Do Not Upset Grandpa or Grandma Before Surgery, It
Can Hinder Recovery
Family conflicts, other non-physical worries before
colon cancer surgery raise patients’ complication risk; reducing stress
2, 2014 - How well patients recover from cancer surgery may be
influenced by more than their medical conditions and the operations
themselves. Family conflicts and other non-medical problems may raise
their risk of surgical complications, a Mayo Clinic study has found.
Addressing such quality-of-life issues before an operation may reduce
stress, speed their recoveries and save health care dollars, the
The study specifically looked at
colon cancer patients, and found that patients with a poor quality
of life were nearly three times likelier to face serious postoperative
The study’s senior author, Heidi Nelson, M.D.,
a colon and rectal surgeon, the Fred C. Andersen Professor and
chair of the Department of Surgery at Mayo Clinic in Rochester,
discusses the study in this
“We know that quality of life is a very complex
thing, but we can now measure it and work with it almost like
blood pressure,” says lead author
Juliane Bingener, M.D., a
gastroenterologic surgeon at Mayo Clinic in Rochester. “We can say,
‘This is good, this is in the normal range, but this one here, that is
not good, and maybe we should do something.’”
Quality of life as measured in the study is about
more than happiness and how well people feel physically, Dr. Bingener
says. It also includes the financial, spiritual, emotional, mental and
social aspects of their lives and whether their needs are being met.
Researchers studied 431 colon cancer surgery
patients and found that before surgery, 13 percent had a quality of life
deficit, defined as an overall quality of life score of less than 50 on
a 100-point scale.
Nearly three times as many patients who entered
cancer surgery with a quality of life deficit experienced serious
post-surgery complications as those with a normal or good quality of
life score. Patients with a postoperative complication spent 3.5 days
longer in the hospital on average than those who didn’t.
“The question I’m exploring is whether, if we
understand before surgery that someone is in the red zone for quality of
life, can we do something to help them cope with the new stress that’s
going to come, so they’re better equipped to go through surgery?” Dr.
Preventing complications by intervening with
behavioral therapy or other assistance would likely cost much less than
an ICU stay for an infection after major surgery, Dr. Bingener notes.
Stress can weaken patients’ immune response,
putting them at higher risk of infection. A patient’s outlook on life
can also influence how active they are in working to recover.
“You have a surgery, you’re lying there in pain,
now you wonder, ‘Why should I even get up and walk around? Why do I have
to do these deep-breathing exercises? I don’t feel like it.’ You might
get pneumonia much faster than somebody who says, ‘Oh, I have to get up.
There’s something worth living for, my quality of life is good and I
need to get back to that,’” Dr. Bingener says.
The study is part of ongoing work by Mayo to
identify and address factors that can influence patients’ recovery from
cancer surgery, to help improve their outcomes. Years ago, physicians
were just concerned with whether patients survived cancer, because
survival was so hard to achieve, Dr. Bingener says. Now, there is
growing awareness of the
mind’s influence on the body’s health.
“We’re understanding much better now that patients
are not just a body with a disease: There’s a whole person with that,
and everything plays together,” Dr. Bingener says.
“Now that survival is possible, we want to achieve
it in a way that preserves normal life for patients as much as possible.
And we think that’s probably also the most economical way to go.”
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