Tailored information and supportive care important interventions for breast and gynaecological cancer patients: Study
The most common cancer among women is breast cancer. The fifth leading localisation for cancer is the uterus, especially corpus uteri. More than 3% of female cancer is caused by ovarian cancer. Summing up about 40% of female patients with cancer are affected by gynaecological malignancies and breast cancer. Since patients with cancer are confronted with physical symptoms, psychological and psychosocial problems especially during treatment, health care providers have to focus on patients’ needs. Unmet supportive care needs can lead to reduced quality of life and decreased compliance, with worsened outcomes. Saskia‑Laureen Herbert and team investigated supportive care needs and quality of life among women with breast cancer and gynaecological cancer during the period of treatment.
Supportive care can be defined as the provision of necessary support meeting informational, physical, social, and emotional needs. These needs can be felt differently and differ between patients. “During the time of treatment” is defined as a visit in hospital for either surgery or neoadjuvant/adjuvant/palliative systemic therapy, which allows distinguishing local and systemic issues. Supportive care needs can be identified by health care providers. Felt needs and professionally captured needs are not always matching.
Treatment of breast cancer and gynaecological cancer shows acute as well as long-term side effects. Severity is dependent on personal factors such as age and comorbidities as well as the type of therapy. Patients with breast cancer and gynaecological cancer can be affected by general symptoms as well as specific toxicities such as pain, nausea, vomiting, fatigue, insomnia, alopecia, stomatitis, myelosuppression, lymphedema, premature menopause and thromboembolism caused by therapy. These sequelae require supportive care. Besides, psychological and social complications can also affect patients with cancer and lead to decreased quality of life. Many patients with breast cancer suffer from distress caused by therapy, fear of recurrence, different body image as well as changes in sexuality. Although effective interventions improved quality of life in patients with breast cancer during the last years there are still many issues that require further consideration in order to improve quality of life. For patients with gynaecological cancer, it is already known that treatment with chemotherapy still leads to a lower quality of life and lower involvement in social activities.
Improving supportive care during treatment of breast cancer and gynaecological cancer is of great importance concerning management of treatment related symptoms, increasing adherence to treatment, and addressing psychological and social aspects of cancer and cancer treatment. Hence, meeting supportive care needs should be a part of interdisciplinary cancer care requiring education of health care providers and patient awareness of supportive care services.
This study had three aims: (1) to identify information and supportive care needs and to explore to which extent they are met in patients with breast cancer compared to patients with gynaecological cancer during the time of treatment; (2) to examine associations between information/ supportive care needs and sociodemographic and medical parameters; (3) to explore the associations between information/supportive care needs and quality of life.
In this German prospective study, authors enrolled 292 patients with breast cancer and gynaecological cancer during the time of treatment. Data on needs were assessed using instruments that had proven feasible in earlier studies. Data on quality of life (QoL) were assessed using the European Organization for Research and Treatment of Cancer QoL Core Questionnaire (EORTC QLQ-C30). They investigated correlations between needs and sociodemographic data as well as quality of life.
Among all cancer entities authors observed that 150 patients (51.5%) showed unmet information needs, 221 patients (75.7%) showed at least one high supportive care need, and 91 patients (31.2%) had psychological care needs. Data showed statistically significant correlations between these needs and sociodemographic data as well as quality of life. These correlations generally showed small to medium effect sizes.
Older women showed less supportive care needs (r=− 0.24; p<0.001), (r=− 0.15; p=0.010).
Furthermore, recruitment after surgery was associated with statistically significant higher information needs (r=0.14; p=0.015), whereas recruitment during chemotherapy was associated with statistically significant less information needs (r=− 0.15; p=0.013).
Positive correlations were shown for the level of received information and physical functioning (r=0.12; p=0.047), social functioning (r=0.16; p=0.009) and global quality of life (r=0.19, p=0.002) as well as satisfaction with information and physical (r=0.16; p=0.006), social (r=0.24; p<0.001), cognitive functioning (r=0.14; p=0.017) as well as global quality of life (r=0.25; p<0.001).
Negative correlations were reported for information needs and emotional functioning (r=− 0.12; p=0.035) and global quality of life (r=− 0.15; p=0.011).
Supportive care needs also correlated negatively with physical (r=− 0.23; p0.001), emotional (r=− 0.35; p<0.001), cognitive (r=− 0.24; p<0.001), social functioning (r=− 0.30; p<0.001), and global quality of life (r=− 0.35; p<0.001).
Also, patients with at least one high supportive care need correlated negatively with role (r=− 0.15; p=0.014), emotional (r=− 0.23; p<0.001), social functioning (r=− 0.30; p=0.001), and global quality of life (r=− 0.35; p0.001). There was no statistical significance concerning cancer side. Thus, both groups are reported together. Furthermore, there was no statistical significance concerning disease status.
In this study, authors analysed needs and quality of life of patients with breast cancer and gynaecological cancer during the time of treatment. Overall, the results suggest that cancer patients still experience an unacceptable level of unmet needs which can reduce quality of life.
This data indicated that unmet needs, particularly regarding information and supportive care, are associated with poorer quality of life. By focusing on patient-oriented conversations, healthcare providers can more effectively identify individual concerns and tailor support accordingly. This approach fosters a deeper understanding of each patient’s unique needs, allowing for more personalized care and ultimately improving patient outcomes. Based on the findings of this study, authors assume that a more patient-oriented communication approach as part of routine care could be beneficial.
Source: Saskia‑Laureen Herbert, A. S. Payerl, M. Prange; Archives of Gynecology and Obstetrics
https://doi.org/10.1007/s00404-024-07805-7
