ing science and practice. Nurses traditionally have viewed
patients from a holistic perspective, focusing not only on
the length of life but also on the quality of life. Over the
past 30 years, nurse scientists have been among the front-
runners in the development of quality of life as an important
gauge for evaluating healthcare outcomes. Recognizing the
fact that information beyond tumor response and survival
time was needed, much of the ground-breaking work in
the assessment of quality of life has been accomplished in
oncology. In 1985, the US Food and Drug Administration
identified ed quality of life as a key parameter for approval of
new anticancer drugs for advanced metastatic disease.
In 1988, improvement of quality of life was identified ed as one
of the highest priorities of the Cancer Therapy Evaluation
Program of the National Cancer Institute (NCI).
Quality of life components now are included in many of the clinical
trials conducted by the cancer cooperative groups in the
United States, Canada, and Europe. In fact, the Canadian
NCI requires quality of life end points to be included in all
phase III clinical trials.
In April 2006, the importance of
quality of life was further recognized by the American NCI,
by instituting the Symptom Management and Health-
Related Quality of Life Steering Committee, within its
Coordinating Center for Clinical Trials.
Quality of life issues, however, are not limited to clinical
trials of therapeutic agents. Such information is critically
important for the entire spectrum of cancer care, including
palliative care, end-of-life care, and long-term survivorship.
Oncology nurses focus on all aspects of life affected by can-
cer and treatment, such as physical symptoms, treatment
toxicities, mental and physical functioning, body image,
psychological state, work and role responsibilities, social
and family life, and spiritual concerns. Because the con-
cept of quality of life is a multidimensional construct that
encompasses the whole of life, it is a useful parameter for
outcomes important in oncology nursing.