VCU researchers target "inner strength" as a way to improve quality of life for aging women with cancer

By Lorraine Cichowski and Gayle Roux

RICHMOND, Va. – Helping aging women with cancer to build their inner strength could improve their quality of life and health outcomes, according to researchers at Virginia Commonwealth University.

The VCU researchers have developed and are testing an Inner Strength Questionnaire, which is designed to identify and measure the needs of women living with chronic health conditions, including cancer. Each of the questionnaire's four scales, which address the areas of spirituality, balance, problem solving and mental spirit, are accompanied by suggested interventions that clinicians could use to help the women avoid the weight gain, depression, anxiety and other issues that commonly occur after cancer treatment and which can lead to decreased longevity and quality of life.

The questionnaire and discussion about quality of life in aging women with cancer are included in the April issue of the Journal of Cultural Diversity. The area is of interest to researchers because of demographic changes that are dramatically increasing the number of people over age 65 and the impact of age on increased cancer risk. Few studies look specifically at the health needs and disparities for aging women with cancer.

"As a result of improved diagnosis and treatment, more women are surviving cancer," says Dr. Gayle M. Roux, assistant professor of maternal child health and lead author of the study. "Some women emerge from a stressful event such as cancer with an enhanced sense of inner strength or mastery, which are characteristics of improved quality of life. But, for some women, cancer survival can be accompanied by negative physical and psychological syndromes, such as fear of disease and loneliness that affect their quality of life and impact their health outcomes. 

"We have a keen interest, therefore, in helping cancer survivors to build their inner strength so they can better manage their symptoms, restore their sense of purpose and live life more fully." 

Among strategies identified by the VCU researchers to assess health needs in aging women with cancer and improve their health outcomes:

• Identify "symptom clusters" in cancer patients of three or more closely related negative symptoms. For example, Roux said, weight gain, depression and decreased quality of life often appear in aging female cancer survivors as a symptom cluster. She said clinicians can help the women to take advantage of preventive and protective interventions.

• Target middle-aged and aging adults who survive cancer for increased physical activity, such as walking, because surviving cancer treatment may increase the risk for weight gain, osteoporosis, cardiovascular disease, depression and emotional distress.

"As aging women continue to live longer after surviving cancer, quality of life issues become increasingly relevant," Roux says.

For this study, Roux and her team tested the Inner Strength Questionnaire on 27 cancer patients, aged 60-87, recruited from VCU's Massey Cancer Center and the Richmond area.  Subsequent testing of the questionnaire on 281 female patients of the Massey Cancer Center and various VCU clinics living with chronic conditions was completed in March. The findings will contribute to development of future programs and interventions to improve health outcomes for women.