Why You Should Prioritize Your Quality of Life: A Guide for Cancer Patients

Quality of life encompasses more than mere survival; it is about thriving each day, a consideration that becomes particularly relevant for those facing a cancer diagnosis. While the gravity of such a diagnosis can invoke a sense of urgency, it can also push individuals to pursue aggressive treatments, while neglecting vital self-care. While not in any way meant to diminish the importance of direct clinical interventions, it is essential to recognize that prioritizing quality of life and effectively managing cancer are not independent priorities – they are two sides of the same coin, each reinforcing the other in the patient’s treatment journey.

Research shows that by actively nurturing your overall well-being, you can significantly enhance your ability to cope with your diagnosis and even improve your longevity. Focusing on quality of life yields numerous benefits (1-4):

1. Enhanced treatment outcomes and improved longevity: Predictive of better overall survival and treatment response, as supported by numerous research studies.
2. Better symptom management: Facilitates improved control over physical symptoms, such as pain and fatigue, which are common among cancer patients.
3. Improved emotional well-being: Reduces anxiety and depression, promoting better emotional and psychological health.
4. Early detection of complications: Aids in identifying emerging health issues early; effective doctor-patient communication allows for timely intervention.
5. Empowerment: Fosters a greater sense of control over one’s situation, which is crucial when navigating a cancer diagnosis.

By prioritizing quality of life, a patient can not only make their days more comfortable and fulfilling but also enhance their body’s ability to respond to treatment and combat the disease more effectively.

Patient-Reported Outcomes and SPROUT

At Hope4Cancer, our Research and Education Team has developed an in-house System for Patient Reported Outcomes (SPROUT), which delivers quality of life and symptom surveys to patients at various points in their treatment journey. Interpreting these PROs in collaboration with their medical team can lead to effective interventions or advice tailored to their specific needs and goals.

To uncover the status of a patient’s quality of life, it is essential to look beyond imaging and lab data. We must listen to their voices and understand their daily experiences and feelings. Our surveys capture these patient-reported outcomes (PROs) across various dimensions of health-related quality of life—physical, functional, cognitive, and emotional. As such, PROs provide valuable insights that help healthcare providers better understand the patient’s evolving condition, complementing their medical assessments (Figure 1).

Figure 1. How patient-reported outcomes complement clinical outcomes to synergistically enhance both treatment effectiveness and quality of life.

 

Does Improving QOL Actually Help Improve Cancer Care Results?

The vast majority of oncological studies focus primarily on clinical data, such as tumor size reduction and treatment responses. However, these studies often overlook the broader impact of cancer on patients’ lives. Even when clinical indicators show progress, patients may still face significant discomfort and challenges in various aspects of their daily lives, which can hinder their ability to function and navigate everyday activities successfully.

This under-prioritization of psychological, emotional, cognitive, and general well-being often obscures the broader picture of health, affecting day-to-day living, eventually impacting longevity. For instance, research indicates that many cancer patients who have undergone chemotherapy and radiotherapy report low levels of general, physical, and psychological well-being due to symptoms commonly accepted simply as part of the treatment process (1, 5-6). For example, a study involving 33 women diagnosed with early-stage breast cancer utilized the EORTC QLQ-C30 and EORTC QLQ-BR23 survey instruments and found that their health-related quality of life (HRQOL) indices significantly decreased during their third month of chemotherapy compared to one week before treatment (Figure 2) (7).

In a 10-year, multicenter randomized clinical study of 342 disease-free breast cancer survivors in Finland who were on conventional therapies during their first year of treatment, it was found that the health-related quality of life parameters for these patients remained lower than that of the general population to clinically significant levels throughout the entire period of study (8). Even more remarkable, was that the drop in quality of life in younger patients (under 50 years of age) was significantly worse than that of patients over 50 years old. So, while the patients survived the disease, their quality of life got impacted literally for the rest of their lives!

Figure 2. Median values of health-related quality-of-life indices in a study of 33 early-stage breast cancer patients, assessed one week before and three months after the initiation of chemotherapy (Ref. 7).

 

In contrast, an internal patient-reported outcomes (PRO) research study conducted by our Research and Education Team on Hope4Cancer patients revealed significantly more positive results (9). As part of our ongoing tracking of patient quality of life, we compared surveys completed by a cohort of 233 patients admitted between 2023 and 2024 at intake and discharge during their three-week treatment program. Our findings indicated that most of our patients either improved or maintained their quality-of-life indices across all measured domains—functional, emotional, cognitive, and overall quality of life—regardless of their disease stage. While the quality of life (QOL) indices for Stage IV patients were slightly lower than those for earlier stages, the high percentages observed were remarkable given the typical complications associated with advanced stages of the disease.

Figure 3. Percentage of patients (N=233) admitted to Hope4Cancer in 2023 and 2024 who improved or maintained their quality of life across each measured domain—functional, emotional, cognitive, and overall QOL—by cancer stage (Ref. 9).

 

To track the sustained impact of our treatment program, we followed a smaller cohort of 57 patients using patient-reported outcomes (PROs) one month after they returned home. We discovered that an even greater percentage of patients maintained or improved their quality of life across all domains compared to their intake data, and similar percentages reflected these positive results when compared to their discharge data.

Given that over 76% of our patients are at an advanced stage of disease (Stage III and above), and more than 70% have undergone prior toxic or invasive treatments such as chemotherapy, radiotherapy, and/or surgery, these results are even more significant—they highlight the value of integrative, holistic treatment protocols compared to their more unidimensional conventional counterparts.

Numerous studies have demonstrated a link between psychological well-being and improvements in physical health. For instance, a study published in JAMA Oncology found that enhancements in quality of life were associated with better overall survival among cancer patients (10). According to the study, 41% of phase 3 randomized controlled trials that demonstrated improved overall survival also showed improvements in quality of life. Conversely, trials that reported inferior quality of life did not demonstrate any improvement in overall survival, indicating that there is a strong link between quality of life and overall survival.

Furthermore, research shows that implementing integrative therapy approaches can Improve quality of life. For example, among breast cancer patients receiving radiotherapy, the introduction of physical resistance training and relaxation exercises improved overall quality of life and reduced fatigue (11). A large-scale clinical trial in the United Kingdom (PROSPER) found that physical activity programs and behavioral change techniques enhanced functional health in breast cancer patients (12). At our treatment centers, we offer Behavioral Emotional Spiritual TransformationTM (BEST) sessions to all our patients because we recognize that resolving past emotional traumas and reducing psychosocial stress are critical to improving the patient’s sense of well-being, which affects their clinical outcomes.

 

Quality of Life for Patients with Comorbidities

Maintaining quality of life is particularly crucial for cancer patients with additional medical conditions (comorbidities) such as hypertension, pulmonary disease, gastrointestinal disorders, and diabetes (13). Conventional approaches often treat each of these comorbidities as independent silos, overlooking the fact that these conditions frequently interact with one another. Conversely, measures that improve quality of life related to one condition also enhance the prognosis for the others. Therefore, focusing on quality of life is essential for developing a comprehensive treatment plan that addresses the interconnected nature of these comorbidities (14).

 

Why Are Quality of Life Assessments Often Overlooked in Oncology?

If quality of life assessments are so important, why do most medical institutions overlook this critical aspect of long-term patient progress? Consistent evaluations over a period can offer valuable insights into patient experiences and outcomes. However, research indicates a significant gap in their adoption. For instance, a meta-analysis found that while 69.8% of oncology clinical trials assess quality of life during the intervention phase, only 3.4% continue to evaluate it long-term (15).

Several reasons contribute to this gap. First, patients often prioritize clinical outcomes over measures aimed at restoring quality of life. Second, significant barriers hinder the integration of quality-of-life assessments into routine clinical practice, including costs, the availability of trained staff to administer surveys, and logistical challenges in data collection and analysis. Most importantly, a prevailing perception that these assessments are less relevant than traditional clinical metrics creates a substantial mental block to implementing effective quality of life tracking programs for patients.

 

Examples that Demonstrate the Value of Patient-Reported Outcomes

Here are some examples from published research that demonstrate the power of tracking quality-of-life metrics:

• Patients followed with PRO surveys demonstrate better overall survival. At Sloan Kettering Memorial Hospital, a group of 441 patients with solid metastatic tumors were followed over a period of 8 years using electronic PROs (ePROs), and compared to a group of 325 patients who did not have that advantage. Patients with ePRO follow up showed a significantly improved overall survival (31.2 months) compared to the non-ePRO group (26.0 months) (16). In a multicenter randomized controlled trial conducted in the United States and France, which focused on detecting lung cancer recurrence (Stages IIA to IV) through symptom tracking, the electronic surveillance group (60 patients) demonstrated a significant improvement in overall survival, averaging 22.5 months, compared to the routine surveillance group (61 patients) that averaged only 14.9 months (17).
• Understanding treatment efficacy: PROs help clinicians and researchers gauge how well treatments are working. For instance, an international clinical trial utilized PROs to confirm that a treatment for multiple myeloma was effective in patients, aligning with laboratory and early-stage clinical trial results (18).
• Differentiating treatment options: Medical centers have employed PROs to distinguish between established treatments, identifying those that deliver comparable disease-specific impacts while also maintaining or enhancing patient quality of life. For instance, a study from UC San Francisco used PROs to identify a superior surgical treatment for head and neck cancer, resulting in significant improvements in patient pain, ability to eat and smell, and overall quality of life (19).
• Clinical benefits in cancer care: A randomized study involving breast cancer patients receiving chemotherapy showed that using a patient-reported outcome (PRO) monitoring system helped improve survival rates. This improvement occurred because patients systematically reported their symptoms along with standard medical information, allowing for better management of their care. (20).

As you may have observed, most of these publications are in the realm of conventional oncology. However, Hope4Cancer’s SPROUT platform was designed to support holistic, integrative cancer care, enabling our clinicians to better understand the multidimensional factors that influence healing. By prioritizing quality of life and utilizing tools like PROs, we can create a more comprehensive and effective approach to cancer care, ultimately leading to better outcomes for patients.

 

References

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4. Deshpande PR, Rajan S, Sudeepthi BL, et al. Patient-reported outcomes: A new era in clinical research. Perspect Clin Res, 2011; 2(4): 137-144.
5. Gandhi AK, Roy S, Thakar A, et al. Symptom burden and quality of life in advanced head and neck cancer patients: AIIMS study of 100 patients. Indian J Palliat Care, 2014; 20:189-193. 
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7. Binotto M, Reinert T, Werutsky G, et al. Health-related quality of life before and during chemotherapy in patients with early-stage breast cancer. Ecancermedicalscience, 2020l 14:1007.
8. Roine E, Sintonen H, Kellokumpu-Lehtinen P-L, et al. Long-term health-related quality of life of breast cancer survivors remains impaired compared to the age-matched general population especially in young women. Results from the prospective controlled BREX exercise study. The Breast, 2021; 59:110-116.
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11. Steindorf K, Schmidt ME, Klassen O, et al. Randomized, controlled trial of resistance training in breast cancer patients receiving adjuvant radiotherapy: results on cancer-related fatigue and quality of life. Ann Oncol, 2014; 25(11): 2237-2243.
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13. Fowler H, Belot A, Ellis L, et al. Comorbidity prevalence among cancer patients: a population-based cohort study of four cancers. BMC Cancer. 2020; 20(1): 2.
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17. Denis F, Basch E, Septans A-L, et al. Two-year survival comparing web-based symptom monitoring vs routine surveillance following treatment for lung cancer. JAMA, 2019;321(3):306.
18. Martin TG, Moreau P, Usmani SZ, et al. Teclistamab improves patient-reported symptoms and health-related quality of life in relapsed or refractory multiple myeloma: results From the phase II MajesTEC-1 study. Clin Lymphoma Myeloma Leuk, 2024; 24(3): 194-202.
19. Plonowska-Hirschfeld KA, Gulati A, Stephens EM, et al. Treatment modality impact on patient-reported quality of life in human papilloma virus-associated oropharyngeal carcinoma. Laryngoscope, 2024; 134(4): 1687-1695.
20. Phillips SM, Penedo FJ, Collins LM, et al. Optimization of a technology-supported physical activity promotion intervention for breast cancer survivors: Results from Fit2Thrive. Cancer, 2022; 128(5): 1122-1132.