Patients with gastric or gastroesophageal cancer commonly experience long-term complications from treatment that compromise their quality of life (QOL), according to self-reported answers to an Internet-based survey questionnaire. Difficulty swallowing appears to be universal, and other problems range from dry mouth and taste changes to cardiovascular disease, according to a study presented at the 2012 American Society of Clinical Oncology Gastrointestinal Symposium held in San Francisco, California.
“Survivors…unanimously and voluntarily report significant health problems after treatment for gastroesophageal cancers. The data reported here are important for designing future studies of QOL, as well as patient counseling and comprehensive survivor care,” stated lead author James M. Metz, MD, Department of Radiation Oncology at University of Pennsylvania’s Abramson Cancer Center, Philadelphia, Pennsylvania.
The authors of this study utilized an Internet-based tool for creation of survivorship plans (available at www.livestrongcareplan.org and through the OncoLink Web site). The tool enables survivors to enter data regarding diagnosis and treatments and provides customized guidelines for future care. Patients who use this tool are asked about late effects associated with specific treatment and answer “yes,” “no,” or “I don’t know.” They are also asked to score toxicity using World Health Organization criteria.
Questions about late effects of treatment were answered by 66 survivors: 80% with esophageal cancer and 20% with gastric cancer. Median age was 55 years. Slightly less than two-thirds were female, and 93% were Caucasian. Average time from diagnosis was 3.8 years. Of the sample, 91% of those with esophageal cancer and 77% of those with gastric cancer underwent surgery; 79% and 85%, respectively, received chemotherapy; and 53% and 31%, respectively, were treated with radiation.
Late effects, in descending order from most common to least frequent, were difficulty swallowing (100%), dry mouth/taste changes (60%), cognitive changes (42%), dental changes (40%), tinnitus (36%), cardiovascular disease (35%; hypertension, 21%; hyperlipidemia, 13%; angina, 2%), sexual changes (28%), peripheral neuropathy (24%), and chronic lung disease (14%).
