Phone Counseling Improves QOL in Cervical Cancer Survivors

Quality-of-life outcomes improved in cervical cancer survivors who received telephone counseling

Cervical cancer survivors saw improvements in self-reported quality-of-life (QOL) outcomes with a psychosocial telephone counseling (PTC) intervention, according to a new study.

“[Cervical cancer] survivors, many of whom are young and underserved minorities, experience QOL disruptions that can persist long after cancer treatment has ended, resulting in unmet supportive care needs,” wrote study authors led by Lari Wenzel, PhD, of the University of California, Irvine. “Within the intervention literature, the benefits of PTC to improve QOL in survivors of cancer have also been well documented.”

In this study, researchers compared PTC to usual care in 204 women; all patients were at least 9 months and less than 30 months from diagnosis. The mean age was 43 years, and 40% of the women were Hispanic; 51% were non-Hispanic white. The results were published online ahead of print in the Journal of Clinical Oncology.

The PTC intervention consisted of five telephone sessions and a 1-month booster, and included discussion of topics such as managing stress and emotions, health and wellness, and managing relationship and sexuality concerns. Patient-reported outcomes were assessed over time, as were longitudinal changes in cytokine levels.

After adjustment for age and baseline characteristics, patients assigned to PTC showed better scores at 4 months with regard to depression and gynecologic and cancer-specific concerns. PTC patients had a 2.4-point decrease in the FACT Additional Concerns subscale, compared with a 0.82-point decrease in the usual care group (P = .040). PTC patients also saw a 3.13-point decrease in the mean PROMIS depression scale, while the usual care patients had a 0.59-point decrease (P = .014). A similar effect was seen using the BSI depression scale (P = .041). Anxiety scores were no different between the groups.

At 9 months, PTC had better scores for gynecologic and cancer-specific concerns, though depression scores were no longer significantly different.

The researchers also studied changes in levels of interleukin-4, IL-5, and IL-13, because “the chronic stress response is associated with a heightened Th2 cytokine response.” Those participants with a longitudinal decrease in Th2 cytokines had significantly greater improvements in FACT-Cx (Functional Assessment of Cancer Therapy-Cervical) scores than those with increasing cytokine levels.

“Notably, PTC participants 4- and 9-month scores on both measures of distress improved to levels at or less than (better than) national norms,” the authors wrote. “Although some may question the power of telephone counseling to address such sensitive topics, we assert that for vulnerable survivors of cancer, the opportunity to extend an intervention via telephone may be the optimal (and often only) way to reach this population.”