Bakgrund: Cancer är en sjukdom som omfattar tumörsjukdomar med onaturlig och okontrollerad cellväxt. Sjukdomen drabbar tiotusentals personer i Sverige varje år. Hälsorelaterad livskvalitet är ett begrepp som använts för att beskriva individers uppfattning av sitt välmående i relation till sin hälsa. Livskvaliteten kan användas som ett verktyg för att förstå patientgruppen och de förändringar de genomgår i samband med sjukdomsprogression och behandling. Onkologisk rehabilitering erbjuds vissa patientgrupper. Syftet med rehabiliteringen är främst att genom patientundervisning och träning återge patienten kontroll över sitt liv. Syfte: Att undersöka hälsorelaterad livskvalitet över tid hos patienter som genomgått onkologisk rehabilitering. Metod: Studien har en prospektiv design. Samtliga patienter som remitterades till en onkologisk rehabiliteringsverksamhet i Sverige under ett år tillfrågades. För att utvärdera livskvaliteten användes enkäten EORTC QLQ-C30. Enkäten lämnades ut till patienterna vid baseline, efter tre och sex månader. Deskriptiv statistik. Resultat: Studiens resultat visar att livskvaliteten var låg och oförändrad vid de tre mätningarna. Deltagarnas uppvisar goda funktioner i samtliga mätningar, högst vid tre månader. Symtomen minskar överlag vid varje mätning. Kraftigast minskar sömnsvårigheterna. Slutsats: Sammanfattningsvis visar studien att livskvaliteten var opåverkad de sex första månaderna efter rehabiliteringen. Dock förbättrades deltagarnas sömn, vilket kan ses som en positiv effekt av rehabiliteringen. Viss skillnad mellan kön, cancerdiagnoser samt svenskfödda och utlandsfödda finns; men dessa kan även bero på skillnader inom normalpopulationen. Funktionsskalornas maxvärde efter tre månader kan visa på behov av uppföljande rehabilitering. Klinisk betydelse: Studiens resultat ska användas i ett kvalitetsgranskningsarbete. / Background: Cancer is a diagnosis which encompasses diseases with abnormal and uncontrolled cellular growth. Tens of thousands of people are affected by cancer every year in Sweden. Health-related quality of life (HRQoL) is a concept used to describe people’s perception of well-being in relation to their health. HRQoL can also be used as a tool to understand the patients and the changes they go through during progression of disease and treatment. Oncological rehabilitation is offered to some patient groups. The goal with the rehabilitation is to give the patients control back over their lives through education and training. Aim: To study the oncological rehabilitations effect on HRQoL over time. Method: All patients remitted to a certain rehabilitation facility in Sweden during one year were asked to participate. To evaluate the HRQoL the EORTC QLQ-C30 questionnaire was used. The questionnaire was sent out to the respondents at baseline and after three and six months. Descriptive statistics. Result: The results of the study showed that quality of life was low and unaffected at the three measurements. The functions reached their highest value after three months. The symptoms overall decreased at each measurement. The most positive change was seen with insomnia. Conclusion: In conclusion, the quality of life was unaffected during the first six months after the rehabilitation. The improvement of the participants’ insomnia might be a positive outcome of the rehabilitation. The results points to some differences between gender, cancerdiagnose and people born in Sweden or abroad; but these might as well depend on differences in the population. The functions higher value after three months might show a need for follow-up rehabilitation. Clinical implication: The result of the study is to be used in a quality audit.

PURPOSE: To compare the characteristics of cancer patients in Taiwan who use complementary and alternative medicine (CAM) to cancer patients who do not use CAM and determine the predictors of quality of life (QoL) among cancer patients who use CAM. PATIENTS AND METHODS: Face-to-face interviews were conducted with and 3 questionnaires (the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire, the Brief Fatigue Inventory, and the Pittsburgh Sleep Quality Index) were administered to 216 cancer patients being treated at the Nuclear Medicine Department in southern Taiwan. Chi-square testing for categorical variables and t-testing for continuous variables were conducted to determine the correlation between sociodemographic and clinical data and CAM use. Analysis of variance was performed to conduct within-group comparison of QoL scales and CAM use. Linear regression models were established to predict QoL score. RESULTS: A total of 216 cancer patients were interviewed. The prevalence of CAM use was found to be 69.4% (150 of 216 subjects). Among the CAM users, 91.6% had used traditional Chinese medicine (TCM), dietary supplementation (vitamin, herbal, mineral, glucosamine, mushroom, and/or fish oil supplementation), or detoxification therapy. A greater percentage (49.5%) of CAM users had breast cancer than any other type of cancer, and a very large percentage (74.7%) did not inform their primary caregiver of their CAM use, whereas 52.7% used CAM after initiation of diagnosis and 26.7% increased the original frequency of their CAM use during the course of their treatment. Overall QoL was not found to be significantly different between CAM users and nonusers. Predictors of poor QoL were female gender, breast or liver cancer patient, younger age, lower education, chemotherapy, increased frequency of CAM use, non-vitamin/TCM use, and having received CAM information from primary caregiver. The factors of CAM use, number of CAM modalities used, frequency of CAM use, duration of cancer diagnosis, mineral/algae supplementation, and detoxification therapy were not found to be significant in this population. CONCLUSION: Cancer patients in Taiwan have a high rate of CAM use but a low rate of disclosure of CAM use to their primary caregivers. Multiple factors appear to have a significant correlation with poor QoL. Clinical physicians should emphasize the QoL of cancer survivors, providing more accurate CAM information and endeavoring to address their unmet needs.

Introduction: Each year 1200-1300 patients are diagnosed with head neck cancer. Treatment that involves radiotherapy can cause severe side effects for example trismus that affects quality of life. Purpose: To study health-related quality of life in patients who have undergone radiation treatment for head and neck cancer and participated in a intervention group who received training intended to prevent trismus or in a control group who received standard treatment. Method: This is a prospective study in which data is collected from 66 patients participating in a randomized study aiming to evaluate a training program to prevent trismus. Thirty three participated in the intervention group and thirty three in the control group. Both patient groups assessed health related quality of life (HRQOL) with EORTC QLQ C30 and QLQ-H&N35, at start and end of the radiation treatment, and at 3 and 6-months after completing radiation treatment. Results: There is no difference between the intervention and control groups regarding symptoms, functional status and global health, except for intake of nutritional supplements.  For both groups almost all scales measuring HRQOL deteriorated under the radiation treatment. However, 3 and 6 months after end of radiotherapy HRQOL had improved and had returned to the baseline values. The only exceptions were dry mouth, sticky saliva, problems with social eating, senses and physical ability. Conclusion: Radiation therapy for head and neck cancer affects patients HRQOL both in the short and long term. Medical staff needs strategies to manage patients ' functional and symptomatic deterioration throughout the treatment period and try to prevent or relieve the symptoms that may still remain several months after radiotherapy.

In Anbetracht steigender Inzidenzraten für Tumorerkrankungen, bei gleichzeitig steigenden Überlebensraten, gewinnt die Frage nach der verbleibenden gesundheitsbezogenen Lebensqualität (HRQOL) im klinischen Alltag immer größere Bedeutung. Für einige HRQOL- Domänen bzw. Symptom-Items konnte bereits gezeigt werden, dass diese mit der Überlebenszeit von Patienten korrelieren bzw. Prädiktoren für längeres Überleben sind. Ziel der vorliegenden Studie war es die gesundheitsbezogenen Lebensqualität (HRQOL) bei einer großen Kohorte (N=1879) deutscher Tumorpatienten zu untersuchen. Mit Hilfe des Fragebogens EORTC QLQ-C30 (Version 3.0) wurde die physische Funktion, Rollenfunktion, emotionale Funktion, kognitive Funktion, soziale Funktion, Fatigue und die globale Lebensqualität gemessen. Aus der Krankenakte der betreffenden Patienten wurden relevante soziodemographische Merkmale (Alter, Geschlecht, Nationalität, Body-Mass-Index) und klinische Merkmale (Diagnose, TNM- Stadium, Therapieform, Intervall seit Diagnose, Rehabilitationsmaßnahme) extrahiert und statistisch ausgewertet. Wir stellten fest, dass die Tumorpatienten in allen HRQOL-Domänen starke Beeinträchtigungen im Vergleich zur gesunden deutschen Allgemeinbevölkerung zeigen. In besonderem Maße zeigten sich jüngere Tumorpatienten (≤59Jahre) beeinträchtigt. Weiterhin sahen wir klinisch relevante Beeinträchtigungen bei Patienten mit einer Therapiekombination aus Radio- und Chemotherapie, Patientinnen mit Brustkrebs und Tumoren des weiblichen Genitaltrakts und Patienten mit Migrationshintergrund aus Südosteuropa. Im gesamten Patientenkollektiv stellten wir eine überdurchschnittlich hohe Ausprägung von Fatigue (CRF) fest. Aufgrund der gemessenen Beeinträchtigungen der HRQOL, sowie der hohen Ausprägung von CRF sollten den betroffenen Patienten möglichst frühzeitig zusätzliche spezifische Therapie-Angebote unterbreitet werden, wie z.B. eine onkologische Rehabilitation und psycho-onkologische Therapiemaßnahmen, denn diese Intervention zeigte eine klinisch relevante Verbesserung in allen HRQOL-Domänen. Die routinemäßige Erfassung der subjektiven Lebensqualität der Betroffenen stellt in unseren Augen eine wichtige Zielgröße dar, welcher in der Routineversorgung neben objektiven Befunden (wie Tumoransprechen usw.) viel mehr Beachtung geschenkt werden sollte.