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Effects of cancer stigma on quality of life of patients with hepatobiliary and pancreatic cancer

  • Naru Kim (Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Danbee Kang (Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University) ;
  • Sang Hyun Shin (Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jin Seok Heo (Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sungkeun Shim (Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jihyun Lim (Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Juhee Cho (Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University) ;
  • In Woong Han (Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2022.09.14
  • Accepted : 2022.11.24
  • Published : 2023.05.31

Abstract

Backgrounds/Aims: Cancer stigma (CS), a self-inflicted sense of hopelessness, has been identified as a major factor affecting cancer patients' outcomes. However, few studies have investigated the CS-related outcomes in hepatobiliary and pancreatic (HBP) cancer. Thus, the aim of this study was to investigate effects of CS on quality of life (QoL) of HBP cancer. Methods: From 2017 to 2018, 73 patients who underwent curative surgery for HBP tumor at a single intuitive were enrolled prospectively. The QoL was measured using the European Organization for Research and Treatment of Cancer QoL score, and CS was evaluated in three categories, "impossibility of recovery," "cancer stereotypes," and "social discrimination." the stigma was defined by higher scores of attitudes compared with the median value. Results: The stigma group showed a lower QoL (-17.67, 95% confidence interval [CI]: -26.75 to 8.60, p < 0.001) than the no stigma group. Similarly, most function and symptoms of the stigma group showed worse results than the no stigma group. The difference in function scores between the two groups according to CS was highest in cognitive function (-21.20, 95% CI: -30.36 to 12.04, p < 0.001). Fatigue showed the largest difference between the two groups at 22.84 (95% CI: 12.88-32.07, p < 0.001) and was the most severe symptom in stigma group. Conclusions: CS was an important negative factor affecting the QoL, function, and symptoms of HBP cancer patients. Therefore, appropriate management of CS is crucial for improved postoperative QoL.

Keywords

Acknowledgement

The authors would like to thank Hyemin Kim (Data Manager, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) for help with data collection.

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