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Research Encourages Surgeons To Ask About Quality Of Life Before Operation

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A new study may encourage surgeons to ask patients about their quality of life before operating. Dr. JulianeBingener of the Mayo Clinic explains. 

Bingener: The data actually comes from a study that was done 20 years ago when surgeons wanted to find out if colon cancer surgery done laparoscopically was just as good as open colon cancer surgery. They measured quality of life as one of the pieces to see if patients did better with laparoscopy than with open surgery. So they used three different tools. One of them was just a question, “What is your quality of life, 1-100?” Then they used another symptom index and a third tool. All of those tools had been tested before and were known to be reliable tools to measure quality of life. Surprisingly enough the simple question, “What is your quality of life? Give us a number 1 to 100,” if you were scoring to less than 50, you had a higher likelihood of having a complication after surgery.

Lewis: Why do you think that having a poorer quality of life before the surgery would mean complications afterwards?

Bingener: I don’t know exactly why that is. I started asking the question because colleagues of mine had started researching if quality of life correlated to survival. And they had found that for colon cancer, for pancreas cancer and for lung cancer, poor quality of life meant patients were less likely to survive long-term. We think that complications may be similar to survival. So one of the things is ok, how was the operation? What other medical problems do you have? There also seems to be a patient factor in that how fit are you, how much do you want this, how much “oomph” is there behind the patient? Many surgeons know that when they see somebody with a given diagnosis of colon cancer, have a similar age group, similar other diseases. And one patient will shake their hand and they’ll think, “Oh they’re going to do well” and the other patient will shake their hand and they’ll think, “Hmm, something’s missing.” So quality of life I think is one of the tools that will help us measure these hard-to-describe other things.

Dr. Juliane Bingener is a professor of surgery at the Mayo Clinic.