Empowering Cancer Patients: Supporting Quality of Life Enhancement
Empowering Cancer Patients: Supporting Quality of Life Enhancement
Cancer presents a formidable challenge, but it does not imply a compromise in quality of life. Proactive measures can be taken to support patients in enhancing their quality of life.
Quality of life (QoL) serves as a vital indicator of human satisfaction and well-being. For patients diagnosed with cancer, their quality of life experiences significant and enduring impacts. The severe side effects associated with potent medications have long been viewed as a necessary sacrifice for extending life expectancy. However, patients and physicians are now questioning the necessity of this suffering.
Recently, the U.S. FDA initiated the “Project Optimus,” which encourages pharmaceutical companies to conduct low-dose testing on a broader spectrum of patients to obtain better low-dose data. Based on several cases, it becomes evident that the current dose selection and regimen based on cytotoxic chemotherapeutics often pose challenges. This may lead to selecting doses that offer more toxicity without additional benefits, or triggering severe toxic reactions necessitating frequent dose adjustments, or even premature cessation of treatment due to intolerable toxicity, thereby missing out on the opportunity for sustained benefits. Additionally, these doses and regimens may result in persistent or irreversible toxicities, consequently limiting the options for subsequent treatments.
In Taiwan, according to statistics from the Ministry of Health and Welfare for the year 112, there were over 53,000 cancer-related deaths, accounting for 25.8% of the total mortality. Notably, 87% of these deaths occurred in individuals aged 55 and above.
The top ten causes of cancer mortality are, in order: (1) tracheal, bronchial, and lung cancer; (2) liver and intrahepatic bile duct cancer; (3) colon, rectum, and anus cancer; (4) breast cancer in females; (5) prostate cancer; (6) oral cancer; (7) pancreatic cancer; (8) stomach cancer; (9) esophageal cancer; and (10) ovarian cancer. Cancer has consistently been the leading cause of death, highlighting the need for continuous focus on cancer treatment and improving the quality of life for patients in Taiwan. This is an area that merits significant attention.
What is Quality of Life?
The World Health Organization (WHO) defines quality of life as individuals’ perceptions of their position in life within the context of their culture and value systems, while taking into consideration their goals, expectations, standards, and concerns. It is a broad concept that encompasses the complex interplay between individuals’ physical health, psychological state, level of independence, social relationships, personal beliefs, and their relationship to significant environmental features.
The WHO Quality of Life Assessment (WHOQOL) is a tool developed collaboratively by the WHOQOL Group and fifteen international field centers to develop a quality of life assessment applicable across cultures. It includes individuals’ perceptions of their health status, psychosocial status, and other aspects of life.
- WHOQOL-100: This tool assesses individuals’ perceptions of their position within cultural and value systems, as well as their associations with their goals, expectations, standards, and concerns. It consists of a 100-item assessment tool currently available in 29 directly comparable language versions. It provides a multidimensional profile of scores across domains and sub-domains (facets) of quality of life.
- WHOQOL-BREF: This is a brief version, shortened to only 26 items for assessment.
Reference: https://iris.who.int/bitstream/handle/10665/77932/WHO_HIS_HSI_Rev.2012.03_eng.pdf?sequence=1
The EORTC QLQ-C30 questionnaire is commonly used in the field of cancer treatment. Developed by the European Organisation for Research and Treatment of Cancer (EORTC) in 1993, this tool is designed for assessing the quality of life of cancer patients. Widely employed in numerous clinical trials involving cancer, it comprises 30 questions aimed at evaluating various aspects of cancer patients’ quality of life.
Reference: https://qol.eortc.org/questionnaires/core/eortc-qlq-c30/
Challenges to Quality of Life Faced by Cancer Patients
Cancer patients encounter numerous challenges to their quality of life throughout the course of cancer treatment:
- Physical Health: Cancer treatment may lead to physical weakness, fatigue, and other bodily discomfort, impacting patients’ daily activities and functional abilities.
- Psychological Stress: Diagnosis and treatment of cancer can induce anxiety, depression, and other psychological stressors, affecting patients’ emotional well-being and mental health.
- Social Relationships: Due to the effects of treatment and illness, cancer patients may feel disconnected from family, friends, and society, leading to feelings of loneliness and isolation.
- Financial Burden: Cancer treatment can result in high medical expenses and income loss, placing financial strain on patients and their families.
- Lifestyle Changes: Cancer treatment may necessitate lifestyle modifications, such as adjustments to diet, exercise, and sleep habits, which can impact patients’ lifestyle and quality of life.
Cancer patients face various challenges to their quality of life, and in addition to patients, family members also encounter significant stressors and challenges that must be addressed and resolved.
Challenges to Quality of Life in New Drug Development
Improving the quality of life for patients has always been a paramount goal in new drug development. Several ongoing efforts are continuously being pursued, including:
- Early Detection of Lesions: Utilizing AI technology for assisted diagnosis and developing clearer screening mechanisms can help detect signs and symptoms of diseases earlier, allowing for early treatment or prevention.
- Precision Therapy: Developing precision therapy drugs or advanced medical surgical equipment, such as targeted medications, immunotherapy, etc., and developing non-cytotoxic drugs targeting cancer cells, to improve cancer treatment and reduce side effects, or to enable patients to recover at home more quickly after surgery or treatment.
- Improved Drug Delivery Methods: Developing more convenient and easily accepted drug delivery methods, such as oral medications as alternatives to injections, to enhance treatment convenience and comfort for patients.
- Provision of Supportive Care: In addition to directly treating tumors, providing supportive care such as pain management, cancer fatigue management, emotional and psychological support, and nutritional assistance to alleviate patient symptoms and improve their quality of life.
- Encouragement of Clinical Trial Participation: Providing patients with the opportunity to access the latest treatment methods and medical technologies through clinical trials, thereby improving treatment outcomes and quality of life.
Through the development of safe and effective drugs, it is hoped that the quality of life of cancer patients can be effectively improved.
Enhancing Quality of Life for Cancer Patients
Adequate Rest
During the recovery period, it is essential to ensure adequate rest, allowing the body to get sufficient sleep to aid in cellular repair, boost the immune system, and alleviate fatigue. Additionally, many cancer patients experience Cancer-Related Fatigue (CRF), a physical and mental exhaustion caused by prolonged cancer treatment. This type of fatigue can be more severe than other cancer side effects and may lead to issues such as anxiety, depression, anemia, and sleep disturbances, gradually affecting the patient’s overall physical and mental well-being.
A plant-based new drug named PG2 Injection has been launched in Taiwan to treat Cancer-Related Fatigue (CRF). This medication is indicated for managing CRF, alleviating the side effects of cancer chemotherapy and radiotherapy, and improving anemia caused by cancer treatments. PG2 Injection is included in the National Health Insurance (NHI) coverage and helps mitigate the associated symptoms in cancer patients.
Balanced Diet
Maintaining good dietary habits can aid in the body’s recovery and enhance physical strength. It is recommended to consume plenty of fresh vegetables and fruits while reducing intake of high-fat, high-sugar, and processed foods. It’s also important to follow dietary recommendations provided by healthcare professionals.
Moderate Exercise
Engaging in light exercise during the recovery period, such as walking, yoga, or tai chi, can promote physical recovery, alleviate fatigue, and boost immunity.
Adherence to Medication Schedule and Instructions
Following the physician’s instructions and taking medications correctly is crucial for cancer treatment. The primary goal during treatment is to minimize disease progression while maintaining a good quality of life for patients. Regular follow-up appointments and tests are essential.
Psychological or Spiritual Therapy
Cancer patients and their families often endure significant psychological stress during the treatment process. Acknowledge these challenges and seek therapy to find encouragement and release stress.
Adjustment of Lifestyle Pace
In the face of the long and uncertain journey of cancer treatment, besides taking an active approach, it’s also important to plan life well. Completing unfinished life goals, enjoying outings, cherishing time spent with family, etc., are all worthwhile endeavors that deserve your time and attention.
Support from Family and Friends
As a patient’s family member or friend, your companionship and support are crucial to their recovery process. Through honest communication with the patient and providing the most caring and supportive presence, you can make them feel like you are always by their side. This support not only helps the patient regain confidence in life but also provides them with warmth and comfort.At the same time, as a caregiver, it’s important to take care of yourself. Make sure you have enough rest, maintain healthy eating habits, and give yourself some time to relax and unwind to avoid becoming overly exhausted. Only by maintaining physical and mental health can you better take care of the patient and provide the best support when they need you most.
