Karen Hassey Dow

An evaluation of the quality of life among long-term survivors of breast cancer

SummaryAttention to the quality of life (QOL) among long-term of breast cancer is long overdue. Modest improvements in overall survival have led to a greater emphasis on how women are living with the disease. The purpose of this paper is to report the results of a descriptive study that evaluated the quality of life of 294 breast cancer survivors, and to review the continuum of positive and negative QOL outcomes in this population. Members of the National Coalition for Cancer Survivorship (NCCS) were surveyed and received two QOL instruments: the Quality of Life — Cancer Survivors Tool (QOL-CS) and the Functional Assessment of Cancer Therapy (FACT-G), and a demographic data tool. The main research variables were the subscales (Physical, Psychological, Social, and Spiritual Well-being) and individual items of the QOL-CS and the FACT-G. Results indicated that: a) fatigue, aches and pains, and sleep problems were persistent after treatment ended; b) psychological distress from cancer diagnosis and treatment, and fear of recurrent, metastatic, and recurrent disease were problematic over time; c) family distress, sexuality, and family burden issues were of greatest social concern; and d) uncertainty over the future plagued breast cancer survivors long-term. Breast cancer survivors also reported good outcomes in hopefulness, having a life purpose, and having a positive change after the treatment. Conclusions: breast cancer survivors experienced long-term changes after completion of treatment which affected overall quality of life. However, many positive benefits were also gained which helped to balance the worse outcomes.

Quality of Life in Women with Ovarian Cancer

Despite growing interest in quality of life (QOL) as an important variable in nursing and health care, little research focuses on QOL in women with ovarian cancer (OVCA). The purpose of this study was to examine QOL in OVCA survivors. The convenience sample consisted of 152 women in all disease stages. Quantitative data were collected using the QOL-Cancer Survivors tool and a demographic sheet. Qualitative data were collected by asking participants to write their definitions and experiences of QOL since their diagnosis. Reliability and validity of all data and findings were established. Findings reveal that QOL is moderately highfor this group of cancer survivors, despite some specific negative facets of the illness and treatment experience. Qualitative analysis elaborates the four domains of Ferrells QOL model: physical, psychological, social, and spiritual well-being. Qualitative data also reflect the complexity of the cancer experience.

A review of late effects of cancer in women

The phenomenal changes in womens advocacy, activism, and consumerism, coupled with advances in screening and early detection, and improved supportive therapies have led to long-term survival for many womens cancers (with the exception of lung cancer). These results have, in turn, had an effect on the experience of surviving cancer in women. Late physical effects, and changes in psychologic, social, and spiritual well-being have become an important aspect of follow-up care. Health promoting activities, supportive care, and future research are integral to the continuing care and rehabilitation of women surviving cancer.

Fertility Options in Young Breast Cancer Survivors: A Review of the Literature

PURPOSE/OBJECTIVES To describe the impact of treatment on fertility, discuss fertility-sparing options available for women with breast cancer, and explore pregnancy subsequent to breast cancer. DATA SOURCES Published research, clinical articles, book chapters, and abstracts. DATA SYNTHESIS The risk of amenorrhea associated with alkylating agents in breast cancer survivors is well known. Fertility-sparing options before, during, and after treatment are possible with the use of assistive reproductive technology. Young breast cancer survivors are concerned about stimulating recurrence with subsequent pregnancy, health during pregnancy, and family matters. CONCLUSIONS Current data about the effects of treatment on amenorrhea, subsequent pregnancy after treatment, preservation of ovarian function during adjuvant therapy, and management of ovarian failure in young women with breast cancer are important to include in discussions and counseling. IMPLICATIONS FOR NURSING Young women deserve a thoughtful discussion about their concerns among their multidisciplinary team, including oncology nurses, oncologists, and social workers. Effects of treatment on fertility are well known. Women with fertility concerns should be referred to a reproductive endocrinology team at the time of diagnosis rather than after treatment has ended.

Challenges and Opportunities in Cancer Survivorship Research

455 P resenting the keynote address for the Seventh National Conference on Cancer Nursing Research was a distinct honor and pleasure. My focus was on the challenges and opportunities facing us in cancer survivorship research. We have witnessed major changes in cancer survival during the past three decades, with an increase in survival of all cancers combined. At the same time, we are at a unique juncture in our current scientific knowledge of late effects among childhood, adolescent, and adult cancer survivors. Accumulating evidence documents the existence of late physical and psychosocial morbidity from cancer and its treatment that challenges some of our prevailing notions, approaches, and paradigms. In addition, our lack of knowledge in other arenas presents tremendous opportunities for new and exciting research directions. This article focuses on four specific questions for which we have some answers. 1. Who are cancer survivors? 2. What is cancer survivorship research? 3. What do we know about cancer survivors? 4. How do we meet the challenges in cancer survivorship research? It also will focus on some yet-to-be-answered questions.