Symptom burden and quality of life in survivorship: a review of the literature.
BACKGROUND
Cancer has a great impact on the well-being of affected persons and their caregivers long into survivorship.


OBJECTIVE
This article reviews the state of science on the survivorship experience of cancer survivors and caregivers, with a focus on symptom burden and quality of life (QOL) after treatment termination.


METHODS
The primary databases utilized included PubMed and CINAHL. Search results were limited to human participants, English language, and publications from 2008 to 2013. The articles retrieved included studies of prostate, breast, colorectal, and gynecologic cancers during adulthood.


RESULTS
As many as a third of cancer survivors experienced symptoms after treatment cessation equivalent to those experienced during treatment. Fatigue, depression or mood disturbance, sleep disruption, pain, and cognitive limitation were commonly reported by survivors across various malignancies; depression, anxiety, and sleep disturbance affected some caregivers. The studies indicated residual symptoms that extend into survivorship have a great impact on QOL and are associated with disability and healthcare utilization. Younger age, lower socioeconomic status, and increased comorbidities are associated with poorer QOL and higher symptom distress in cancer survivors. Younger age and lower income are associated with greater distress and poorer QOL in caregivers.


CONCLUSIONS
Survivors and caregivers struggle with symptom burden and diminished QOL long into survivorship. Longitudinal studies are needed to investigate the persistence and severity of symptom burden over time as well as long-term and late effects of these symptoms.


CONCLUSIONS
Interventions designed to help alleviate symptom burden in those most affected are needed.
Author Affiliation: College of Nursing, Wayne State University, Detroit, Michigan.
Horng-Shiuann
HS
Wu
Janet K
JK
Harden
D017028:Caregivers / Q000523:psychology; D017281:Cost of Illness; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D017741:Survivors / Q000523:psychology*