Breast cancer (BC) survivors experience ongoing health problems compared to the general population. The Sydney Survivorship Clinic aims to help cancer survivors better manage their disease and treatment effects. Here we report the health status of breast cancer survivors post primary adjuvant treatment.
BC survivors completed questionnaires assessing: distress, symptoms, quality of life (QOL), diet and exercise before attending the Sydney Survivorship Clinic. Attendees were seen by a multidisciplinary team (medical oncologist, cancer nurse specialist, dietitian, clinical psychologist and exercise physiologist).
A total of 96 women with BC have attended an initial clinic visit from September 2013 to July 2016: median age 52 years (range 30-75). Median time from diagnosis: 10.4 months (range 2.3-134). All had undergone surgery, 97% had received chemotherapy, 68% radiotherapy, and 64 were receiving hormonal treatment. Most common symptoms of at least moderate severity were: fatigue (58%), insomnia (53%), hot flushes (44%), pain (37%), anxiety (37%), numbness (37%), and sore hands/feet (37%). 54% had a distress thermometer score of 4+, meeting screening guidelines for further investigation. Overall, 76% were rated by the clinical psychologist as having ‘fear of cancer recurrence’; 30% were referred for follow-up, and a further 9% were already linked with psychological services.
Overall QOL score (FACT-G) was 55.9, with physical and emotional domain t-scores more than 3SD below peer-matched population scores.
Average BMI was 28.4kg/m2 (range 18-59kg/m2); 65% were overweight or obese, with mean weight gain since diagnosis of 2kg (range: -10 to 18kg). Only 33% of survivors reported meeting physical activity guidelines. Self-rated ECOG performance status (PS) was: PS0 41%, PS1 52%, and PS2 6.5%.
Distress, fatigue, insomnnia, hot flushes, poor QOL, obesity and sedentary lifestyle are common in this cohort of breast cancer survivors, persisting years after cancer diagnosis. The Survivorship clinic identifies important issues for women with breast cancer after adjuvant treatment and facilitates effective management of these concerns.