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Author Notes:

Corresponding author: Eliza M Park, MD, Department of Psychiatry, University of North Carolina, 170 Manning Drive, CB#7305, Chapel Hill, NC 27599, Phone: 919-966-3494, Fax: 919-966-6735, leeza_park@med.unc.edu.

Eliza Park: Conceptualization, methodology, validation, formal analysis, investigation, resources, data curation, writing-original draft, writing-review and editing, visualization, supervision, project administration, funding acquistion

Allison Deal: Conceptualization, methodology, software, validation, formal analysis, writing-original draft, writing-review and editing, visualization

Justin Yopp: Conceptualization, investigation, resources, writing-review and editing

Teresa Edwards: Methodology, investigation, resources, data curation, writing-review and editing

Sam Resnick: Investigation, data curation, writing-review and editing

Mi-Kyung Song: Conceptualization, methodology, writing-review and editing, supervision

Zev Nakamura: Investigation, writing-original draft, writing-review and editing

Donald Rosenstein: Conceptualization, methodology, investigation, resources, writing-original draft, writing-review and editing, project administration

The authors wish to gratefully acknowledge the individuals who participated in this study and gave their time to shaire their experiences as well as the following organizations for their invaluable assistance distributing the survey: Metastatic Breast Cancer Network, Living Beyond Breast Cancer, MetaCancer, Livestrong, Stupid Cancer, Colon Cancer Alliance, and the Melanoma Research Foundation.

The authors have no conflicts of interest to disclose.


Research Funding:

The project described was supported by the Junior Faculty Development Award (University of North Carolina), the Doris Duke Charitable Foundation (Grant No. 2015213), the Foundation of Hope, and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through Grant No. 1KL2TR001109, and the NIH, Grant No. 1K07CA218167-01.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • cancer
  • neoplasm
  • parenting
  • patient-reported outcomes
  • quality of life

Understanding Health-Related Quality of Life in Adult Women With Metastatic Cancer Who Have Dependent Children


Journal Title:



Volume 124, Number 12


, Pages 2629-2636

Type of Work:

Article | Post-print: After Peer Review


BACKGROUND: Cancer is a leading cause of death among women of parenting age in the United States. Women living with advanced or incurable cancer who have dependent children experience high rates of depression and anxiety as well as unique parenting challenges. To the authors' knowledge, few studies to date have examined the parenting factors associated with health-related quality of life (HRQOL) in women with advanced cancer. METHODS: The authors conducted a cross-sectional, Web-based survey of the psychosocial concerns of 224 women with a tumor-node-metastasis staging system of the AJCC stage IV solid tumor malignancy who had at least 1 child aged <18 years. Participants completed validated measures of HRQOL (Functional Assessment of Cancer Therapy–General [FACT-G]); depression and anxiety symptom severity; functional status; parenting concerns; and investigator-designed questions to assess demographic, communication, and parenting characteristics. Multiple linear regression models were estimated to identify factors associated with FACT-G total and subscale scores. RESULTS: The mean FACT-G score was 66 (standard deviation, 16). The mean Emotional Well-Being subscale scores were particularly low (13; standard deviation, 5). In multivariable linear regression models, parenting variables explained nearly 40% of the HRQOL model variance. In the fully adjusted model, parenting concerns and the absence of parental prognostic communication with children both were found to be significantly associated with HRQOL scores. For each 1-point increase in parenting concern severity, FACT-G scores decreased by 4 points (P =.003). CONCLUSIONS: Women with metastatic cancer who are parents of dependent children are at risk of high psychological distress and low HRQOL. Parenting factors may have a negative influence on HRQOL in this patient population. Cancer 2018;124:2629-36. © 2018 American Cancer Society.

Copyright information:

© 2018 American Cancer Society

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