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Abstract Goals of work  Cancer and its treatment often lead to financial difficulty in patients with advanced cancer. The goal of this study was to investigate the relationship between perceived cancer-related financial difficulty and patient satisfaction with quality of life (QoL) in advanced cancer. Materials and methods  A case series of 954 cancer patients treated at Cancer Treatment Centers of America, a private tertiary care oncology facility in the USA, was investigated. Perceived financial difficulty was measured using the QLQ-C30 financial difficulty subscale. Patient satisfaction with QoL was measured using the Ferrans and Powers Quality of Life Index (QLI). The relationship between perceived financial difficulty and QLI was evaluated using multivariate analysis of variance and multiple regression analysis. Results  Of 954 patients, 579 were women and 375 were men, with the median age at presentation of 56 years (range 20–90 years). Sixty-six percent did not respond to prior treatment. Most common cancers were breast (26%), colorectal (19%), and lung (16%). Two hundred ninety-six (31%) patients perceived their financial condition as poor. Every 10-year increase in current age was significantly associated with a decline in all QLI subscales except for family subscale. Newly diagnosed patients had significantly better QLI scores for all subscales as compared to those who did not respond to definitive treatment elsewhere before coming to our hospital. After controlling for the effects of age and treatment history, every 10-unit increase in perceived financial difficulty score was statistically significantly associated with 0.52, 0.36, 0.32, 0.24, and 0.40 unit decline in QLI health/physical, social/economic, psychological/spiritual, family, and overall function score, respectively. Conclusions  We found that perceived financial difficulty is strongly correlated with patient satisfaction with QoL in advanced cancer. These findings indicate a need for the providers of cancer care to be aware that nonclinical factors such as perceived financial difficulty can have an important bearing on QoL of cancer patients. [ABSTRACT FROM AUTHOR]

Abstract Goals of the work  Dyspnea is a common symptom in patients with advanced cancer. The goal of this study was to investigate the relationship between dyspnea and patient satisfaction with quality of life (QoL) in advanced cancer. Materials and methods  A case series of 954 cancer patients treated at the Cancer Treatment Centers of America was investigated. Dyspnea was measured using the EORTC dyspnea subscale. Patient satisfaction with QoL was measured using the Ferrans and Powers Quality of Life Index (QLI). The relationship between dyspnea and QLI was evaluated using multivariate analysis of variance and multiple regression analysis. Results  Of 954 patients, 579 were females and 375 males with the median age at presentation of 56 years (range: 20–90 years). Of these patients, 66% did not respond to prior treatment. Most common cancers were breast (26%), colorectal (19%) and lung (16%). After controlling for the effects of age and treatment history, every ten unit increase in dyspnea was statistically significantly associated with 0.81, 0.16, 0.47, and 0.47unit decline in QLI health/physical, social/economic, psychological/spiritual and global function score, respectively. Conclusions  We found that dyspnea is strongly correlated with patient satisfaction with QoL in advanced cancer. Future studies should evaluate the impact of integrative cancer care services on patient satisfaction with QoL. [ABSTRACT FROM AUTHOR]

Abstract Goals of work  There is extensive data showing that health-related quality of life (HRQOL) tools measuring the activities of daily life provide prognostic information in cancer. However, similar information on HRQOL tools measuring patient satisfaction with their life is sparse. The Ferrans and Powers quality of life index (QLI) is one such instrument. This study evaluated the association between HRQOL, as measured by the QLI, and survival in breast cancer. Materials and methods  We examined a consecutive case series of 251 histologically confirmed breast cancer patients treated at Cancer Treatment Centers of America between April 2001 and November 2004. QLI measures overall HRQOL and the HRQOL in four major subscales: health and physical functioning, social and economic, psychological and spiritual, and family. All scores range from 0 to 30 with higher scores indicating a better HRQOL. Study patients were dichotomized into two groups based on the median scores for all QLI subscales. Kaplan–Meier method was used to calculate survival. Log-rank test was used to study the equality of survival distributions. Multivariate Cox regression analyses were then performed to evaluate the joint prognostic significance of HRQOL and clinical factors. Results  Patient satisfaction with health and physical subscale was significantly associated with survival (p = 0.0006), with the median survival for low and high scores being 17.8 and 35.3 months, respectively. Similarly, patient satisfaction with overall HRQOL was significantly associated with survival (p = 0.0006), with the median survival for low and high scores being 17.8 and 34.6 months, respectively. Patient satisfaction with health and physical subscale and overall HRQOL were found to be predictive of survival independent of the effects of stage at presentation. Conclusions  This study suggests that baseline patient satisfaction with health and physical functioning and overall HRQOL, as measured by QLI, provides useful prognostic information in patients with breast cancer independent of stage at presentation. [ABSTRACT FROM AUTHOR]