MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

This systematic review and meta-analysis investigated the impact of quality of life (QoL) on mortality risk in patients with esophageal cancer.

A literature search was conducted using the CINAHL, PubMed/MEDLINE, and Scopus databases for articles published from inception to December 2022. Observational studies that examined the association between QoL and mortality risk in patients with esophageal cancer were included. Subgroup analyses were performed for time points of QoL assessment and for types of treatment.

Seven studies were included in the final analysis.

  • Overall, global QoL was significantly associated with mortality risk (hazard ratio 1.02, 95% confidence interval 1.01–1.04; p < 0.00004).
  • Among the QoL subscales of QoL, physical, emotional, role, cognitive, and social QoL were significantly associated with mortality risk.
  • A subgroup analysis by timepoints of QoL assessment demonstrated that pre- and posttreatment global and physical, pretreatment role, and posttreatment cognitive QoL were significantly associated with mortality risk.
  • Moreover, another subgroup analysis by types of treatment demonstrated that the role QoL in patients with surgery, and the global, physical, role, and social QoL in those with other treatments were significantly associated with mortality risk.

The authors concluded that these findings indicate that the assessment of QoL in patients with esophageal cancer before and after treatment not only provides information on patients’ condition at the time of treatment but may also serve as an outcome for predicting life expectancy. Therefore, it is important to conduct regular QoL assessments and take a proactive approach to improve QoL based on the results of these assessments.

Am I missing something here?

Isn’t this rather obvious?

The way this paper is written, some practitioners of so-called alternative medicine (SCAM) might feel that, by improving QoL (for instance, by some fancy aromatherapy, reflexology, etc.), they can significantly better the cancer prognosis.

Patients with a poor prognosis are more seriously ill and therefore have a lowe QoL. Assessing QoL might be a useful marker, but would it not be better to ask why the QoL is in some patients less than in others?

2 Responses to Impact of quality of life on mortality risk in patients with esophageal cancer

  • Such a QoL is used to calibrate effectiveness for cost-effectiveness or cost benefit studies. Nothing to do with SCAM.

  • Edzard Ernst wrote:

    [*QUOTE*]
    —————————–
    The way this paper is written, some practitioners of so-called alternative medicine (SCAM) might feel that, by improving QoL (for instance, by some fancy aromatherapy, reflexology, etc.), they can significantly better the cancer prognosis.

    Patients with a poor prognosis are more seriously ill and therefore have a lowe QoL. Assessing QoL might be a useful marker, but would it not be better to ask why the QoL is in some patients less than in others?
    —————————–
    [*/QUOTE*]

    First, Quality of Life is NOT quality of life. There is a difference between WHAT IS and What PEOPLE ARE MADE BELIEVE.

    The difference is made by cheating, brainwashing, indoctrinating.

    Is the body of the patient really in a better condition or is the patient simply accustomed to pain and other bad things (whatever they may be)?

    The difference is essential.

    Say, a patient is in a bad state. Giving him hope, cheering him up, does it better the state of his body? No. But the patient feels better. Until he bites the dust.
    Now, when a patient in a bad state becomes victim of a brain-washer, the patient is made believe he is in a better state. He wants to go on. And he pays for it. Will it do him good? No. He will bite the dusty anyway.

    Here, exactly here, the trap snaps: the effect of brain-washing is claimed to be better well-being, and that is claimed to be caused by the SCAM “treatment”. This then is considered as a positive result of the treatment – and sold as such.

    Make a study about the better well-being. Publish it. What will happen? Answer: Patients are made believe, that this study proves that this treatment works.

    So, such a study boosts the sales, and it part of a PR wave. But it does not do the patients any good.

    Edzard Ernst wrote: “they can significantly better the cancer prognosis”. EXACTLY THIS is the lever. For what? For fooling the patients. Because it does not better the cancer prognosis, but only make people think it does.

    Now comes one more ugly trap: That people feel better (because they are brain-washed) is taken as WELLBEING! Wellbeing, how wonderful, because, even when the patient is in a final state and it is sure, that he will die and has only some short time left, the WELLBEING is the goal to achieve. THIS now is taken as positive (“make the patients happy”), and so normal “schoolmedicine” doctors will suggest such “treatments” to their patients. Welcome, you SCAM frauds, you got the foot in the door. This is how the SCAM fraud enters normal medical life.

    Once the fraud is taken into normal medical life, normal, unsuspecting patients believe (because normal schoolmedicine doctors propose it) that this fraud is useful medicine, and believe (and wait for) the bettering to happen.

    It all is a pile of vicious tricks, enabled by the stupidity of the schoolmedicine doctors, who are too damned stupid to understand the mechanisms the SCAM artists use. It is, what we say for over 2 decades now, a war with language. It is war rhetoric.

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