Family conflicts, other worries before cancer surgery raise complication risk

Volume 3, Issue 4, 2014


Addressing quality-of-life issues may speed recovery, reduce stress and save money.

Photograph of Juliane Bingener-Casey, M.D.

Juliane Bingener-Casey, M.D.

How well patients recover from cancer surgery may be influenced by more than just their condition and the procedure.

Family conflicts, financial worries and other nonmedical problems may raise the risk of post-surgical complications, a Mayo Clinic Cancer Center study has found.

But addressing such quality-of-life issues before surgery may reduce patient stress, speed recovery and save health care dollars, the research suggests.

The study specifically looked at colon cancer patients, and found that patients with a poor quality of life were almost three times as likely to develop serious postoperative complications compared with those with a better quality of life.

The findings were published in the Aug. 5, 2014, issue of the Journal of Gastrointestinal Surgery.

"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 lead author Juliane Bingener-Casey, M.D., a Mayo Clinic Cancer Center gastroenterologic surgeon. "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.' ''

Quality of life as measured in the study is about more than happiness and how well people feel physically. It also includes the financial, spiritual, emotional, mental and social aspects of their lives and whether their needs are being met.

Researchers studied 431 colon cancer surgery patients and found that before surgery, 13 percent had a quality-of-life deficit, defined as an overall quality of life score of less than 50 on a 100-point scale.

Patients who entered surgery with a quality-of-life deficit were nearly three times as likely to experience serious post-surgery complications compared with those with a normal or good quality-of-life score. Patients with a postoperative complication spent 3.5 days longer in the hospital on average than those who didn't have a postoperative complication.

"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 explained.

Watch a video of Dr. Bingener discussing this study.