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Monib S, Abdelaziz MI. Epidemiology and Predictive Factors for Persistent Breast Pain Following Breast-Conserving Surgery. Cureus 2021; 13:e14063. [PMID: 33898146 PMCID: PMC8061752 DOI: 10.7759/cureus.14063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background In general, breast pain is one of the most common causes for referral to breast units; treatment-related breast pain is frequently seen in clinical practice but not well addressed in the literature. While our primary objective was to identify the incidence of persistent breast pain following breast-conserving surgery and possible risk factors, our secondary aim was to assess the possibility of using a breast ultrasound scan to detect parenchymal changes that can contribute to breast pain. Methods We have conducted a prospective study including patients who had wide local excision for primary breast cancer treatment between January 2017 and January 2019. Patients’ demographics, including age, BMI, breast volume, and tumour characteristics, were noted. All patients had a clinical assessment and were asked standard questions about their breast pain each visit; they also had an ultrasound scan of the breast and axilla 6 and 12 months after surgery to look for parenchymal changes. Results A total of 239 female breast cancer patients were included in our analysis. The mean age was 43.9 years, mean weight was 72.8 kg, mean BMI was 27.4 and mean breast volume was 1173 ml. In total, 38.5% had standard wide local excision, and 61.5% had oncoplastic resection; the mean specimen weight was 74.6 grams. All patients had adjuvant whole breast radiotherapy. We found that patients with younger age, larger breast size, high BMI, oncoplastic resections, and persistent parenchymal changes are associated with an increased incidence of postoperative breast pain while the type of axillary procedure and adjuvant chemotherapy had no significant effect. Conclusion Persistent postoperative breast pain was noted in 33% of our patients. We have also indicated that younger patients, patients with larger breast, those with high BMI, with preoperative breast pain, who had oncoplastic resections, and patients with persistent parenchymal changes, as fat necrosis and scarring, are associated more with persistent breast pain.
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Affiliation(s)
- Sherif Monib
- Breast Surgery, St Albans and Watford General Hospitals, West Hertfordshire Hospitals NHS Trust, St Albans, GBR
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Gadisa DA, Wang SH, Yimer G. The Impact of AC and AC-T Chemotherapy's Toxicities on Quality of Life Among Women with Breast Cancer in Ethiopia: A Prospective Patient-Reported Outcomes Study. BREAST CANCER (DOVE MEDICAL PRESS) 2021; 13:107-132. [PMID: 33658844 PMCID: PMC7917350 DOI: 10.2147/bctt.s289014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/22/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE The study aimed to evaluate the quality of life patterns and the effects of AC and AC-T chemotherapy's toxicities on QoL among Ethiopian women with breast cancer. METHODS QoL was measured at baseline and at every end of two cycles, for the median of 8 cycles among 146 breast cancer women on AC and AC-T chemotherapy, using EORTC QLQ-C30 and BR23 instruments. The effect of QoL score, socio-demographic, and clinical variables at baseline were adjusted for the effect of chemotherapy's toxicities on QoL. RESULTS Overall QoL, all functional scales (except cognitive functioning, body image, future perspectives, and sexual functioning) and symptom scales (except dyspnea, insomnia, pain score, arm, and breast symptoms) of EORTC QLQ-C30 and BR23 deteriorated significantly both clinically and statistically, in particular, during the first two cycles of chemotherapy. After the end of cycle 2 or 4, except for cognitive, social functioning, and financial difficulties of the patients, almost all other QoL dimensions were improved towards pretreatment score by the end of cycle 8. In addition to age, educational status, and tumor stage, the Global Health Status (-10.55≤B≤-7.71, P≤0.013), and the functional scales (-25.320≤B≤-6.351, P≤0.033) of EORTC QLQ-C30 and BR23 were significantly affected at least by one of the AC and AC-T chemotherapy's toxicity such as grade≥2 fatigue, dysgeusia, constipation, dry mouth, vomiting, oral mucositis, skin hyperpigmentation and/or peripheral neuropathy than their lower grade. Grade≥2 fatigue, dysgeusia, oral mucositis, constipation, peripheral neuropathy, anemia arthralgia/myalgia, dry mouth, diarrhea, constipation, and/or skin hyperpigmentation were positively predicted for the deterioration of symptoms scale of EORTC QLQ-C30 and BR23 (4.819≤B≤26.451, P≤0.043). CONCLUSION Quality of life among Ethiopian breast cancer patients on AC and AC-T regimens significantly deteriorated particularly during the first two cycles of chemotherapy. In addition to the age, tumor stage and educational status of the patients, grade≥2 fatigue, dysgeusia, constipation, oral mucositis, dry mouth, peripheral neuropathy, and skin hyperpigmentation due to AC and AC-T chemotherapy were frequently associated with deterioration of different scales/items QoL. Hence, devising different strategies to improve the deteriorated QoL due to chemotherapy's toxicities particularly during the first two cycles has paramount importance.
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Affiliation(s)
- Diriba Alemayehu Gadisa
- Pharmacy Department, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Shu-Hua Wang
- Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
- Ben Franklin TB Control Program, Columbus, OH, USA
| | - Getnet Yimer
- Ohio State Global One Health Initiative, Office of International Affairs, The Ohio State University, Addis Ababa, Ethiopia
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Xu B, Sun T, Wang S, Lin Y. Metronomic therapy in advanced breast cancer and NSCLC: vinorelbine as a paradigm of recent progress. Expert Rev Anticancer Ther 2021; 21:71-79. [PMID: 33054438 DOI: 10.1080/14737140.2021.1835478] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Metronomic chemotherapy (MCT) is based on frequent dosing of the drug. . This leads to pharmacologically active but low plasma concentrations that reduce toxicity. MCT seems to work primarily via indirect effects on tumor cells and their microenvironment, rather than direct antitumor effects. Oral vinorelbine is one of the most widely studied MCT approaches in both advanced breast cancer and non-small cell lung cancer. EXPERT OPINION MCT with vinorelbine has proven efficacy, tolerability and quality of life benefits both as monotherapy and in combination with other MCTs or targeted agents, in first-line therapy and in previously treated patients. Key populations are emerging who may be particularly well suited to metronomic vinorelbine, including those with indolent disease, older individuals, and those with multiple comorbidities and/or bone metastases. Ongoing trials should help to further delineate these target groups. Additional work is needed to better understand the optimal vinorelbine regimen, particularly when used in combination or in non-Caucasian patients. Markers are also required to help identify individuals who are most likely to respond. Nonetheless, the efficacy and tolerability of MCT, allied to improved patient convenience, reduced need for medical engagement and lower cost, make it an appealing option - particular in resource-constrained healthcare environments.
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Affiliation(s)
- Binghe Xu
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences , Beijing, P.R. China
| | - Tao Sun
- Department of Medical Oncology, Cancer Hospital of Liaoning Province , shenyang, Liaoining, P.R. China
| | - Shusen Wang
- Department of Medical Oncology, Cancer Center, Sun Yat-sen university , Guang, China
| | - Yingcheng Lin
- Department of Medical Oncology, Shantou University Medical College Cancer Hospital , China
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Lewandowska A, Rudzki G, Lewandowski T, Rudzki S. The Problems and Needs of Patients Diagnosed with Cancer and Their Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010087. [PMID: 33374440 PMCID: PMC7795845 DOI: 10.3390/ijerph18010087] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022]
Abstract
(1) Background: As the literature analysis shows, cancer patients experience a variety of different needs. Each patient reacts differently to the hardships of the illness. Assessment of needs allows providing more effective support, relevant to every person’s individual experience, and is necessary for setting priorities for resource allocation, for planning and conducting holistic care, i.e., care designed to improve a patient’s quality of life in a significant way. (2) Patients and Methods: A population survey was conducted between 2018 and 2020. Cancer patients, as well as their caregivers, received an invitation to take part in the research, so their problems and needs could be assessed. (3) Results: The study involved 800 patients, 78% women and 22% men. 66% of the subjects were village residents, while 34%—city residents. The mean age of patients was 62 years, SD = 11.8. The patients received proper treatment within the public healthcare. The surveyed group of caregivers was 88% women and 12% men, 36% village residents and 64% city residents. Subjects were averagely 57 years old, SD 7.8. At the time of diagnosis, the subjects most often felt anxiety, despair, depression, feelings of helplessness (46%, 95% CI: 40–48). During illness and treatment, the subjects most often felt fatigued (79%, 95% CI: 70–80). Analysis of needs showed that 93% (95% CI: 89–97) of patients experienced a certain level of need for help in one or more aspects. (4) Conclusions: Patients diagnosed with cancer have a high level of unmet needs, especially in terms of psychological support and medical information. Their caregivers also experience needs and concerns regarding the disease. Caregivers should be made aware of the health consequences of cancer and consider appropriate supportive care for their loved ones.
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Affiliation(s)
- Anna Lewandowska
- Institute of Healthcare, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland
- Correspondence: ; Tel.: +48-698757926
| | - Grzegorz Rudzki
- Chair and Department of Endocrinology, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Tomasz Lewandowski
- Institute of Technical Engineering, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland;
| | - Sławomir Rudzki
- Chair and Department of General and Transplant Surgery and Nutritional, Medical University of Lublin, 20-090 Lublin, Poland;
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Verrill M, Wardley AM, Retzler J, Smith AB, Bottomley C, Ní Dhochartaigh S, Tran I, Leslie I, Schmid P. Health-related quality of life and work productivity in UK patients with HER2-positive breast cancer: a cross-sectional study evaluating the relationships between disease and treatment stage. Health Qual Life Outcomes 2020; 18:353. [PMID: 33138835 PMCID: PMC7607622 DOI: 10.1186/s12955-020-01603-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 10/20/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The impact of different disease stages and treatment for human epidermal growth factor 2 positive (HER2-positive) breast cancer (BC) on work productivity and health-related quality of life (HRQoL) is poorly understood. METHODS This was a UK cross-sectional study of 299 adult patients with HER2-positive early or metastatic BC (NCT03099200). Productivity was assessed using the work productivity and activity impairment scale; HRQoL was measured using EuroQol-5 Dimensions-5 levels (EQ-5D-5L), and Functional Assessment of Cancer Therapy Breast (FACT-G and -B) instruments. Three balanced patient groups were recruited: (1) early BC on treatment post-surgery, (2) early BC after completion of adjuvant treatment, (3) during metastatic BC treatment. Between-group comparisons were performed using an analysis of variance. RESULTS Group 1 comprised 89 patients, Group 2, 108 and Group 3, 102. Age, ethnicity and comorbidities were similar across groups. Patients in Group 3 reported more often being unable to work (significant Bonferroni adjusted p < 0.003). Proportions of employed patients were 50.6%, 50.9% and 27.5% in Groups 1, 2 and 3, respectively. For patients in part-time employment, the number of hours worked was significantly higher in Group 2 patients versus Group 3 (p = 0.002). Group 2 also had significantly lower levels of work absenteeism and overall work impairment compared with Group 1 (p < 0.001). Patients in Group 3 reported worse health utility scores (p ≤ 0.002), moderate or worse problems in the EQ-5D-5L self-care and usual activity domains (p ≤ 0.001), and lower HRQoL as assessed by FACT summary scores (p < 0.001 for FACT-B and -G) than Groups 1 and 2. Poorer HRQoL was significantly associated with higher work impairment (p < 0.001), with the strongest relationships being observed between activity impairment and HRQoL (Pearson's r: 0.67). CONCLUSIONS Metastatic disease and treatment of HER2-positive BC adversely impacted on work productivity and HRQoL. The results of this study support the idea that being able to delay or prevent the metastatic recurrence of BC, for example by extending the time patients are in remission or at early stage of BC, has wider benefits in terms of patient productivity and HRQoL.
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Affiliation(s)
- Mark Verrill
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Andrew M. Wardley
- Division of Cancer Sciences, University of Manchester and the Christie NHS Foundation Trust, Manchester, UK
| | - Jenny Retzler
- York Health Economics Consortium, York, UK
- Department of Psychology, University of Huddersfield, Huddersfield, UK
| | | | | | | | - Irwin Tran
- Roche Products Ltd, Welwyn Garden City, UK
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Mokhtari-Hessari P, Montazeri A. Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018. Health Qual Life Outcomes 2020; 18:338. [PMID: 33046106 PMCID: PMC7552560 DOI: 10.1186/s12955-020-01591-x] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 10/01/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Breast cancer still is a topic. This overview of the literature aimed to update the current knowledge on quality of life in breast cancer patients. METHODS A review of literature in MEDLINE, Cochrane Database of Systematic Reviews and Google Scholar were carried out to identify review papers on health-related quality of life in breast cancer during the 2008 to 2018. All publications were screened using the PRISMA guideline. The methodological quality of reviews was assessed using the AMSTAR. The findings were summarized and tabulated accordingly. RESULTS Within over a decade, a total of 974 review papers were identified which according to the study selection criteria finally we have evaluated 82 reviews. Of these about 85% had a reasonable methodological quality. The findings were mainly summarized on several headings including instruments used to measure quality of life, treatment, supportive care, psychological distress, and symptoms. Questionnaires had a good performance to quantify quality of life in breast cancer patients. Most reviews were focused on the impact of treatment including endocrine therapy as well as integrating complementary and alternative medicine into the current practice. According to the reviews, yoga was the most recommended exercise to improve quality of life in breast cancer patients. CONCLUSION Overall, the findings from this overview indicated that quality of life in breast cancer patients enhanced during the last decade. Several simple but effective interventions such as physical activity and psychosocial interventions proved to be effective in improving quality of life in this population. However, management of symptoms such as pain, and lymphedema, issues related to worry, sexual function especially for young patients, and the future outlooks all are among topics that deserve further consideration. Also, this overview indicated that methodological issues in measuring quality of life in breast cancer patients improved greatly, but still there is a long way to go to understand what really matter to patients.
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Affiliation(s)
- Parisa Mokhtari-Hessari
- Integrative Oncology Research Group, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Science and Culture, ACECR, Tehran, Iran
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Van Hulle H, Vakaet V, Post G, Van Greveling A, Monten C, Hendrix A, Van de Vijver K, Van Dorpe J, De Visschere P, Braems G, Vandecasteele K, Denys H, De Neve W, Veldeman L. Feasibility study on pre or postoperative accelerated radiotherapy (POP-ART) in breast cancer patients. Pilot Feasibility Stud 2020; 6:154. [PMID: 33062295 PMCID: PMC7547514 DOI: 10.1186/s40814-020-00693-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/23/2020] [Indexed: 12/25/2022] Open
Abstract
Background In early-stage breast cancer, the cornerstone of treatment is surgery. After breast-conserving surgery, adjuvant radiotherapy has shown to improve locoregional control and overall survival rates. The use of breast radiotherapy in the preoperative (preop) setting is far less common. Nevertheless, it might improve disease-free survival as compared to postoperative radiotherapy. There is also a possibility of downsizing the tumour which might lead to a lower need for mastectomy. There are some obstacles that complicate its introduction into daily practice. It may complicate surgery or lead to an increase in wound complications or delayed wound healing. Another fear of preop radiotherapy is delaying surgery for too long. At Ghent University Hospital, we have experience with a 5-fraction radiotherapy schedule allowing radiotherapy delivery in a very short time span. Methods Twenty female breast cancer patients with non-metastatic disease receiving preop chemotherapy will be randomized between preop or postoperative radiotherapy. The feasibility of preop radiotherapy will be evaluated based on overall treatment time. All patients will be treated in 5 fractions of 5.7 Gy to the whole breast with a simultaneous integrated boost to the tumour/tumour bed of 5 × 6.2 Gy. In case of lymph node irradiation, the lymph node regions will receive a dose of 27 Gy in 5 fractions of 5.4 Gy. The total duration of therapy will be 10 to 12 days. In the preop group, overall treatment time is defined as the time between diagnosis and the day of last surgery, in the postop group between diagnosis and last irradiation fraction. Toxicity related to surgery, radio-, and chemotherapy will be evaluated on dedicated case-report forms at predefined time points. Tumour response will be evaluated on the pathology report and on MRI at baseline and in the interval between chemotherapy and surgery. Discussion The primary objective of the trial is to investigate the feasibility of preop radiotherapy. Secondary objectives are to search for biomarkers of response and toxicity and identify the involved cell death mechanisms and the effect of preop breast radiotherapy on the in-situ immune micro-environment.
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Affiliation(s)
- Hans Van Hulle
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Vincent Vakaet
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Giselle Post
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Annick Van Greveling
- Department of Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Chris Monten
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - An Hendrix
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Koen Van de Vijver
- Department of Pathology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Pieter De Visschere
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Geert Braems
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Gynaecology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Katrien Vandecasteele
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Hannelore Denys
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.,Department of Medical Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Wilfried De Neve
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Liv Veldeman
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
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Lewandowska A, Rudzki G, Lewandowski T, Próchnicki M, Rudzki S, Laskowska B, Brudniak J. Quality of Life of Cancer Patients Treated with Chemotherapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17196938. [PMID: 32977386 PMCID: PMC7579212 DOI: 10.3390/ijerph17196938] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 12/24/2022]
Abstract
Background: Life-quality tests are the basis for assessing the condition of oncological patients. They allow for obtaining valuable information from the patients regarding not only the symptoms of disease and adverse effects of the treatment but also assessment of the psychological, social and spiritual aspects. Taking into account assessment of the quality of life made by the patient in the course of disease has a positive effect on the well-being of patients, their families and their caregivers as well as on satisfaction with the interdisciplinary and holistic oncological care. Methods: A population-based, multi-area cross-sectional study was conducted among patients with cancer in the study in order to assess their life quality. The method used in the study was a clinical interview. Quality of life was measured using the EQ-5D-5L Quality of Life Questionnaire, the Karnofsky Performance Status, our own symptom checklist, Edmonton Symptom Assessment and Visual Analogue Scale. Results: In the subjective assessment of fitness, after using the Karnofsky fitness index, it was shown that 28% (95% CI (confidence interval): 27–30) of patients declared the ability to perform normal physical activity. In the assessment the profile, quality of life and psychometric properties of EQ-5D-5L, it was shown that patients had the most severe problems in terms of self-care (81%, 95% CI: 76–89) and feeling anxious and depressed (63%, 95% CI: 60–68). Conclusions: Cancer undoubtedly has a negative impact on the quality of life of patients, which is related to the disease process itself, the treatment used and the duration of the disease.
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Affiliation(s)
- Anna Lewandowska
- Institute of Healthcare, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland; (B.L.); (J.B.)
- Correspondence: ; Tel.: +48-698757926
| | - Grzegorz Rudzki
- Chair and Department of Endocrinology, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Tomasz Lewandowski
- Institute of Technical Engineering, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland;
| | - Michał Próchnicki
- I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-439 Lublin, Poland;
| | - Sławomir Rudzki
- I Chair and Department of General and Transplant Surgery and Nutritional, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Barbara Laskowska
- Institute of Healthcare, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland; (B.L.); (J.B.)
| | - Joanna Brudniak
- Institute of Healthcare, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland; (B.L.); (J.B.)
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Gayatri D, Efremov L, Kantelhardt EJ, Mikolajczyk R. Quality of life of cancer patients at palliative care units in developing countries: systematic review of the published literature. Qual Life Res 2020; 30:315-343. [PMID: 32948975 PMCID: PMC7886760 DOI: 10.1007/s11136-020-02633-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2020] [Indexed: 12/22/2022]
Abstract
Purpose This systematic review aims to summarize factors that influence the quality of life (QOL) of advanced cancer patients in palliative care (PC) in developing countries. Understanding this context in developing countries milieu is necessary; however, this outcome is rarely reported. Methods Following the PRISMA guidelines, the electronic databases MEDLINE, Embase, CINAHL, and Web of Science were systematically searched using the search terms: QOL, cancer, PC, and names of all developing countries. Studies with less than ten subjects, qualitative or pilot studies, reviews, conference abstracts, and that reported validation of QOL questionnaires were excluded. Results Fifty-five studies from 15 developing countries in the African (n = 5), Latin America and the Caribbean (n = 10), and Asian (n = 40) region were included in the narrative synthesis. 65.4% were cross-sectional, 27.3% were cohort studies, 7.3% were RCTs or quasi-experimental studies. Around 30 QOL factors were studied with 20 different types of QOL instruments. Advanced cancer patients who were older, married/ever married, participated in additional care within PC, used complementary and alternative medicine (CAM), and practiced spirituality/religiosity showed higher QOL score. Low educational level and high depression were associated with a lower QOL. Conclusion Various factors affect QOL among cancer patients in PC. Patients valued the use of CAMs; however, the quality and safety aspects should be properly addressed. Important factors that influenced the QOL score were social and spiritual support. While there is a general need to develop PC strategies further, recognizing patients’ needs should be prioritized in national cancer programs. Electronic supplementary material The online version of this article (10.1007/s11136-020-02633-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dwi Gayatri
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06097, Halle (Saale), Germany.,Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Ljupcho Efremov
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06097, Halle (Saale), Germany
| | - Eva Johanna Kantelhardt
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06097, Halle (Saale), Germany. .,Department of Gynecology, Medical School of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany.
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06097, Halle (Saale), Germany
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Van Hulle H, Vakaet V, Bultijnck R, Deseyne P, Schoepen M, Van Greveling A, Post G, De Neve W, Monten C, Lievens Y, Veldeman L. Health-related quality of life after accelerated breast irradiation in five fractions: A comparison with fifteen fractions. Radiother Oncol 2020; 151:47-55. [PMID: 32663539 DOI: 10.1016/j.radonc.2020.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION In breast cancer patients, duration of illness and treatment have a negative impact on the quality of life. The duration of radiotherapy can be shortened by reducing the number of treatment fractions. In this study, the impact of an accelerated breast irradiation schedule in 5 fractions over 10 to 12 days on health-related quality of life (HRQoL) was investigated and compared to a standard hypofractionation schedule of 15 fractions. METHODOLOGY The study population was composed of 530 patients treated in 15 fractions and 196 patients treated in 5 fractions. Patients were included in different trials evaluating HRQoL. Radiotherapy-related items of the EORTC QLQ-C30 and BR23 and Breast-Q questionnaires were evaluated by comparing baseline scores to scores at 2-4 weeks and 1 year after radiotherapy. Clinically important improvements and deteriorations of HRQoL were compared between the 2 radiation schedules. RESULTS Patients treated in 5 fractions show less deterioration of physical well-being 2-4 weeks after radiotherapy. One year after radiotherapy, the 5 fractions schedule results in more patients reporting a clinically important improvement in pain, arm and breast symptoms and future perspective. CONCLUSION Radiotherapy in 5 fractions over 10-12 days results in more improvement and less deterioration of HRQoL than a 15 fractions schedule over 3 weeks.
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Affiliation(s)
- Hans Van Hulle
- Department of Human Structure and Repair, Ghent University, Belgium.
| | - Vincent Vakaet
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Renée Bultijnck
- Department of Human Structure and Repair, Ghent University, Belgium.
| | - Pieter Deseyne
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Max Schoepen
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Industrial Systems Engineering and Product Design, Kortrijk, Belgium.
| | | | - Giselle Post
- Department of Human Structure and Repair, Ghent University, Belgium.
| | - Wilfried De Neve
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Chris Monten
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Yolande Lievens
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Liv Veldeman
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
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Relationship of objectively measured physical activity and sedentary behaviour with health-related quality of life among breast cancer survivors. Health Qual Life Outcomes 2020; 18:222. [PMID: 32650777 PMCID: PMC7350582 DOI: 10.1186/s12955-020-01478-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 07/03/2020] [Indexed: 12/14/2022] Open
Abstract
Background Lack of physical activity throughout one’s lifetime has been associated with obesity and it is also an important risk factor of breast cancer. This study aimed to determine the relationship between objectively measured physical activity and sedentary behaviour with health-related quality of life (HRQoL) among breast cancer survivors in the East Coast region of Peninsular Malaysia. Methods A cross-sectional study involving 83 breast cancer survivors was carried out in two main government referral hospitals in the region. Participants wore the ActivPAL3™ microdevice physical activity monitor for seven consecutive days. The validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ–C30) and Breast Cancer Supplementary Measure (EORTC QLQ-BR23) were used to measure their HRQoL. Multiple linear regression analysis was conducted to determine the relationship between objectively measured physical activity and sedentary behaviour with HRQoL. Results Longer time spent on moderate to vigorous physical activity (MVPA) was significantly associated with an improvement of HRQoL (p = 0.039) whereas longer time spent on sedentary behaviour significantly reduced the functioning score (p = 0.005). In addition, prolonged sedentary bouts were also significantly associated with better body image that led to improved HRQoL (p = 0.013). Conclusions The study findings suggest that an increase in the time spent on MVPA was associated with improved HRQoL while sedentary behaviour was associated with poorer HRQoL among breast cancer survivors. Thus, it is essential to displace sedentary behaviour with MVPA to improve the quality of life of breast cancer survivors.
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Bhattacharyya GS, Doval DC, Desai CJ, Chaturvedi H, Sharma S, Somashekhar S. Overview of Breast Cancer and Implications of Overtreatment of Early-Stage Breast Cancer: An Indian Perspective. JCO Glob Oncol 2020; 6:789-798. [PMID: 32511068 PMCID: PMC7328098 DOI: 10.1200/go.20.00033] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 12/15/2022] Open
Abstract
The prevalence and mortality of breast cancer is increasing in Asian countries, including India. With advances in medical technology leading to better detection and characterization of the disease, it has been possible to classify breast cancer into various subtypes using markers, which helps predict the risk of distant recurrence, response to therapy, and prognosis using a combination of molecular and clinical parameters. Breast cancer and its therapy, mainly surgery, systemic therapy (anticancer chemotherapy, hormonal therapy, targeted therapy, and immunotherapy), and radiation therapy, are associated with significant adverse influences on physical and mental health, quality of life, and the economic status of the patient and her family. The fear of recurrence and its devastating effects often leads to overtreatment, with a toxic cost to the patient financially and physically in cases in which this is not required. This article discusses some aspects of a breast cancer diagnosis and its impact on the various facets of the life of the patient and her family. It further elucidates the role of prognostic factors, the currently available biomarkers and prognostic signatures, and the importance of ethnically validating biomarkers and prognostic signatures.
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Affiliation(s)
| | - Dinesh C. Doval
- Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Chirag J. Desai
- Vedanta Institute of Medical Sciences, Ahmedabad, Gujarat, India
| | | | - Sanjay Sharma
- Asian Cancer Institute, Somaiya Ayurvihar, Mumbai, Maharashtra, India
| | - S.P. Somashekhar
- Department of Surgical Oncology, Manipal Comprehensive Cancer Center, Manipal Hospital, Bengaluru, India
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Zhou K, Wang W, Zhao W, Li L, Zhang M, Guo P, Zhou C, Li M, An J, Li J, Li X. Benefits of a WeChat-based multimodal nursing program on early rehabilitation in postoperative women with breast cancer: A clinical randomized controlled trial. Int J Nurs Stud 2020; 106:103565. [PMID: 32272281 DOI: 10.1016/j.ijnurstu.2020.103565] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 01/01/2020] [Accepted: 03/01/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Primary treatments for early-stage breast cancer can cause adverse effects, such as pain, fatigue, and sleep disturbance, that can markedly affect the patients' health-related quality of life. OBJECTIVE This study aimed to evaluate the benefits of a WeChat-based multimodal nursing program on early rehabilitation in postoperative women with breast cancer. DESIGN Clinical randomized controlled trial. SETTING Surgical breast cancer department of a general hospital in Shaanxi Province, China. PARTICIPANTS Women with breast cancer were recruited via convenience sampling. The inclusion criteria were (1) age ≥18 years, (2) newly diagnosed with breast cancer, (3) stage I-III disease, and (4) indicated for surgery with adjuvant therapy. Exclusion criteria were (1) comorbidity with other malignant tumors and infections and (2) cognitive or psychiatric disorders. METHODS We recruited patients with breast cancer and randomly allocated them to the intervention (n = 56) and control (n = 55) groups. The former was subjected to the WeChat-based multimodal nursing program plus routine nursing care for 6 months, whereas the latter received only routine nursing care. The primary endpoint (health-related quality of life) and secondary endpoints (pain, fatigue, and sleep) were measured using the Functional Assessment of Cancer Therapy-Breast version 4.0 (FACT-Bv4.0) and the Numerical Rating Scale at 4 time points (i.e., pre-surgery and 1, 3, and 6 months post-surgery). RESULTS The intervention group had significantly improved total FACT-Bv4.0 scores owing to the effects of group (F = 16.28, P < 0.001), time (F = 28.82, P < 0.001), and group-time interaction (F = 5.35, P = 0.001). Similar improvements were also found in social/family well-being and functional well-being (P < 0.05). Emotional well-being was improved based on the effects of time (F = 42.12, P < 0.001) and group-time interaction (F = 10.20, P < 0.001). The 'breast cancer-specific subscale for additional concerns' was affected by group (F = 21.55, P < 0.001) and time (F = 28.96, P < 0.001), whereas physical well-being was only affected by time (F = 35.39, P < 0.001). Pain, fatigue, and sleep were not significantly influenced by group effects. CONCLUSIONS We found a significant improvement in the health-related quality of life of postoperative women with breast cancer who used the WeChat-based multimodal nursing program during early rehabilitation. This demonstrated that the program is an effective intervention for postoperative rehabilitation in such patients. Findings of the study will provide evidence for eHealth services in clinical and transitional nursing care.
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Affiliation(s)
- Kaina Zhou
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, Shaanxi 710061, China.
| | - Wen Wang
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, Shaanxi 710061, China
| | - Wenqian Zhao
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, Shaanxi 710061, China
| | - Lulu Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, Shaanxi 710061, China
| | - Mengyue Zhang
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, Shaanxi 710061, China
| | - Pingli Guo
- Surgical Breast Cancer Department, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, Shaanxi 710061, China
| | - Can Zhou
- Surgical Breast Cancer Department, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, Shaanxi 710061, China
| | - Minjie Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, Shaanxi 710061, China
| | - Jinghua An
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, Shaanxi 710061, China
| | - Jin Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, Shaanxi 710061, China.
| | - Xiaomei Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, Shaanxi 710061, China.
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Wu TY, Chang TW, Chang SM, Lin YY, Wang JD, Kuo YL. Dynamic Changes Of Body Image And Quality Of Life In Breast Cancer Patients. Cancer Manag Res 2019; 11:10563-10571. [PMID: 31908528 PMCID: PMC6925559 DOI: 10.2147/cmar.s223314] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/07/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Dynamic changes of body image and quality of life (QoL) in breast cancer patients were not commonly investigated. We aimed to compare the dynamic changes in QoL and body image of breast cancer survivors receiving breast-conserving surgery or total mastectomy within 5–10 years after surgery. Methods Patients with non-metastatic breast cancer who received surgery were invited to complete the World Health Organization Quality of Life–Brief (WHOQOL-BREF) questionnaire and the Body Image Scale (BIS) within 10 years after surgery. We applied kernel smoothing methods to capture the dynamic changes of the patients’ QoL and body image within 5 years after surgery. We also constructed multiple linear regression models to identify predictive factors for QoL and body image. Results A total of 581 patients were collected, and 211 of them received breast-conserving surgery. There were no statistically significant differences in QoL and body image for breast-conserving surgery versus total mastectomy, but the former showed fluctuating trends. BIS was a predictor of every item and domain in the WHOQOL-BREF in the multiple linear regression model, and explanatory of the trends of dynamic change over time. Patients without lymph node dissection seemed to have less positive feelings but were more satisfied with sexual activities. Conclusion Body image is predictive of the QoL of breast cancer patients. Dynamic changes of body image and QoL would be useful for shared decision-making regarding surgery in breast cancer patients.
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Affiliation(s)
- Tzu-Yi Wu
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Tsai-Wang Chang
- Division of Breast Surgery, Department of Surgery, Tainan Municipal An-Nan Hospital - China Medical University, Tainan, Taiwan
| | - Sheng-Mao Chang
- Department of Statistics, National Cheng Kung University, Tainan, Taiwan
| | - Yun-Ying Lin
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Der Wang
- Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yao-Lung Kuo
- Department of Surgery, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan and Dou-Liou, Taiwan
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65
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Trajectories of health-related quality of life in breast cancer patients. Support Care Cancer 2019; 28:3381-3389. [DOI: 10.1007/s00520-019-05184-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
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Harbeck N, Penault-Llorca F, Cortes J, Gnant M, Houssami N, Poortmans P, Ruddy K, Tsang J, Cardoso F. Breast cancer. Nat Rev Dis Primers 2019; 5:66. [PMID: 31548545 DOI: 10.1038/s41572-019-0111-2] [Citation(s) in RCA: 1456] [Impact Index Per Article: 291.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2019] [Indexed: 12/24/2022]
Abstract
Breast cancer is the most frequent malignancy in women worldwide and is curable in ~70-80% of patients with early-stage, non-metastatic disease. Advanced breast cancer with distant organ metastases is considered incurable with currently available therapies. On the molecular level, breast cancer is a heterogeneous disease; molecular features include activation of human epidermal growth factor receptor 2 (HER2, encoded by ERBB2), activation of hormone receptors (oestrogen receptor and progesterone receptor) and/or BRCA mutations. Treatment strategies differ according to molecular subtype. Management of breast cancer is multidisciplinary; it includes locoregional (surgery and radiation therapy) and systemic therapy approaches. Systemic therapies include endocrine therapy for hormone receptor-positive disease, chemotherapy, anti-HER2 therapy for HER2-positive disease, bone stabilizing agents, poly(ADP-ribose) polymerase inhibitors for BRCA mutation carriers and, quite recently, immunotherapy. Future therapeutic concepts in breast cancer aim at individualization of therapy as well as at treatment de-escalation and escalation based on tumour biology and early therapy response. Next to further treatment innovations, equal worldwide access to therapeutic advances remains the global challenge in breast cancer care for the future.
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Affiliation(s)
- Nadia Harbeck
- LMU Munich, University Hospital, Department of Obstetrics and Gynecology, Breast Center and Comprehensive Cancer Center (CCLMU), Munich, Germany.
| | - Frédérique Penault-Llorca
- Department of Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, UMR INSERM 1240, University Clermont Auvergne, Clermont-Ferrand, France
| | - Javier Cortes
- IOB Institute of Oncology, Quironsalud Group, Madrid and Barcelona, Spain.,Vall d´Hebron Institute of Oncology, Barcelona, Spain
| | - Michael Gnant
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Nehmat Houssami
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Philip Poortmans
- Department of Radiation Oncology, Institut Curie, Paris, France.,Université PSL, Paris, France
| | - Kathryn Ruddy
- Department of Oncology, Mayo Clinic, Rochester, MN, USA
| | - Janice Tsang
- Hong Kong Breast Oncology Group, The University of Hong Kong, Hong Kong, China
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
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Zhou K, Li X. ASO Author Reflections: Consideration of a Comprehensive and Progressive Upper Limb Exercise Program Following Surgery in Women with Breast Cancer. Ann Surg Oncol 2019; 26:674-675. [PMID: 31385131 DOI: 10.1245/s10434-019-07681-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Kaina Zhou
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China
| | - Xiaomei Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China.
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68
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Zhou K, Wang W, An J, Li M, Li J, Li X. Effects of Progressive Upper Limb Exercises and Muscle Relaxation Training on Upper Limb Function and Health-Related Quality of Life Following Surgery in Women with Breast Cancer: A Clinical Randomized Controlled Trial. Ann Surg Oncol 2019; 26:2156-2165. [DOI: 10.1245/s10434-019-07305-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Indexed: 12/21/2022]
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69
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Roopchand-Martin S, Rajkumar F, Creary-Yan S. Quality of life of cancer patients living in Trinidad and Tobago. Qual Life Res 2019; 28:1863-1872. [PMID: 30826980 DOI: 10.1007/s11136-019-02151-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine quality of life (QoL) of cancer patients in The Republic of Trinidad and Tobago using the European Organization for Research and Treatment of Cancer Care Quality of Life Instrument (EORTC QLQ-C30) and examine relationships between QoL and socioeconomic and medical variables. METHOD A cross-sectional study, consisting of 480 cancer patients being managed at the National Radiotherapy Centre, was conducted. One-way, multiple analysis of variance (MANOVA) with post hoc testing was used to analyze relationships between socioeconomic and medical variables and scales on the EORTC QLQ-C30. Stepwise linear regression was used to evaluate which independent variables contributed to the global QoL and function scores. RESULTS Participants were of mean age 64.1 ± 12.1 years (males) and 56.7 ± 16.6 years (females). Mean values for global QoL and function scales were below 75. Persons in younger age groups had significantly better physical and cognitive function scores (p < 0.05). Males had higher emotional function scores than females (p < 0.05). Persons with higher income and education had better scores on all function scales, except social, and less symptoms (p < 0.05). Persons receiving chemotherapy had more nausea/vomiting, appetite loss, and constipation (p < 0.05). CONCLUSION Age, income, education, and cancer treatment were factors most associated with scores on the EORTC QLQ-C30. Further research is required in this population to examine these variables in more depth and explore methods to improve QoL of cancer patients in this population.
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Affiliation(s)
- S Roopchand-Martin
- Faculty of Sport, Mona Academy of Sport, The University of the West Indies-Mona, Mona Campus, Kingston 7, Jamaica.
| | - F Rajkumar
- Physiotherapy Department, Eric Williams Medical Sciences Complex, Uriah Buttler Highway, Champs Fleurs, Trinidad
| | - S Creary-Yan
- Faculty of Sport, Mona Academy of Sport, The University of the West Indies-Mona, Mona Campus, Kingston 7, Jamaica
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Hashemi SM, Balouchi A, Al-Mawali A, Rafiemanesh H, Rezaie-Keikhaie K, Bouya S, Dehghan B, Farahani MA. Health-related quality of life of breast cancer patients in the Eastern Mediterranean region: a systematic review and meta-analysis. Breast Cancer Res Treat 2019; 174:585-596. [PMID: 30632022 DOI: 10.1007/s10549-019-05131-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 01/04/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Breast cancer is the most common type of cancer in women around the world, and this applies to the Middle East as well. The goal of all medical care and treatment is to improve the quality of life (QoL) of patients. Accordingly, the present study aimed at evaluating the QoL of patients with breast cancer in the Middle East region. METHODS In this meta-analysis, three electronic databases (PubMed, Web of Science, and Scopus) were searched from inception until August 2018. The hoy et tool was used to evaluate the quality of the articles included in the meta-analysis. The search, screening, quality evaluation, and data extraction were carried out by two of the researchers. RESULTS Thirty-six studies conducted on 8347 Middle Eastern women with breast cancer entered the final stage. QoL was assessed by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire in 20 studies, with 6034 patients. The mean of the reported QoL was between 31.1 and 75.6. Based on the results of the random effect method, the overall mean of the QoL was 60.5 (95% confidence interval 56.0, 65.0; I2 = 99.0%). In six studies performed on 1053 individuals, QoL was classified as good, moderate, or poor. Less than one-third of patients (21%) had a good QoL. CONCLUSIONS Since less than one-third of patients had a good QoL, it seems necessary to design and implement an integrated and multidimensional educational program to improve QoL of patients with breast cancer.
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Affiliation(s)
- Seyed-Mehdi Hashemi
- Clinical Immunology Research Center, Department of Internal Medicine, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Abbas Balouchi
- Nursing Department, Zabol University of Medical Sciences, Zabol, Iran.,Student Research Committee, Nursing and Midwifery School, Iran University of Medical Sciences, Tehran, Iran
| | - Adhra Al-Mawali
- Director of Centre of Studies and Research, Ministry of Health, Muscat, Oman
| | - Hosein Rafiemanesh
- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Salehoddin Bouya
- Clinical Immunology Research Center Ali-ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Mansoureh Ashghali Farahani
- Nursing Care Research Center and School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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71
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Hsiao FH, Kuo WH, Jow GM, Wang MY, Chang KJ, Lai YM, Chen YT, Huang CS. The changes of quality of life and their correlations with psychosocial factors following surgery among women with breast cancer from the post-surgery to post-treatment survivorship. Breast 2019; 44:59-65. [PMID: 30669032 DOI: 10.1016/j.breast.2018.12.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 11/30/2018] [Accepted: 12/22/2018] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES This 14-month study aimed to examine the changes of quality of life following breast cancer surgery and associations of such changes with depression and anxiety levels, and protective factors (attachment styles in close relationship, and meaning in life) based on positive psychology theory. MATERIALS AND METHODS Women with breast cancer were recruited within one week of completion of breast cancer surgery. They were asked to complete several questionnaires to measure the generic and breast cancer specific quality of life, depression and anxiety levels, attachment styles in close relationship, and meaning in life. Assessments were performed at baseline (T0), T1 (the 2nd month), T2 (the 5th month), T3 (the 8th month), and T4 (the 14th month). RESULTS While the generic functions of quality of life improve after surgery, no significant changes of the breast-specific functions were found during the 14-month follow up period. While physical, role, and social functions improved immediately after surgery, the improvements of emotional and cognitive functions began to occur at the 5th and the 8th months after surgery. Depressive symptoms predicted almost all general and breast-specific QOL functions and symptoms. Avoidant and anxious attachment styles were associated with the negative scores for breast-specific functions and symptoms. CONCLUSION Breast-specific functions, in particular body image and sexual function, remain unchanged with the passage of time following surgery. A psychological rehabilitation program aiming to reduce depressive symptoms and enhance secure attachment styles in close relationships needs to be established immediately following surgery and continue through the post-treatment survivorship stages.
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Affiliation(s)
- Fei-Hsiu Hsiao
- School of Nursing, College of Medicine, National Taiwan University, Vice Director, Department of Nursing, National Taiwan University Hospital, No.1, Jen-Ai Rd. Sec. 1, Taipei, Taiwan.
| | - Wen-Hung Kuo
- Breast Center, National Taiwan University Hospital, Department of Surgery, Collage of Medicine, National Taiwan University, Taiwan.
| | - Guey-Mei Jow
- School of Medicine, Fu-Jen Catholic University, 510 Chung-Cheng Road, Hsin-Chuang, Taipei, Taiwan.
| | - Ming-Yang Wang
- Breast Center, National Taiwan University Hospital, Department of Surgery, Collage of Medicine, National Taiwan University, Taiwan.
| | - King-Jen Chang
- Taiwan Breast Cancer Foundation, Professor, Department of Surgery, College of Medicine, National Taiwan University, Taiwan.
| | - Yu-Ming Lai
- School of Nursing, College of Medicine, Chang-Gung University, Taiwan.
| | - Yu-Ting Chen
- School of Nursing, College of Medicine, Chang-Gung University, Taiwan.
| | - Chiun-Sheng Huang
- Breast Center, National Taiwan University Hospital, Professor, Department of Surgery, Collage of Medicine, National Taiwan University, Taiwan.
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Rajaram N, Lim ZY, Song CV, Kaur R, Mohd Taib NA, Muhamad M, Ong WL, Schouwenburg M, See MH, Teo SH, Saunders C, Yip CH. Patient-reported outcome measures among breast cancer survivors: A cross-sectional comparison between Malaysia and high-income countries. Psychooncology 2018; 28:147-153. [PMID: 30346074 DOI: 10.1002/pon.4924] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/06/2018] [Accepted: 10/17/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Patient-reported outcomes (PROs) in high-income countries (HICs) suggest that physical, emotional, and psychological needs are important in cancer care. To date, there have been few inconsistent descriptions of PROs in low-income and middle-income Asian countries. Using a standard questionnaire developed by the International Consortium for Health Outcomes Measurement (ICHOM), we compared the perceived importance of PROs between patients in Malaysia and those in HICs and between clusters of Malaysian women. METHODS Breast cancer patients were recruited from three Malaysian hospitals between June and November 2017. We compared the proportion of patients who rated PROs as very important (scored 7-9 on a 9-point Likert scale) between Malaysian patients and data collected from patients in HICs via the ICHOM questionnaire development process, using logistic regression. A two-step cluster analysis explored differences in PROs among Malaysian patients. RESULTS The most important PROs for both cohorts were survival, overall well-being, and physical functioning. Compared with HIC patients (n = 1177), Malaysian patients (n = 969) were less likely to rate emotional (78% vs 90%), cognitive (76% vs 84%), social (72% vs 81%), and sexual (30% vs 56%) functioning as very important outcomes (P < 0.001). Cluster analysis suggests that older, parous, Malaysian women, who were less likely to have received breast reconstructive surgery, were more likely to rate body image and satisfaction with the breast as very important outcomes. CONCLUSION Taking into account the differences in PROs by cultural and socioeconomic settings could improve patient expectation of services and refine the assessment of cancer care outcomes.
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Affiliation(s)
- Nadia Rajaram
- Breast Cancer Research Group, Cancer Research Malaysia, Subang Jaya, Malaysia
| | - Zhi Ying Lim
- Breast Cancer Research Group, Cancer Research Malaysia, Subang Jaya, Malaysia
| | - Chin Vern Song
- Breast Cancer Research Group, Cancer Research Malaysia, Subang Jaya, Malaysia
| | - Ranjit Kaur
- Breast Cancer Welfare Association, Petaling Jaya, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, University Malaya Cancer Research Institute, Kuala Lumpur, Malaysia
| | - Mazanah Muhamad
- KanWork Cancer Society, Seri Kembangan, Malaysia.,Faculty of Education, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Wee Loon Ong
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maartje Schouwenburg
- Breast Cancer Working Group, International Consortium for Health Outcomes Measurement, Cambridge, Massachusetts, USA.,Dutch Institute for Clinical Auditing, Amsterdam, The Netherlands
| | - Mee Hoong See
- Department of Surgery, University Malaya Cancer Research Institute, Kuala Lumpur, Malaysia
| | - Soo-Hwang Teo
- Breast Cancer Research Group, Cancer Research Malaysia, Subang Jaya, Malaysia.,Department of Surgery, University Malaya Cancer Research Institute, Kuala Lumpur, Malaysia
| | | | - Cheng Har Yip
- Department of Surgery, Subang Jaya Medical Centre, Subang Jaya, Malaysia
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Guo L, Chen D, Yin X, Shu Q. GSK-3β Promotes Cell Migration and Inhibits Autophagy by Mediating the AMPK Pathway in Breast Cancer. Oncol Res 2018; 27:487-494. [PMID: 30037362 PMCID: PMC7848277 DOI: 10.3727/096504018x15323394008784] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
GSK-3β is a versatile protein kinase participating in many reactions. Currently, there is insufficient understanding of its influence on breast cancer (BC). In order to explore its influence on migration and invasion in BC, we investigated its expression in BC cell lines using qRT-PCR and Western blot (WB). Immunohistochemistry (IHC) was used to examine the potential of GSK-3β to predict clinical outcome in BC patients. GSK-3β knockdown was achieved using an shRNA plasmid vector in T47D cells. Our research explored the biological reactions and downstream pathways involved. We found excessive GSK-3β expression in BC tissues, which was correlated with worse clinicopathological parameters and clinical outcome. Progression of BC was suppressed by GSK-3β knockdown. Furthermore, suppression of GSK-3β function led to a noticeable decrease in ATP generation, and this was associated with stimulation of AMP-activated protein kinase (AMPK) in T47D cells. Activation of AMPK, a typical sign of autophagy stimulation, was triggered after suppression of GSK-3β function, in parallel with increased generation of LC3 II. Our findings therefore indicate that GSK-3β participates in regulation of migration as well as stimulation of autophagy via mediating activation of the AMPK pathway. This suggests that GSK-3β has potential as a predictor of clinical outcome and as a target for BC therapy.
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Affiliation(s)
- Lu Guo
- Jinan University, Guangzhou, Guangdong, P.R. China
| | - Duankai Chen
- General Surgery, YouJiang Medical University for Nationalities, Guangxi, P.R. China
| | - Xing Yin
- Wound Regeneration and Vascular Surgery Department of the First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, P.R. China
| | - Qingfeng Shu
- General Surgery, YouJiang Medical University for Nationalities, Guangxi, P.R. China
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Health-Related Quality of Life among Women Breast Cancer Patients in Eastern China. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1452635. [PMID: 30065931 PMCID: PMC6051298 DOI: 10.1155/2018/1452635] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/29/2018] [Accepted: 06/05/2018] [Indexed: 11/18/2022]
Abstract
Objectives Breast cancer is one of the major cancers in Chinese women. European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30 and QLQ-BR23) are now the most common and well developed instruments assessing the health-related quality of life (HRQOL) of breast cancer patients internationally, whereas there are relatively few Chinese studies. This study has two aims: to investigate the HRQOL and explore which dimensions of HRQOL play more important roles in breast cancer patients' overall quality of life in China and to explore the latent factor structure and the potential complementary relationship between these two EORTC questionnaires. Methods This cross-sectional and descriptive study was performed from October 2014 to February 2015 in Qingdao Municipal Hospital, China. A total of 621 women breast cancer patients were enrolled. EOTRC QLQ-C30 and QLQ-BR23 were used to evaluate the HRQOL of the participants. The nonparametric test, multiple linear regression, and exploratory factor analysis (EFA) were the main statistical methods we used. Results 608 participants completed the questionnaires with a response rate of 97.9%. The mean age of the participants was 48.0 years (SD=9.6). About 33% were illiterate or only finished primary school education. Almost half participants (47.4%) only adopted chemotherapy. HRQOL was significantly different with regard to patients' social-demographic and clinical characteristics. Age, residence, educational level, employment status, and TNM stage were five significant predictors for global health status. Pain, dyspnea, sexual enjoyment, and systemic therapy side-effect were main subscales which had a significant impact on the global health status for patients in different TNM stage. The EFA result suggested that QLQ-C30 and QLQ-BR23 were complementary questionnaires. Conclusions The EORTC QLQ-C30 and QLQ-BR23 questionnaires provide complementary information regarding breast cancer patients' HRQOL, and depending on the different cancer staging functional/symptom scales which significantly contributed to the overall HRQOL differed.
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