Quality of life after breast cancer

Every year more than 70,000 women in Germany get breast cancer. Thanks to major advances in early detection and therapy, well over 80 percent of those affected now survive the first five years after diagnosis. The number of women who live without disease for many years after breast cancer therapy is high and rising. The long-term quality of life after a breast cancer therapy is therefore becoming increasingly important. The data on the problems and needs of the disease-free women was so far still thin.

In the German Cancer Research Center, Martina Schmidt examined various aspects of quality of life over time up to five years after a breast cancer diagnosis and compared them with the data of women of the German general population of the same age. In addition, the scientist interviewed 190 women who were still free of disease five years after diagnosis, for problems, symptoms and satisfaction with support offers.

Concentration and sleep still impaired even after five years

During cancer therapy, overall quality of life as well as physical, emotional, social, cognitive functions were severely limited. Patients also suffered more from chronic exhaustion (fatigue), sleep disorders and financial worries than the general population.

After five years, however, the values had returned to normal for almost all functions and symptoms. The disease-free breast cancer survivors, however, still suffered significantly more from sleep problems and reported significantly worse cognitive functions than women in the general population.

After five years, 39 percent of the disease-free breast cancer survivors reported having moderate or severe sleep problems, and 22 percent had memory problems. In addition, 24 percent of the survivors were still affected by fatigue. Of all reported symptoms, fatigue had the greatest impact on the quality of life. Fatigue has often been associated with mental health problems, sleep problems, pain or memory problems.

Another common symptom complex that occurred independently of fatigue included hormone-related climacteric problems such as sexual dysfunction (such as vaginal dryness, irritation, pain during sexual intercourse, loss of libido), memory or concentration disorders, hot flashes, osteoporosis and mental health problems. 43 percent of breast cancer survivors would have liked more advice or treatment from their physicians on these complaints.
In terms of loss of physical performance, sleep problems, joint problems, cognitive problems, weight problems and fatigue, more than a third of women felt that support was inadequate.

"The results are a reassuring message to breast cancer patients: Even if they suffer from marked impairments of quality of life during treatment, the distressing symptoms recede over the long term in the majority," says Karen Steindorf, head of the study. This applies to patients whose tumor has not yet spread. "On the other hand, the results show a clear need for action for better and longer-term management of fatigue, sleep problems, cognitive problems, menopausal problems and joint discomfort in breast cancer survivors."

Martina E. Schmidt, Joachim Wiskemann, Karen Steindorf: Quality of life, problems, and needs of disease-free breast cancer survivors 5 years after diagnosis.
Quality of Life Research 2018, DOI: 10.1007 / s11136-018-1866-8