Commentary on Schultz PN, Klein MJ, Beck ML, Stava C & Sellin RV (2005) Breast cancer: relationship between menopausal symptoms, physiologic health effects of cancer treatment and physical constraints on quality of life in long-term survivors. Journal of Clinical Nursing 14, 204-211.

摘要

In the last 10 years, research being conducted into quality of life issues for people surviving and living with cancer has continued to expand. Increasing long-term survival for cancer sufferers has led to studies investigating the biopsychosocial and spiritual needs of long-term survivors rather than focusing on active disease and effects of treatments alone. In the UK, health policy in the last five years has highlighted the need for the supportive and ongoing care of those people living with cancer (Department of Health 2000, National Institute for Clinical Effectiveness 2004). In this paper, Schultz et al. present useful and thorough research into quality of life issues for long-term breast cancer survivors.The impact of cancer on quality of life is well documented in the literature and, although the impact of menopausal symptoms in breast cancer survivors is acknowledged, most of the studies rely on quantitative assessment with instruments not specifically designed for the breast cancer population. In qualitative work conducted by Ferrell et al. (1997), an interview schedule specifically aimed at breast cancer survivors highlighted how physical symptoms and social concerns influenced quality of life: The women in the study discussed their frustration in seeking support for their symptoms, how they felt that certain symptoms such as vaginal dryness and other menopausal symptoms were minimized by health care providers and also highlighted their perception that they should feel grateful that they had survived. Further studies suggest that symptoms of oestrogen deficiency, which occur in 66% of women treated for breast cancer, are the most common side effects of adjuvant therapy, persist for a longer period of time and can be more severecompared with the same symptoms experienced by healthy women (Harris et al. 2002).