Parenting concerns are a major factor contributing to the psychological distress of women with late-stage cancer, and are associated with a lower quality of life, a study has found.
Researchers found that mothers with advanced cancers, such as breast cancer, have more depression and anxiety. Parenting concerns made up 39 percent of the decline in quality of life scores in these patients, which was almost at the same level as declines in day-to-day physical functioning.
Led by researchers at the University of North Carolina’s Lineberger Comprehensive Cancer Center, the study, “Understanding health‐related quality of life in adult women with metastatic cancer who have dependent children,” was published in the journal Cancer.
“As part of cancer care, we ask about patients’ functional status, and how they are responding to treatment, but we are not systematically asking how cancer impacts our patients as parents, yet we know being a parent is incredibly important to their identity and well-being,” Eliza M. Park, MD, lead author of the study and an assistant professor in the UNC School of Medicine Department of Psychiatry and Department of Medicine, said in a press release.
“Among women with metastatic cancer, their health-related quality of life is powerfully interlinked with their parenting concerns about the impact of their illness on their minor children. It appears to equally contribute to someone’s assessment of their quality of life as some of the clinical variables we routinely ask about,” she said.
A total of 224 mothers with late-stage cancers that had metastasized who had at least one child younger than 18 years old were surveyed online by Park and her team.
Unsurprisingly, these mothers were found to have, on average, higher depression and anxiety scores than the general population in the U.S. Their emotional well-being was also lower than for other adults with cancer.
“We found … that parenting-related factors contributed to the amount of variation you see in quality of life almost equally as something like your functional status,” Park said.
Communication was found to be a key determinant of a mother’s emotional well-being as well. The fact that some mothers communicated better with their children about their illness and financial concerns affected the results.
Park and her team are now planning to investigate new ways of addressing these concerns for parents, so strategies can be outlined to help parents and children communicate better about their needs.
“We’re working to develop interventions for parents with advanced cancer or another serious illness to help them and their families adjust to the changes that occur with the diagnosis,” Park said. “Part of the strategy may be helping them to learn how to communicate effectively with their other family members as well as their children, identifying future care planning needs if their illness gets worse, and providing education about how families can cope and promote resilience in their children.”
The investigators believe that these results can guide the development of theoretical models to describe how individual, couple, family, and illness-related factors interfere with psychosocial outcomes in parents with advanced cancer.
Future studies that test these models in a broader demographic population are needed, including among racial and ethnic minorities and men. Studies looking at how roles and functions within the family are impacted by parents with advanced cancer are also necessary.
Given these findings, the researchers advise that, to reduce suffering and improve quality of life for patients with advanced cancer, healthcare providers and researchers must consider these patients’ roles as parents when discussing their concerns.