Quality of Life of Long-Term Survivors of Non–Small-Cell Lung Cancer

Abstract

PURPOSE: To describe the quality of life (QOL) among survivors of non–small-cell lung cancer (NSCLC).PATIENTS AND METHODS: One hundred forty-two 5-year minimum self-reported disease-free survivors of NSCLC completed QOL instruments (QOL-Survivor and Medical Outcomes Study 36-Item Short Form [SF-36]) and assessments of emotional distress (Center for Epidemiologic Studies Depression Scale [CES-D]), comorbid disease, and tobacco use. Pulmonary function was assessed with a hand-held spirometer. Multivariate regression methods were used on total QOL-Survivor scores and physical (PC) and mental (MC) component scores of the SF-36.RESULTS: The majority (71%) of survivors described themselves as hopeful, and 50% viewed the cancer experience as contributing to positive life changes (QOL-Survivor). Comorbidity was common (60% ≥ one condition); 22% had distressed mood (CES-D ≥ 16). Most were former smokers (76%); 13% continued to smoke. Half had moderate/severe pulmonary distress (forced expired volume in 1 second [FEV1] < 70% of predicted). Regression models including the set of variables (age, sex, living alone, education, smoking status, pulmonary function category, distressed mood, time since diagnosis, and comorbidity) accounted for 37%, 48%, and 29% in the QOL-total, MC, and PC scores, respectively. Primary predictors of lower QOL scores were white ethnicity and distressed mood (CES-D ≥ 16) (34% of the variance explained). The primary predictor of lower MC scores was distressed mood (R2= 0.45). Lower PC scores were associated with older age, living alone, FEV1less than 70% of predicted, distressed mood, time since diagnosis, and more comorbid diseases (R2= 0.28).CONCLUSION: These findings provide the first description of the QOL of long-term survivors of lung cancer. Risk factors for poorer QOL are strongly linked to distressed mood, which is a potential target for intervention.