The August 2024 issue of Elsevier’s The Breast journal carried a provocative paper, “Perspective: An integrated vision of the quality of life of breast cancer survivorship trajectory” that focuses on the complex trajectory of cancer survivorship. Food for thought, indeed, as there are now an estimated 3.8 million breast cancer survivors (BCs) in the US (Cathcart-Rake & Ruddy, 2023). While this is a testament to the success of medical screening, diagnosis, and breast cancer treatments, for many, survivorship involves a compromised QoL.
This paper asks the question: is it time to design a new, patient-centered metric to assess the ‘health’ of the expanding population of breast cancer survivors?
The research team at the University of Milan argue that the QoL checklist needs to be expanded beyond medical criteria to include the long-term issues faced by survivors. Based on meta-analysis of other survivorship research, the team emphasizes the benefits of developing metrics such as “Health-Related Quality of Life”; one that incorporates not only the physical, but also the psychological, social, and financial impacts of breast cancer. However, the authors note progress related to tools measuring QoL do not mirror the rapid strides seen in cancer treatments. Thus, the tools may not adequately describe survivors’ experiences.
"Although breast-cancer care frequently offers cutting-edge biomedical interventions, it fails to address the broader psychosocial and QoL issues linked with survivorship." (Culbertson et al., 2020)
The authors do, however, point to promising efforts led by the European Commission. We quote from Europe’s Beating Cancer Plan: “We should no longer focus on ‘how long’ people live after diagnosis, but rather on ‘how well and how long’ they live” (Europe’s Beating Cancer Plan, 2021). The Plan maintains that there is more to life after breast cancer than just survival.
Hear, hear.
Thank you to Marzorati, Masiero, and Pravettoni for assimilating these meta data – and spelling out what every breast cancer survivor knows: We want more from our clinical practitioners.
Sources:
Culbertson, M. G., Bennett, K., Kelly, C. M., Sharp, L., & Cahir, C. (2020). The psychosocial determinants of quality of life in breast cancer survivors: a scoping review. BMC cancer, 20(1), 948. https://doi.org/10.1186/s12885-020-07389-w
Marzorati, C., Masiero, M., & Pravettoni, G. (2024). "Perspective: An integrated vision of the quality of life in breast cancer survivorship trajectory". Breast (Edinburgh, Scotland), 77, 103785. Advance online publication. https://doi.org/10.1016/j.breast.2024.103785
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