UICC World Cancer Congress 2006

Objective:Functional status is an outcome variable of clinical and research interest to oncology clinicians and is an important component of quality of life. However, functional status has received little directed attention in the oncology literature. This paper synthesizes the literature concerning the impact of cancer and its treatment on functional status, and outlines implications for oncology research, education and practice.

Methods:PubMed, CINAHL, EMBASE and CancerLit, were queried using the search terms: return to usual function, functional status, functional disability, functional ability, function, physical functioning, functional capacity, with cancer. These search strategies produced more than 1000 abstracts. Each abstract was reviewed, and those studies, published in English in which functional status was a main variable of interest were analyzed.

Results:Functional status in patients with cancer was evaluated primarily by self-report and the SF-36 was the measure most frequently used. Objective, performance-based measures of function (eg. grip strength, 6 minute walk) were used in only a few studies. Study designs were mostly cross sectional and produced limited information about the trajectory of functional decline or recovery across the cancer experience. Symptoms and symptom clusters were not consistently associated with compromised functioning across all disease sites or at all points in the illness trajectory. Symptoms found to negatively affect functional status included pain, fatigue, peripheral neuropathy, sexual or urinary dysfunction. Few studies describe the impact of symptom intensity and distress on function. Evaluations of how educational interventions, traditional rehabilitation programs, or nursing service delivery models impact functional status are limited.