Quality of life in survivors of multiple primary cancers compared with cancer survivor controls

BACKGROUND. Cancer survivors may develop additional cancers after their first diagnosis, but to the authors' knowledge the quality of life (QOL) consequences of a second cancer are not known. The current study assessed QOL and its correlates after a second cancer diagnosis. METHODS. QOL was compared between 487 survivors of second-order and higher-order primary cancer diagnoses, and a matched group of 589 survivors of a single cancer diagnosis. Outcome measures included standardized question-naires that assessed depressive symptoms, perceived stress, vitality, post-traumatic growth, existential well-being, sexual adjustment, and global QOL. RESULTS. Survivors of multiple primary cancer diagnoses had significantly lower global QOL (t (792) = 5.42; P <.001), vitality (Student t test [t] (794) = 2.41; P <.01), and existential well-being (t (775) = 2.78; P <.01), and higher intrusive stress symptoms (t (775) = -1.93; P <.05). Controlling for demographic, medical, and trait-like psychosocial characteristics (eg, optimism and resilience), having multiple primary cancer diagnoses explained small, although significant, variances in global QOL (coefficient of determination [R-2] =.04; P <.001), vitality (R-2 =.01; P <.05), and existential well-being (R-2 =.01; P <.05), with patients in the multiple primary cancer group faring worse on all of these measures. CONCLUSIONS. The results of the current study suggest that the typical survivor of multiple primary cancers experiences modest but lasting QOL deficits.