Delaying Cancer Treatment May Worsen Quality of Life in Patients

Active surveillance for progression of indolent non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL) appears actually to worsen quality of life in patients compared with treatment, according to study findings published online ahead of print in Clinical Lymphoma, Myeloma, & Leukemia.

“Newly diagnosed indolent NHL/CLL patients are often monitored for disease progression to delay the impact of cancer-directed therapy on patients’ quality of life,” explained researchers from Memorial Sloan Kettering Cancer Center and New York Presbyterian Hospital in the study introduction. “However, research on quality of life in patients under active surveillance versus in cancer-directed treatment has yielded mixed results.”

To investigate the effect of active surveillance, compared with cancer-directed treatment, the year after diagnosis, researchers had 64 patients self-report measures of distress and quality of life every 4 months.

According to the study, patients undergoing cancer-directed treatment showed improved total quality of life over time, as well as improved physical, social, and functional quality of life. However, the same quality-of-life measures for patients under active surveillance decreased over time.

Overall, social, and functional quality of life changes occurred more slowly in patients under surveillance, researchers noted.

“Active surveillance may have negative implications for patient quality of life,” researchers wrote, “despite that a common goal of active surveillance is to delay the impact of treatment (eg, appointments, toxicities) on quality of life.”

Reference:
Trevino KM, Martin P, Chen Z, Leonard JP. Worsening Quality of Life in Indolent Non-Hodgkin Lymphoma and Chronic Lymphocytic Leukemia Patients in Active Surveillance: A 12-Month Longitudinal Study [published online ahead of print, 2021 Aug 12]. Clin Lymphoma Myeloma Leuk. 2021;S2152-2650(21)00329-3. doi:10.1016/j.clml.2021.08.001