Health related quality of life in adult cancer survivors: Importance of social and emotional support

1

Introduction

Advances in early stage diagnosis and cancer treatments in the United States (U.S.) led to increasing number of cancer survivors during the past three decades. The 5-year cancer survival rate during 2011–2017 was 66.2 % [ 1 ]. As of January 1, 2019, an estimated 16.9 million cancer survivors lived in the U.S. and this number is expected to increase to more than 22.1 million by 2030. Among those currently living in the U.S., majority of them (67 %) were diagnosed 5 or more years ago [ 2 ]. As cancer is changing from a life-threating disease into a chronic condition [ 3 ], adult cancer survivors (ACS) are at increased risk for developing various comorbid conditions and having poor health related quality of life (HRQOL) when compared to adults with no history of cancer [ 456789 ]. HRQOL is a multidimensional construct comprising individual’s self-rated general, physical, mental, and social functioning [ 10 ]. As such, there has been a growing interest in evaluating the determinants (e.g., social and emotional support) that may attenuate some of the negative effects of cancer and cancer treatment on HRQOL of the cancer survivors [ 11 ].

Social support includes both structural and functional support. Structural support is about the composition of a social network or sources of support while functional support is about the provision of specific resources or types of support (e.g., emotional support). Emotional support is well documented to facilitate the psychological adjustment to cancer [ 12 ]. It is the perceived availability of caring, trusting individuals with whom life experiences can be shared. It involves the provision of love, trust, empathy, and caring, and is the most often thought of support protecting individuals from potentially adverse effects of stressful events in life [ 131415 ].

Lack of social and emotional support is shown to be significantly associated with poor HRQOL in a large community sample of adults in the U.S. [ 16 ]. And, several other studies have reported positive impact of social support on HRQOL in populations involving older adults [ 17 ], migrant workers [ 18 ], HIV-infected individuals [ 19 ], kidney disease patients [ 20 ], patients with multiple sclerosis [ 21 ], and individuals with hip and knee osteoarthritis [ 22 ]. However, the effect of social and emotional support on HRQOL among ACS is not fully elucidated. The purpose of this study was to understand the role of social and emotional support on HRQOL in ACS and to examine if the association between social and emotional support and HRQOL is modified by gender, time since cancer diagnosis, or marital status.