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10-01-2018 | Melanoma | Article

Humanistic burden of disease for patients with advanced melanoma in Canada

Journal: Supportive Care in Cancer

Authors: Winson Y. Cheung, Martha S. Bayliss, Michelle K. White, Angela Stroupe, Andrew Lovley, Bellinda L. King-Kallimanis, Kathryn Lasch

Publisher: Springer Berlin Heidelberg

Abstract

Background

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).

Methods

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.

Results

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.

Conclusion

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.
Literature
1.
Ryerson AB, Eheman CR, Altekruse SF, Ward JW, Jemal A, Sherman RL, Henley SJ, Holtzman D, Lake A, Noone AM, Anderson RN, Ma J, Ly KN, Cronin KA, Penberthy L, Kohler BA (2016) Annual report to the nation on the status of cancer, 1975–2012, featuring the increasing incidence of liver cancer. Cancer 122(9):1312–1337. https://​doi.​org/​10.​1002/​cncr.​29936 CrossRefPubMedPubMedCentral
2.
Canadian Cancer Society’s Advisory Committee on Cancer Statistics (2016) Canadian cancer statistics 2016. Canadian Cancer Society, Toronto
3.
National Cancer Institute SEER Cancer Stat Facts: Melanoma of the Skin. https://​seer.​cancer.​gov/​statfacts/​html/​melan.​html. Accessed 23 Feb 2017
4.
Sandru A, Voinea S, Panaitescu E, Blidaru A (2014) Survival rates of patients with metastatic malignant melanoma. J Med Life 7(4):572–576PubMedPubMedCentral
5.
Fong ZV, Tanabe KK (2014) Comparison of melanoma guidelines in the U.S.A., Canada, Europe, Australia and New Zealand: a critical appraisal and comprehensive review. Br J Dermatol 170(1):20–30. https://​doi.​org/​10.​1111/​bjd.​12687 CrossRefPubMed
6.
Greene MH (1999) The genetics of hereditary melanoma and nevi. 1998 update. Cancer 86(11 Suppl):2464–2477CrossRef
7.
Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR, Buzaid AC, Cochran AJ, Coit DG, Ding S, Eggermont AM, Flaherty KT, Gimotty PA, Kirkwood JM, McMasters KM, Mihm MC Jr, Morton DL, Ross MI, Sober AJ, Sondak VK (2009) Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 27(36):6199–6206. https://​doi.​org/​10.​1200/​JCO.​2009.​23.​4799 CrossRef
8.
Kiebert GM, Jonas DL, Middleton MR (2003) Health-related quality of life in patients with advanced metastatic melanoma: results of a randomized phase III study comparing temozolomide with dacarbazine. Cancer Investig 21(6):821–829. https://​doi.​org/​10.​1081/​CNV-120025084 CrossRef
9.
Dubravcic ID, Brozic JM, Aljinovic A, Sindik J (2014) Quality of life in Croatian metastatic melanoma patients. Coll Antropol 38(1):69–74PubMed
10.
Revicki DA, van den Eertwegh AJM, Lorigan P, Lebbe C, Linette G, Ottensmeier CH, Safikhani S, Messina M, Hoos A, Wagner S, Kotapati S (2012) Health related quality of life outcomes for unresectable stage III or IV melanoma patients receiving ipilimumab treatment. Health Qual Life Outcomes 10:66. https://​doi.​org/​10.​1186/​1477-7525-10-66 CrossRefPubMedPubMedCentral
11.
Middleton MR, Grob JJ, Aaronson N, Fierlbeck G, Tilgen W, Seiter S, Gore M, Aamdal S, Cebon J, Coates A, Dreno B, Henz M, Schadendorf D, Kapp A, Weiss J, Fraass U, Statkevich P, Muller M, Thatcher N (2000) Randomized phase III study of temozolomide versus dacarbazine in the treatment of patients with advanced metastatic malignant melanoma. J Clin Oncol 18(1):158–166. https://​doi.​org/​10.​1200/​JCO.​2000.​18.​1.​158 CrossRefPubMed
12.
Brandberg Y, Johansson H, Aamdal S, Bastholt L, Hernberg M, Stierner U, von der Maase H, Hansson J, for the Nordic Melanoma Cooperative Group (2013) Role functioning before start of adjuvant treatment was an independent prognostic factor for survival and time to failure. A report from the Nordic adjuvant interferon trial for patients with high-risk melanoma. Acta Oncol 52(6):1086–1093. https://​doi.​org/​10.​3109/​0284186X.​2013.​789140 CrossRefPubMed
13.
Cormier JN, Cromwell KD, Ross MI (2012) Health-related quality of life in patients with melanoma: overview of instruments and outcomes. Dermatol Clin 30(2):245–254, viii. https://​doi.​org/​10.​1016/​j.​det.​2011.​11.​011 CrossRefPubMed
14.
Sigurdardottir V, Bolund C, Sullivan M (1996) Quality of life evaluation by the EORTC questionnaire technique in patients with generalized malignant melanoma on chemotherapy. Acta Oncol 35(2):149–158. https://​doi.​org/​10.​3109/​0284186960909849​5 CrossRefPubMed
15.
Coates A, Thomson D, McLeod GR, Hersey P, Gill PG, Olver IN, Kefford R, Lowenthal RM, Beadle G, Walpole E (1993) Prognostic value of quality of life scores in a trial of chemotherapy with or without interferon in patients with metastatic malignant melanoma. Eur J Cancer 29A(12):1731–1734CrossRef
16.
Quinten C, Coens C, Mauer M, Comte S, Sprangers MA, Cleeland C, Osoba D, Bjordal K, Bottomley A, EORTC Clinical Groups (2009) Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncol 10(9):865–871. https://​doi.​org/​10.​1016/​S1470-2045(09)70200-1 CrossRefPubMed
17.
Oliver A, Greenberg CC (2009) Measuring outcomes in oncology treatment: the importance of patient-centered outcomes. Surg Clin North Am 89(1):17–vii. https://​doi.​org/​10.​1016/​j.​suc.​2008.​09.​015 CrossRefPubMedPubMedCentral
18.
Vogel RI, Strayer LG, Ahmed RL, Blaes A, Lazovich DA (2017) A qualitative study of quality of life concerns following a melanoma diagnosis. J Skin Cancer 2017:1–8. https://​doi.​org/​10.​1155/​2017/​2041872 CrossRef
19.
Tan JD, Butow PN, Boyle FM, Saw RPM, O’Reilly AJ (2014) A qualitative assessment of psychosocial impact, coping and adjustment in high-risk melanoma patients and caregivers. Melanoma Res 24(3):252–260. https://​doi.​org/​10.​1097/​CMR.​0000000000000059​ CrossRefPubMed
20.
Dunn J, Watson M, Aitken JF, Hyde MK (2016) Systematic review of psychosocial outcomes for patients with advanced melanoma. Psycho-Oncology 26(11):1722–1731. https://​doi.​org/​10.​1002/​pon.​4290 CrossRefPubMed
21.
Strauss A, Corbin J (1998) Basics of qualitative research: techniques and procedures for developing grounded theory. Sage, London
22.
Charmaz K (1995) Grounded theory. In: Smith JA, Harre R, Van Langenhove L (eds) Rethinking methods in psychology. Sage, London, pp 27–49. https://​doi.​org/​10.​4135/​9781446221792.​n3 CrossRef
23.
Lasch KE, Marquis P, Vigneux M, Abetz L, Arnould B, Bayliss M, Crawford B, Rosa K (2010) PRO development: rigorous qualitative research as the crucial foundation. Qual Life Res 19(8):1087–1096. https://​doi.​org/​10.​1007/​s11136-010-9677-6 CrossRefPubMedPubMedCentral
24.
Charmaz K (2000) Grounded theory: objectivist and constructivist methods. In: Denzin N, Lincoln Y (eds) Handbook of qualitative inquiry, 2nd edn. Sage, Thousand Oaks
25.
Patrick DL, Burke LB, Gwaltney CJ, Leidy NK, Martin ML, Molsen E, Ring L (2011) Content validity—establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 1—eliciting concepts for a new PRO instrument. Value Health 14(8):967–977. https://​doi.​org/​10.​1016/​j.​jval.​2011.​06.​014 CrossRefPubMed
26.
ATLAS.ti Scientific Software Development GmbH (2015) ATLAS.ti [computer software]. ATLAS.ti Scientific Software Development GmbH, Version 7.5.4. Berlin, Germany
27.
pan-Canadian Oncology Drug Review (2013) A guide for patient advocacy groups: how to provide patient and caregiver input for a pCODR drug review. https://​cadth.​ca/​sites/​default/​files/​pcodr/​pCODR%27s%20​Drug%20​Review%20​Process/​pcodr-patient-guide.​pdf. Accessed 10 Nov 2017