which is not always the focus for patients,” Malani said. “There is so much related to the details of treatment that the question of what you are doing to stay physically active may get glossed over.”

Financial hardship is another issue that may not always come up in the doctor’s office, said Dr. Melissa Wachterman, a researcher at Harvard Medical School and the VA Boston Healthcare System who wasn’t involved in the study.

“It completely makes sense that being worried about financial issues in the face of a diagnosis of cancer would negatively impact quality of life,” Wachterman said by email.

“Patients and families should know that while doctors may not be trained to ask about financial hardship and may not have a direct tool to address it in the examining room, doctors can often connect patients with another member of the health care team, such as a social worker, who can help them navigate resources to help them with financial issues,” Wachterman advised.