Oral Presentation Cancer Survivorship 2019

Health Concerns of cancer survivors after primary anti-cancer treatment (#10)

Sim Y Tan 1 2 3 , Jane Turner 1 4 , Kim Kerin-Ayres 1 5 , Sue Butler 1 6 , Cole Deguchi 1 5 , Sonia Khatri 1 5 , Christopher Mo 4 , Anne Warby 4 , Ilona Cunningham 1 7 , Ashanya Malalasekera 1 , Haryana Dhillon 3 4 , Janette Vardy 1 3 4
  1. Concord Cancer Centre , Concord Hospital, Concord, NSW, Australia
  2. Nutrition and Dietetics Department, Concord Hospital, Concord, NSW, Australia
  3. Sydney Medical School, University of Sydney, Concord, NSW, Australia
  4. Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Sydney, NSW, Australia
  5. Nursing Services, Concord Hospital, Concord, NSW, Australia
  6. Psychology Department, Concord Hospital, Concord, NSW , Australia
  7. Haematology Department, Concord Hospital, Concord , NSW, Australia

Background:
Cancer survivors experience significant health concerns compared to the general population. Sydney Survivorship Clinic (SSC) is a multi-disciplinary clinic that aims to help survivors treated with curative intent manage side-effects, and establish a healthy lifestyle. Here we determine the health concerns of survivors post-primary treatment.
Methods:
Survivors complete questionnaires assessing: symptoms, quality of life (QOL), distress, diet, and exercise before attending SSC; and a satisfaction survey after. Body mass index (BMI), clinical findings, and recommendations were reviewed. Descriptive statistical methods were used.
Results:
Overall, 410 new patients attended SSC between September 2013-April 2018, with 385 survivors included in analysis: median age 57 years (range 18-86); 69% female; 43% breast, 31% colorectal and 19% haematological cancers. Median time from diagnosis: 12 months. Common symptoms of at least moderate severity: fatigue (45%), insomnia (37%), pain (34%), anxiety (31%); with 56% having >5 moderate-severe symptoms. Overall, 45% scored distress ≥4/10 (cut-off requiring further investigation) and 62% were rated by our clinical psychologist as having ‘fear of cancer recurrence’. Compared to a population mean of 50, the mean global QOL T-score was 47.2, with physical and emotional well-being domains most affected. Mean BMI was 28.2kg/m2 (range 17.0 – 59.1); 61% of survivors were overweight/obese. Only 31% met aerobic exercise guidelines, and 3% met guidelines for aerobic and resistance exercise. In total, 38/113 (34%) had more than two lifestyle risk factors (overweight, not meeting exercise guidelines), in addition to psychological issues (distress thermometer 4+/10, and/or rated as having fear of cancer recurrence), and five or more symptoms of at least moderate severity. Overall, 98% “agreed”/“completely agreed” attending the SSC was worthwhile, and 99% would recommend it to others.
Conclusion:
Distress, fear of cancer recurrence, fatigue, obesity and sedentary lifestyle are common in cancer survivors attending SSC and may best be addressed in a multi-disciplinary Survivorship clinic to minimise longer-term effects. This model was highly rated by survivors.