Quality of Life May Affect Risk of Cancer Surgery Complications

Complications after cancer surgery were less common in patients with happier home lives

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) After surgery, cancer patients are prone to complications like infections, which can be deadly. New research suggests quality of life may play a part in the risk of complications after cancer surgery.

The authors of a recent Mayo Clinic study looked at rates of postsurgery complications and deaths in colon cancer patients.

They found that patients with lower quality of life were much more likely to have complications after surgery.

"Talk to a mental health professional about ways to improve your emotional well-being."

Researchers asked 431 colon cancer surgery patients to rate their home lives in terms of social, emotional, financial and spiritual quality.

“We know that quality of life is a very complex thing, but we can now measure it and work with it almost like blood pressure,” said study author Juliane Bingener, MD, a gastroenterologic surgeon with the Mayo Clinic in Rochester, MN, in a press release. “We can say, ‘This is good, this is in the normal range, but this one here, that is not good, and maybe we should do something.’”

Among the patients with low quality of life, 16 percent had complications after surgery, while only 6 percent with better home lives had complications.

That's a nearly three-times higher risk of complications after surgery for patients with lower quality of life.

“The question I’m exploring is whether, if we understand before surgery that someone is in the red zone for quality of life, can we do something to help them cope with the new stress that’s going to come, so they’re better equipped to go through surgery?” Dr. Bingener said.

In an interview with dailyRx News, Brian D. Lawenda, MD, national director of Integrative Oncology and Cancer Survivorship at 21st Century Oncology and founder of IntegrativeOncology-Essentials.com, explained how he gets patients ready for surgery.

"We know that preoperative stress can lead to worse peri-operative outcomes, such as higher pain levels and slower wound healing. Studies have shown that a brief instruction in simple mind-body techniques (i.e. hypnotherapy, guided imagery) can improve both of these outcomes, so I will often recommend specific products and techniques to help patients prepare for surgery," said Dr. Lawenda, who was not involved in this study.

"Counseling patients on the importance of getting adequate and healthful nutrition and sleep, as well as reducing stress, are also all very important since failure to do any one of these things can cause delays in wound healing and impairments in immunity," Dr. Lawenda said.

"Whenever patients see me for an integrative oncology consult before surgery, I teach them techniques they can use to reduce stress and improve their sleep. In my practice, I use validated stress assessments tools to identify those who may need further management beyond what we can provide in the office (i.e. psychosocial counseling, financial counseling, support groups, etc.). I also counsel them on nutrition and place nutrition/dietary referrals when needed," he said.

"Empowering our patients with the information they can use to better cope with side effects, optimizing their mind and body before surgery and hopefully making their bodies less conducive to cancer growth and recurrence are all areas that integrative oncologists focus on with their patients," Dr. Lawenda explained. "Armed with this knowledge, our patients feel more in control of their cancer care and a better quality of life."

The research, which was published online Sept. 2 in the Journal of Gastrointestinal Surgery, suggested that stress as a result of a bad home life could weaken patients' immune systems, making them more prone to complications.

“You have a surgery, you’re lying there in pain, now you wonder, ‘Why should I even get up and walk around? Why do I have to do these deep-breathing exercises? I don’t feel like it.’ You might get pneumonia much faster than somebody who says, ‘Oh, I have to get up. There’s something worth living for, my quality of life is good and I need to get back to that,’” Dr. Bingener said.

The National Institute of Diabetes and Digestive and Kidney Diseases funded the study. The authors disclosed no conflicts of interest.

Review Date: 
September 3, 2014
Last Updated:
September 4, 2014