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May 29, 2026Journal of Clinical Oncology

Fatigue strongly correlates with lower QoL, while difficult access and advanced disease link to worse depression.

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Why the study?

In low-resource and conflict-affected settings, barriers to cancer care may amplify symptom burden and psychological distress, leading to poor quality of life.

Do symptom burden, psychological distress, and treatment accessibility impact quality of life in people with cancer in Syria?

Population

225 adult outpatient oncology patients at Albairwni Hospital in Syria

Design

Cross-sectional study

Key result

Fatigue was strongly inversely correlated with quality of life (ρ = -0.71, P<0.001), while difficult treatment access and advanced disease were associated with worse depression, fatigue, and QoL.

Authors

MAMohamad Yousef AlmawazAKAlyaa KheirbekRARain Yassin Alkhalil

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Overview

Supports targeted symptom relief in Syrian oncology; leaves open whether easing access improves outcomes in prospective studies.

Key Points

  • This study aimed to assess how symptom burden, psychological distress, and treatment accessibility affect the quality of life in patients with cancer in Syria.
  • Conducted a cross-sectional study at Albairwni Hospital, Syria from April to May 2025.
  • Adult oncology patients completed validated questionnaires assessing depression, fatigue, and quality of life.
  • Statistical analyses included group comparisons and Spearman correlation.
  • 41.8% of participants reported difficult access to treatment, correlating with worse depression and fatigue (PHQ-9 P = 0.01; BFI P = 0.01).
  • 77.3% exhibited depressive symptoms, with advanced cancer stages associated with poorer quality of life (PHQ-9 & FACT-G7 P < 0.001).
  • Health-provider support linked to lower symptom severity and better quality of life (BFI P = 0.01; FACT-G7 P = 0.003).

Study Design

Type

Cross-Sectional (n=225)

Multicenter

No

Structured PICO

Do symptom burden, psychological distress, and treatment accessibility impact quality of life in people with cancer in Syria?

P
Population
225 adult outpatient oncology patients at Albairwni Hospital, Syria's national cancer center, median age 53, 71.6% female, 65.8% rural. Breast cancer comprised 49.3% of cases.
O
Outcome
Quality of life (measured by FACT-G7), psychological distress (measured by PHQ-9), and symptom burden/fatigue (measured by BFI)patient reported

Main Result

Effect estimate: ρ = -0.71

p-value: p=<0.001

In Syrian cancer patients, depressive symptoms, fatigue, and difficult treatment access are strongly associated with poorer quality of life.

Cite This Study

Almawaz et al. (2026) conducted a cross-sectional in Cancer (n=225). Fatigue was strongly inversely correlated with quality of life (ρ = -0.71, P<0.001), while difficult treatment access and advanced disease were associated with worse depression, fatigue, and QoL.

synapsesocial.com/papers/6a192da0fab5b468c4416895https://doi.org/10.1200/jco.2026.44.16_suppl.11046
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