The impact of age, treatment, and symptoms on the physical and mental health of cancer patients. A longitudinal perspective.
BACKGROUND
To describe continuing care and rehabilitation needs of cancer patients, a longitudinal design (6 months) was performed among patients 50 years of age and older with solid tumors. The study examined how age, type of treatment, site of cancer, and symptom experience affect physical functioning and their mental health; age, site of cancer and the interval of time out of treatment influence changes in their symptom experience; and age, site of cancer, the interval of time out of treatment, and changes in symptom experience influence changes in physical and mental health.


METHODS
Patients (n = 111) who completed an intake and a 6-month self-administered questionnaire were included. Treatment included chemotherapy, radiation, or hormonal treatment at intake and for 6 months. Scales of nine symptoms and physical health using activities of daily living and measures of vigorous function were composed. Mental health was measured by the Center for Epidemiological Studies--Depression Scale.


RESULTS
The analyses yielded the following findings: (1) Primary site may have had an impact on symptom experience, limitations in functioning, and mental health if more patients with lung cancer had survived to 6 months. (2) Age, gender, treatment, or change in treatment had no impact on symptoms, functioning, or mental health at intake or changes in these variables. (3) Symptom experience at intake and the changes in symptoms predicted physical functioning and mental health at intake and the changes in these variables over time. (4) Gender differences were important in predicting mental health.


CONCLUSIONS
Strategies for continuing care and rehabilitation need to focus on symptom management, and strategies need to be different for male and female patients.
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College of Human Medicine Department of Family Practice, Michigan State University, East Lansing 48824.
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Stommel
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D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology; D003131:Combined Modality Therapy; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D011336:Probability; D012044:Regression Analysis; D012737:Sex Factors; D015996:Survival Rate