BC Cancer Agency and University of British Columbia, Vancouver, BC, Canada.
Optum, Johnston, RI, USA.
Support Care Cancer. 2018 Jun;26(6):1985-1991. doi: 10.1007/s00520-017-4025-9. Epub 2018 Jan 10.
Metastatic melanoma is a highly aggressive cancer, often striking in the prime of life. This study provides new information directly from advanced melanoma (stage III and IV) patients on how their disease impacts their health-related quality of life (HRQL).
Twenty-nine in-depth, qualitative interviews were conducted with adult patients with advanced melanoma in Canada. A semi-structured interview guide was used. Interviews were transcribed verbatim and key concepts were identified using a grounded theory analytic approach.
Many patients' journeys began with the startling diagnosis of an invasive disease and a vastly shortened life expectancy. By the time they reached an advanced stage of melanoma, these patients' overall functioning and quality of life had been greatly diminished by this quickly progressing cancer. The impact was described in terms of physical pain and disability, emotional distress, diminished interactions with friends and family, and burden on caregivers.
Our findings provide evidence of signs, symptoms, and functional impacts of advanced melanoma. Signs and symptoms reported (physical, mental, and social) confirm and expand on those reported in the existing clinical literature. Primary care physicians should be better trained to identify melanomas early. Oncology care teams can improve on their current approaches for helping patients navigate treatment options, with information about ancillary services to mitigate disease impacts on HRQL, such as mental health and social supports, as well as employment or financial support services.
转移性黑色素瘤是一种侵袭性很强的癌症,通常在生命的黄金时期发病。本研究直接从晚期黑色素瘤(III 期和 IV 期)患者那里获得了有关疾病如何影响其健康相关生活质量(HRQL)的新信息。
在加拿大对 29 名晚期黑色素瘤成年患者进行了 29 次深入的定性访谈。使用半结构式访谈指南。访谈逐字转录,并使用扎根理论分析方法确定关键概念。
许多患者的旅程始于令人震惊的侵袭性疾病诊断和大大缩短的预期寿命。当他们进入黑色素瘤晚期时,这种快速发展的癌症极大地降低了他们的整体功能和生活质量。其影响表现在身体疼痛和残疾、情绪困扰、与朋友和家人互动减少以及照顾者的负担。
我们的研究结果提供了晚期黑色素瘤的迹象、症状和功能影响的证据。报告的症状(身体、心理和社会)证实并扩展了现有临床文献中报告的症状。初级保健医生应该接受更好的培训,以便及早发现黑色素瘤。肿瘤护理团队可以改进他们目前帮助患者选择治疗方案的方法,提供有关减轻 HRQL 疾病影响的辅助服务信息,例如心理健康和社会支持,以及就业或财务支持服务。