Doctors look for ways to boost quality of cancer patients' lives

Conference brings experts together to talk about nausea, depression, insomnia and anxiety related to the disease and its treatment.

By Victoria Stagg Elliott — Posted Oct. 16, 2006

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

As cancer treatments improve, physicians are increasingly discussing not just how to save lives but also how to ensure that the life is of highest quality possible both during the treatment and after.

"People want the best care possible," said Michael J. Fisch, MD, MPH, medical director of the community clinical oncology program at the University of Texas MD Anderson Cancer Center in Houston. "But they also want quality of life and to maintain their roles as parents, friends and neighbors."

He was speaking at last month's second annual Chicago Supportive Oncology Conference organized by the Journal of Supportive Oncology. This meeting brings together oncologists, palliative care physicians and other health professionals who work with cancer patients around the country to discuss strategies for dealing with the challenges associated with patients being treated for this disease.

"This is really groundbreaking to have a whole conference dedicated to quality of life, because it's something that patients are very concerned about," said Tony L. Back, MD, associate professor in the division of oncology at the University of Washington, Seattle.

The issues are numerous. Fatigue is by far the most common complaint. Others, including anxiety, depression, appetite problems, nausea, vomiting, sexual dysfunction and memory loss also can surface because of treatment or the cancer itself.

But although the list of complaints is long, experts suggest attacking the one or two that are most bothersome to the patient, because other problems might resolve themselves as these are addressed.

"We have to know what we want to pick a fight with and what's worthwhile," said Dr. Fisch, one of the conference's organizers.

The treatment choices, however, may not be obvious because of how different life can be for those being treated for cancer. Sleep problems, for instance, could be caused by depression but also might be linked to the reality of receiving cancer care.

"Don't jump to the conclusion that the cause of [disturbed sleep] is depression," said John L. Shuster, MD, clinical professor of psychiatry at the University of Alabama at Birmingham, who spoke on insomnia. "Cancer treatments can often disturb sleep.

"Are they having a lot of breakthrough pain at night? Is the patient sleeping in an unfamiliar place?" Dr. Shuster asked. "Many patients travel for treatment, and they may be staying with relatives or in a hotel. When you're sick, it's very easy for the sleep cycle to become fairly fragmented."

The experts also warned to be aware of the interaction between the drugs used to treat the ancillary issues and the chemotherapy medicines that are fighting the cancer. For example, several studies have suggested that antidepressants can interfere with tamoxifen in patients who have a particular genotype.

"This does remind us to pay attention to what the goals of therapy are and the impact of supportive therapeutics," Dr. Fisch said.

Some research presented at the conference suggested that lifestyle interventions sometimes might be better options.

One study found that fatigue in breast cancer patients could be ameliorated with increased exercise. Another found that an educational program could help patients cope with cognitive changes after therapy.

While oncologists and other specialties increasingly are taking an interest in the quality of cancer patients' lives, many experts expect this kind of care to become even more important to primary care physicians. Many of these symptoms are common primary care issues, and, particularly once the cancer has been treated, patients often return to their medical home.

"They don't want to hang around the cancer center," Dr. Fisch said.

Back to top

External links

Chicago Supportive Oncology Conference: Improving the Quality of Care, Chicago, Sept. 28-30 (link)

"From Cancer Patient to Cancer Survivor: Lost in Transition," Institute of Medicine, Nov. 7, 2005 (link)

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn