QUALITY OF LIFE RESEARCH THAT SHAPED ONCOLOGISTS' THINKING AND PRACTICE

Alan Coates is a pioneer of quality of life research in oncology. This paper reviews three threads in his extensive program of quality of life research that have had enduring influences on how we think about cancer and manage it. The studies produced counterintuitive conclusions to three pragmatic questions: 1) How long should chemotherapy continue in responding patients with advanced cancer? 2) Is baseline quality of life prognostic in people with advanced cancer? 3) What benefits are needed to make adjuvant chemotherapy worthwhile? This research was done predominantly in people with breast cancer and melanoma, but its implications extend to the management of all malignancies.