While maintaining a good quality of life matters a great deal to most of us, it may come as some surprise to learn it is also a useful survival skill. Family conflicts and other non-medical problems may raise a patient’s risk of surgical complications, say the researchers of a new study of colon cancer patients at the Mayo Clinic. In fact, patients with poor quality of life were nearly three times more likely to face serious postoperative complications than those with normal or better quality of life. “This study suggests that quality of life can provide an early indicator for patients at risk of complications,” wrote the authors in their published research.

That Was Then, This Is Now

Years ago, cancer was considered a death sentence, pure and simple. With survival so extremely difficult, doctors focused on destroying the cancer by whatever means necessary to help patients remain alive. Today, survival in many instances of cancer is not only possible but highly probable, so doctors have a more nuanced approach to cancer care. Increasingly, physicians seek to help their patients preserve as normal a life as possible while undergoing treatment; with these more expansive hopes, doctors also have discovered how many psychological factors may influence survival rates. “We’re understanding much better now that patients are not just a body with a disease,” stated Dr. Juliane Bingener, a gastroenterologic surgeon at Mayo Clinic in Rochester and lead author of the new study. “There’s a whole person with that, and everything plays together.”

To investigate quality of life and the impact of mental attitude on a patient’s health, researchers studied 431 colon cancer surgery patients. The researchers requested participants rate their quality of life, defined as more than just happiness and physical well-being, on a questionnaire probing their financial, spiritual, emotional, mental, and the social aspects of their lives. The researchers discovered 13 percent of patients had a quality of life deficit — a score of 50 or less on a 100-point scale — before undergoing surgery.

Such deficits caused a profound impact on patients' lives. Nearly three times as many patients with a quality of life deficit experienced serious post-surgery complications as those with a normal or good quality of life scores. Plus, patients with a postoperative complication spent 3.5 days longer in the hospital on average than those who didn’t.

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, Bingener observed. Knowing that quality of life can be measured and worked with "almost like blood pressure," Bingener asked in a press release, “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?” Though the elusive "cure for cancer" has not yet been found, cancer care has become quite sophisticated and only continues to evolve.

Source: Bingener J, Sloan JA, Novotny PJ, Pockaj BA, Nelson H. Perioperative Patient-Reported Outcomes Predict Serious Postoperative Complications: a Secondary Analysis of the COST Trial. Journal of Gastrointestinal Surgery. 2014.