Introduction Medical research is focused on the developing of treatments and improving survival outcomes. In recent years, quality of life (QoL) measurements have been included in clinical trials as a relevant outcome variable; however, other psychological variables might have an impact on QoL. This study aims to determine: H1. Whether NET symptoms have a greater impact on QoL than disease severity. H2. Whether coping strategies influence QoL. H3 Whether internal control beliefs in the potential of control cancer growth are associated with QoL.

Methods 74 patients completed a web survey involving: QoL (EORTC C.30 and GI.NET21), a coping styles (Brief cope) and an illness perception measurements. All questionnaires were counterbalanced.

Results Endocrine and gastrointestinal symptoms, were negatively associated with self-reported measures of QoL, r=−46, N=73, p.05. Problem focus strategies such as acceptance, active coping and planning were not associated with QoL. Interestingly, emotion focus strategies such as behavioural disengagement, venting and self-blame were negatively associated with QoL, r=−0.48, N=73. Neuroendocrine patients considered that, keeping a positive attitude, not smoking and limiting alcohol intake would prevent cancer from spreading and progressing; however none of them were correlated with QoL.

Conclusion Disease severity is not associated with to QoL, whereas specific neuroendocrine symptoms, flushing and diarrhoea are. Active coping, acceptance, seeking emotional or instrumental support, were not correlated to QoL. In contrast, behavioural disengagement, denial and self-blame were negatively associated to self reported measures of QoL. Most of our patients endeavour on active or problem focus strategies where there is agreement of being more adaptive long term than avoidant or emotional strategies. This study has shown the relationship between neuroendocrine symptoms and coping strategies with QoL. Prospective and randomised trials will clarify the causal relationship among these constructs. Future research should include the relationship of psychosocial variables and neuroendocrine biomarkers.

Competing interests None declared.

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