Humanistic burden of disease for patients with advanced melanoma in Canada

• Published in: Supportive care in cancer Vol. 26; no. 6; pp. 1985 - 1991
• Main Authors: Cheung, Winson Y., Bayliss, Martha S., White, Michelle K., Stroupe, Angela, Lovley, Andrew, King-Kallimanis, Bellinda L., Lasch, Kathryn
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2018; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Canada; Cancer research; Care and treatment; Cost of Illness; Female; Health aspects; Humans; Male; Medicine; Medicine & Public Health; Melanoma; Melanoma - psychology; Metastasis; Middle Aged; Nursing; Nursing Research; Oncology; Original; Original Article; Pain Medicine; Qualitative research; Quality of life; Quality of Life - psychology; Rehabilitation Medicine; Social aspects; Canada; Health-related quality of life; Burden of disease; Qualitative; Melanoma; Patient interviews; Cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-017-4025-9

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.