Background:
SCSC clinic provides multidisciplinary care after primary adjuvant treatment, with approximately 40% of attendees continuing follow-up with SCSC. We evaluated changes in symptoms, quality-of-life and lifestyle factors.
Methods:
Survivors attending SCSC for follow-up care (2014 - 2019) completed self-report measures of symptoms, quality-of-life and lifestyle factors at initial visit (T1), first follow-up (T2) and 1-year (T3). Analyses used mixed effect models, adjusted for age, sex, and tumour type.
Results:
Data from 206 survivors were included: 49% female, median age 63 (range 32-90) years, tumour types: colorectal 68%, breast 12%, upper gastrointestinal 12%, other 8%; 83% received adjuvant chemotherapy. Mean time from: T1 to T2 3.6 months (SD 0.9); T1 to T3 11.8 months (SD 1.4).
Mean weight remained stable with 61-68% overweight/obese but 47% of overweight/obese survivors lost weight from T1 to T3. Moderately-intense aerobic exercise increased by 64mins/week at T2, and 97mins/week T3 (p=0.002). Proportions meeting aerobic exercise guidelines increased from 21% to 39% at T2 and 41% at T3; with greater improvement in males. Resistance exercise increased by 27mins/week at T2, and 17mins/week at T3.
Global quality-of-life (FACT-G) was unchanged from T1 to T2, improving slightly by T3 (5.3 point increase, p=0.001), especially in males.
Mean distress scores were stable but at T3 the proportion scoring 4+/10 had declined by 10%. At T3 declines were seen in pain (Adjusted Odds Ratio [AOR]=0.43, p=0.003) and fatigue (AOR=0.59, p=0.041), with improvement in energy (AOR=2.2, p=0.004), but >20% reported ongoing moderate-severe fatigue, pain or sleep disturbance. The proportion reporting 5+ symptoms of at least moderate severity declined from 35% at T1 to 26% at T3, remaining higher in women than men.
Conclusions:
Survivors have relatively good quality-of-life and improvement in many symptoms and lifestyle factors at 1-year. Women continue to have greater symptom burden than men.