Positive and negative changes in life after cancer diagnosis. A prospective mixed-methods study

This study investigated what positive and negative changes are experienced by adult cancer patients 2 years after the diagnosis. Patients were enrolled at the time of admission into hospital. They completed questionnaires again before discharge as well as 2 years later. They were asked to report in what areas of life they had experienced negative or positive events and what type of experiences they were. Responses were documented verbatim and subsequently coded into categories. The potential effects of age, gender, and tumor entity as possible predictors of deterioration were analyzed using multiple logistic regressions. The 447 participating patients reported positive events most frequently in the areas "friends and relatives" (66%), "hobbies, vacation, sports" (64%) and "partnership" (61%). Negative events were most frequently related to "sexuality" (54%), "health" (35%) and "financial situation" (32%). Deterioration in sexuality occurred more often in men (odds ratio, OR 4.1, 95% confidence interval, CI 2.0-8.5, p<0.01), patients with gynecological tumors (OR 2.6, CI 1.1-6.2, p=0.04), patients with prostate cancer (OR 8.3, CI 3.9-17.7, p<0.01) and patients with other urological tumors (OR 2.3, CI 1.1-5.0, p=0.04). Patients >= 65 years experienced deterioration less frequently with sexuality (OR 0.5, CI 0.3-0.9, p=0.01) and with their financial situation (OR 0.6, CI 0.4-0.9, p=0.01). There was no evidence for an effect of age, gender or tumor entity on deterioration in health. In this respect the most frequently mentioned issues were pain, problems with the musculoskeletal system, psychological problems, reduced mobility, comorbid diseases and fatigue. During aftercare, not only health problems should be taken into account but also potential financial and sexual problems of the patients.