Despite the physical and emotional struggles cancer patients face, many survivors report good quality of life -- better, in some cases, than the general public or their physicians would guess, according to a new study.

Survivors of gynecological cancers who attended a follow-up clinic reported that their quality of life was the same as or better than before they were diagnosed with the disease.

"There is a misconception amongst the general public and health professionals that the quality of life of cancer patients must be worse than that of the general population," notes lead author Robyn L. Leake of King Edward Memorial Hospital in Western Australia.

Patients were asked to fill out a questionnaire at a clinic, which was designed for those with a low risk of disease recurrence. The physician who saw the patient was asked at the end of the consultation to rate the patient’s overall quality of life, using a ranking of 1 to 7. The doctors consistently rated the patient’s quality of life lower than the patient herself did, in most cases by one point and in several instances by three to five points.

Results of the study appear in the September 2001 issue of Psycho-Oncology.

Evaluation of a patient’s quality of life is key to assessment of new cancer treatments, particularly when several kinds of treatments result in similar survival rates.

Quality of life for a gynecological cancer survivor is influenced by many factors -- concern about things returning to normal at home and at work, financial problems, worries about whether she chose the proper treatment option, side effects from treatment, fear of recurrence and changes in sexual function, fertility and body image.

Researchers used a questionnaire to assesses these factors before diagnosis and after. Most of the patients’ scores were in the top range, demonstrating that the patients considered their quality of life to be good.

Of the 202 patients who participated in the study, 45 were fearful of recurrent cancer and 144 were not. Younger patients were more apt to fear recurrence than older, and patients with invasive ovarian cancer were more likely than not to be fearful of recurrence.

A full 25 percent of the study group did not answer the question regarding how cancer treatment had affected their sexual function. Of those who did respond, 57.4 percent reported their sexual function was the same or better than prior to treatment, while 15.3 percent said it had worsened. Patients who lived with a partner were more likely to report a worsening of sexual function than those who did not.

The two final questions measured improvement or deterioration of quality of life. Responses indicated that quality of life had improved or remained the same for 149 participants, while it deteriorated for 44. Data was missing for nine participants.

Radiation therapy was associated with a greater negative effect of treatment on quality of life, although patients who did receive radiation still had relatively high quality of life measures.

The study was funded by the Women and Infant’s Research Foundation of Western Australia.

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Psycho-Oncology is a bimonthly international journal devoted to the psychological, social and behavioral dimensions of cancer. Published by John Wiley, it is the official journal of the American, British and International Psycho-Oncology Societies. Contact Jimmie Holland, MD, Co-Editor, at (212) 739-7051 for information.