Early Barrett’s neoplasia Gaining insight into patients’ well-being

Endoscopic treatment has proven to be a minimally invasive, safe and effective method to treat patients with early Barrett’s neoplasia. However, the excellent results are not in proportion to patients’ reported health related quality of life (HRQOL), well-being, and fear of cancer recurrence.
We evaluated HRQOL and illness perceptions alongside a randomized controlled trial, in which patients with Barrett’s esophagus were treated with radio frequency ablation (RFA) or were kept under endoscopic surveillance. We found that HRQOL in RFA patients was comparable to that of patients under surveillance. However, RFA patients reported fewer concerns and their overall perception of the condition was less-threatening compared to patients undergoing surveillance We also explored HRQOL, general fear and fear for cancer recurrence in patients treated endoscopically for early Barrett’s neoplasia and compared that with patients with more advanced disease treated surgically. We found that patients treated endoscopically reported better HRQOL and less cancer symptoms than surgically treated patients. However, endoscopically treated patients worried as much about cancer recurrence as patients treated surgically. Furthermore, general fear and fear of cancer (recurrence) of endoscopically treated patients declined over time, but not as much as in surgically treated patients. Finally, we aimed to gain insight into the reasons why endoscopically treated patients fear or do not fear cancer recurrence using interviews. Reasons that induced fear of cancer recurrence were related to physical symptoms, if cancer was diagnosed as an accidental finding, and experiences with cancer in close relations. Endoscopic surveillance was mentioned as a reason for not experiencing fear of cancer recurrence.