1
|
Kim SH, Jo HY. Factors Associated with Poor Quality of Life in Breast Cancer Survivors: A 3-Year Follow-Up Study. Cancers (Basel) 2023; 15:5809. [PMID: 38136354 PMCID: PMC10741455 DOI: 10.3390/cancers15245809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/22/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
The purpose of this study was to identify subgroups of quality of life (QOL) changes in breast cancer survivors (BCSs), and to determine factors associated with subgroups of consistently low or deteriorated QOL. We enrolled 101 women recently diagnosed with breast cancer in South Korea and asked them to complete a questionnaire at baseline (within 1 month of diagnosis), 1 year later (Year 1), 2 years later (Year 2), and 3 years later (Year 3). We assessed QOL using the global QOL subscale from the EORTC QLQ-C30. We defined low QOL as a global QOL score 10 points below the mean score of the general population. Based on low QOL as defined in this study, we identified subgroups of QOL changes over 3 years. We identified four subgroups of QOL changes: improved (47.4%), stable (30%), continuously low (8.8%), and deteriorated (13.8%), and considered the last two categories (22.6%) poor QOL. Logistic regression analyses demonstrated that significant determinants of poor QOL were insomnia at Year 1, fatigue and anxiety at Year 2, and fatigue, depression, and comorbidity at Year 3. In conclusion, persistent symptoms of insomnia, fatigue, anxiety, depression, and comorbidity are potential risk factors for poor QOL in BCSs.
Collapse
Affiliation(s)
- Soo-Hyun Kim
- Department of Nursing, Inha University, Incheon 22212, Republic of Korea;
| | | |
Collapse
|
2
|
Tran TXM, Jung SY, Lee EG, Cho H, Kim NY, Shim S, Kim HY, Kang D, Cho J, Lee E, Chang Y, Cho H. Health-related quality of life in long-term early-stage breast cancer survivors compared to general population in Korea. J Cancer Surviv 2023:10.1007/s11764-023-01482-2. [PMID: 37999857 DOI: 10.1007/s11764-023-01482-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/06/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE This study assessed health-related quality of life (HRQoL) of long-term breast cancer (BC) survivors diagnosed at early stages and compare with cancer-free, age-matched women. METHODS The study population included BC survivors diagnosed with ductal carcinoma in situ (DCIS) or breast cancer stages I-II, who had undergone lumpectomy/mastectomy, with time since diagnosis ranging from 9 to 16 years. Survey was conducted at two tertiary hospitals in 2020. Data for cancer-free female controls was randomly drawn from a population-based survey and age-, education-matched with 1 case: 3 controls ratio. Self-reported HRQoL was assessed using EQ-5D with five dimentions. EQ-5D utility index score was calculated. Difference in EQ-5D score was evaluated using the Tobit regression model with adjustment for other covariates. RESULTS Of 273 survivors. 88% and 12% underwent mastectomy and lumpectomy, respectively. The mean (standard deviation, SD) age at survey was 57.3 (8.5) years old. BC survivors reported significantly more problems performing daily activities (11% vs. 5%, p < 0.001), pain/discomfort (46% vs. 23%, p < 0.001), and anxious/depressed feelings (44% vs. 8%, p < 0.001) relative to the controls. Difference in EQ-5D score between BC survivors and the general population was higher in older age groups. The overall EQ-5D score of BC survivors was statistically lower than that of the control subjects (adjusted [Formula: see text]=0.117, p < 0.001). CONCLUSION Long-term BC survivors who survived beyond ten years post-diagnosis experience more pain, anxiety, and distress, leading to an overall poorer HRQoL. IMPLICATIONS FOR CANCER SURVIVORS This study suggest the importance of follow-up care, particularly focusing on pain, anxiety, and distress management to enhance the HRQoL of long-term BC survivors.
Collapse
Affiliation(s)
- Thi Xuan Mai Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, 10408, Republic of Korea
| | - So-Youn Jung
- Center for Breast Cancer, National Cancer Center, Goyang, 10408, Republic of Korea
| | - Eun-Gyeong Lee
- Center for Breast Cancer, National Cancer Center, Goyang, 10408, Republic of Korea
| | - Heeyoun Cho
- Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang-Si, Goyang, Gyeonggi-Do, 10408, Republic of Korea
| | - Na Yeon Kim
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Sungkeun Shim
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Ho Young Kim
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Danbee Kang
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06351, Republic of Korea
| | - Juhee Cho
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06351, Republic of Korea
| | - Eunsook Lee
- Center for Breast Cancer, National Cancer Center, Goyang, 10408, Republic of Korea
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, 10408, Republic of Korea
| | - Yoonjung Chang
- Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang-Si, Goyang, Gyeonggi-Do, 10408, Republic of Korea.
- Department of Cancer AI and Digital Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang-Si, Goyang, Gyeonggi-Do, 10408, Republic of Korea.
| | - Hyunsoon Cho
- Department of Cancer AI and Digital Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang-Si, Goyang, Gyeonggi-Do, 10408, Republic of Korea.
- Integrated Biostatistics Branch, Division of Cancer Data Science, Research Institute, National Cancer Center, Goyang, Republic of Korea.
| |
Collapse
|
3
|
Tran TXM, Jung SY, Lee EG, Cho H, Cho J, Lee E, Chang YJ, Cho H. Long-term trajectory of postoperative health-related quality of life in young breast cancer patients: a 15-year follow-up study. J Cancer Surviv 2023; 17:1416-1426. [PMID: 35279800 DOI: 10.1007/s11764-022-01165-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Breast cancer (BC) patients often experience various long-term sequelae due to aggressive treatment. We analyzed and illustrated long-term trajectory during different phases of treatment and survivorship. METHODS Data were obtained from a cohort of 298 BC patients diagnosed between 2004 and 2006 and were followed up until 2020. We measured HRQoL using EORTC QLQ-C30, QLQ-BR23, and EuroQoL-5D questionnaires and conducted eight assessments right after initial diagnosis, during treatment, post-treatment, and during survivorship phases. Linear mixed model was used to assess changes in HRQoL. Overall HRQoL measured by EQ-5D index of long-term BC survivors were further compared with that of the age-matched general population. RESULTS Of 298 participants, 246 women survived and 124 participated in the long-term follow-up survey (LTFU). Overall, HRQoL functions deteriorated during treatment but gradually improved between 1- and 3-year post-diagnosis and stabilized over LTFU measure. Significant recovery was observed in physical, role, emotional, social functions, and future perspectives (p < 0.05). Treatment-related acute symptoms were reported in the first year but diminished afterward, and treatment-related financial difficulties lessened. At LTFU, BC survivors reported a high level of insomnia, fatigue, and pain and appeared to have poorer overall HRQoL than the general population (mean difference, EQ-5D index: 0.073, p < 0.001). CONCLUSIONS Through 15-year survivorship, BC survivors showed improvement in many aspects of HRQoL. However, some inferior aspects remain relevant for long-term survivors. Ongoing supportive programs concentrating on pain management, persistent cancer-related fatigue, and sleeping problems might aid enhance their HRQoL.
Collapse
Affiliation(s)
- Thi Xuan Mai Tran
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, 10408, Goyang, Republic of Korea
| | - So-Youn Jung
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, 10408, Republic of Korea
| | - Eun-Gyeong Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, 10408, Republic of Korea
| | - Heeyoun Cho
- Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, 10408, Republic of Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06351, Republic of Korea
| | - Eunsook Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, 10408, Republic of Korea
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, 10408, Republic of Korea
| | - Yoon Jung Chang
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, 10408, Goyang, Republic of Korea.
- Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, 10408, Republic of Korea.
| | - Hyunsoon Cho
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, 10408, Goyang, Republic of Korea.
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, 10408, Republic of Korea.
| |
Collapse
|
4
|
Hoogland AI, Small BJ, Oswald LB, Bryant C, Rodriguez Y, Gonzalez BD, Li X, Janelsins MC, Bulls HW, James BW, Arboleda B, Colon-Echevarria C, Townsend MK, Tworoger SS, Rodriguez PC, Bower JE, Apte SM, Wenham RM, Jim HSL. Relationships among Inflammatory Biomarkers and Self-Reported Treatment-Related Symptoms in Patients Treated with Chemotherapy for Gynecologic Cancer: A Controlled Comparison. Cancers (Basel) 2023; 15:3407. [PMID: 37444517 PMCID: PMC10340589 DOI: 10.3390/cancers15133407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Previous research suggests that inflammation triggers cancer-treatment-related symptoms (i.e., fatigue, depression, and disruptions in sleep and physical activity), but evidence is mixed. This study examined relationships between inflammatory biomarkers and symptoms in patients with gynecologic cancer compared to age-matched women with no cancer history (i.e., controls). Patients (n = 121) completed assessments before chemotherapy cycles 1, 3, and 6, and 6 and 12 months later. Controls (n = 105) completed assessments at similar timepoints. Changes in inflammation and symptomatology were evaluated using random-effects mixed models, and cross-sectional differences between patients and controls in inflammatory biomarkers and symptoms were evaluated using least squares means. Associations among inflammatory biomarkers and symptoms were evaluated using random-effects fluctuation mixed models. The results indicated that compared to controls, patients typically have higher inflammatory biomarkers (i.e., TNF-alpha, TNFR1, TNFR2, CRP, IL-1ra) and worse fatigue, depression, and sleep (ps < 0.05). Patients reported lower levels of baseline physical activity (p = 0.02) that became more similar to controls over time. Significant associations were observed between CRP, depression, and physical activity (ps < 0.05), but not between inflammation and other symptoms. The results suggest that inflammation may not play a significant role in fatigue or sleep disturbance among gynecologic cancer patients but may contribute to depression and physical inactivity.
Collapse
Affiliation(s)
- Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (A.I.H.)
| | - Brent J. Small
- School of Aging Studies, University of South Florida, Tampa, FL 33612, USA
| | - Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (A.I.H.)
| | - Crystal Bryant
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (A.I.H.)
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (A.I.H.)
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (A.I.H.)
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (A.I.H.)
| | - Michelle C. Janelsins
- Department of Surgery and Neuroscience, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Hailey W. Bulls
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Brian W. James
- Morsani College of Medicine, University of South Florida, Tampa, FL 33602, USA
| | - Bianca Arboleda
- Morsani College of Medicine, University of South Florida, Tampa, FL 33602, USA
| | | | - Mary K. Townsend
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Shelley S. Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | | | - Julienne E. Bower
- Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Sachin M. Apte
- Department of Obstetrics and Gynecology, Huntsman Cancer Institute, Salt Lake City, UT 84132, USA
| | - Robert M. Wenham
- Department of Gynecologic Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (A.I.H.)
| |
Collapse
|
5
|
Psychosocial Interventions for the Treatment of Cancer-Related Fatigue: An Umbrella Review. Curr Oncol 2023; 30:2954-2977. [PMID: 36975439 PMCID: PMC10047125 DOI: 10.3390/curroncol30030226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/04/2023] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Cancer-related fatigue is one of the most common symptoms of cancer and one of those referred by patients as the most disabling. However, we still do not have enough evidence to allow us to recommend effective and personalized approaches. Goal: To provide evidence on the efficacy of ASCO-recommended psychosocial interventions for reducing cancer-related fatigue. Methodology: A general quantitative systematic review for nonprimary clinical interventions that allows the collection, synthesis and analysis of already published reviews. Systematic reviews of RTCs were selected as these make up the body of knowledge that provides the most evidence in an umbrella format. The results do not provide clear or comparable evidence regarding the different interventions, with moderate evidence standing out for cognitive interventions and mindfulness. Conclusions: Research gaps, study biases and the need for further research to ask more precise questions and to make reliable recommendations to mitigate the impact of cancer-related fatigue are evident.
Collapse
|
6
|
Jung JY, Yun YH. Different effects between the current capability of and changes in self-management strategies on improving health behavior and psychological health after 6 months: evidence from a prospective cohort study of patients with cancer. Qual Life Res 2022; 32:1107-1117. [PMID: 36515757 DOI: 10.1007/s11136-022-03320-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE We aimed to examine different effects of the current capability of and changes in self-management strategies on improving health behavior and psychological health (satisfaction of life, depression, and anxiety) after 6 months in cancer patients. METHODS A prospective cohort study was conducted, including 540 cancer patients. We measured cancer patients' self-management strategies' capability with Smart Management Strategies for Health (SMASH) Assessment Tool (SAT) baseline scores and changes with SMASH change scores based on a clinically meaningful 10% change of the scores. We conducted adjusted multivariate multiple logistic regression analyses using the stepwise selection method between SMASH baseline and health behavior, satisfaction with life (SWL), depression, and anxiety and between SMASH changes and health behavior, SWL, depression, and anxiety. RESULTS 256 cancer patients completed both the first and second surveys. While various SMASH capabilities positively affected each health behavior, SWL, depression, and anxiety, the positive-reframing strategy at baseline only affected all health behavior, SWL, and depression. However, based on SMASH changes, using the positive-reframing strategy a lot for 6 months adversely affected some physical health behaviors' practice (balanced diet and stop smoking and drinking). Changes in the life value pursuing strategy only positively affected HB (proactive living) and anxiety. CONCLUSION SMASH baseline and change scores were generally associated with practicing cancer patients' health behaviors, lower depression, and anxiety. However, it is necessary to consider that excessively using the positive-reframing strategy would interfere with practicing a balanced diet and stopping smoking and drinking behaviors.
Collapse
Affiliation(s)
- Ju Youn Jung
- Department of Biomedical Science, Seoul National University College of Medicine and Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, South Korea
| | - Young Ho Yun
- Department of Family Medicine, Seoul National University College of Medicine and Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, 110-799, South Korea.
| |
Collapse
|
7
|
Owrangi M, Gholamzadeh MJ, Vasaghi Gharamaleki M, Mousavi SZ, Kamali AM, Dehghani M, Chakrabarti P, Nami M. Comparative analysis of the chemotherapy-related cognitive impairments in patients with breast cancer: a community-based research. Cancer Invest 2022; 40:811-821. [PMID: 35880822 DOI: 10.1080/07357907.2022.2106489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
This study aimed to evaluate the effects of two common chemotherapy regimens on breast cancer (BC) survivors' cognition. The participants comprised 35 patients with BC who underwent two chemotherapy regimens, AC-T and TAC, and 24 matched healthy volunteers. The participants were assessed regarding cognitive function through Addenbrooke's Cognitive Examination and Cambridge Brain Science tests. The results represent the AC-T regimen to be more toxic than the TAC in domains of language, concentration, and visuospatial working memory (P-value =0.036, 0.008, and 0.031, respectively) and should be prescribed with caution in patients with BC suffering from baseline cognitive impairments.
Collapse
Affiliation(s)
- Maryam Owrangi
- Students' Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Seyedeh Zahra Mousavi
- Students' Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali-Mohammad Kamali
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,DANA Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
| | - Mehdi Dehghani
- Hematology research center, Department of Hematology and Medical Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,DANA Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran.,Academy of Health, Senses Cultural Foundation, Sacramento, CA, USA.,Neuroscience Center, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama City, Republic of Panama.,Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Pardis, Tehran, Iran.,Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
| |
Collapse
|
8
|
Nabulsi NA, Naing KW, Deng H, Cueto J, Asfaw AA, Hubbard CC, Zhou J, Lee I, Mitra D, Calip GS, Law EH. Health-related Quality of Life in Hormone Receptor-Positive Early Breast Cancer: Analyses From the Surveillance, Epidemiology, and End Results Medicare Health Outcomes Survey. J Patient Exp 2022; 9:23743735221113058. [PMID: 35846244 PMCID: PMC9277434 DOI: 10.1177/23743735221113058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study describes health-related quality of life (HRQoL) among older Medicare
beneficiaries with hormone receptor-positive (HR+) early breast cancer (eBC).
Women aged ≥65 years diagnosed with stage I-III HR+ eBC between 1997 and 2014
using the Surveillance, Epidemiology, and End Results Medicare Health Outcomes
Survey Data Resource were included. HRQoL was measured using the Short Form
Health Survey including physical/mental component summary (PCS/MCS) scores and
subscales. Patient surveys ≤ 24 months post-diagnosis were matched to
non-cancer controls. Mean differences in HRQoL were compared using analysis of
covariance. Among 1880 HR+ eBC patients versus 5640 matched non-cancer controls,
eBC patients surveyed ≤ 6 months post-diagnosis (n = 530) scored lower on
component scores (PCS mean difference = 1.6 [95%CI: 0.6-2.6]; MCS mean
difference = 2.0 [95%CI: 1.0-3.0]) and multiple subscales. Among women
surveyed 19 to 24 months post-diagnosis (n = 402), mean differences in HRQoL
were modest (PCS: 1.2 [95%CI: 0.1-2.4]; MCS: −1.5 [95%CI: −2.7 to −0.3]). Most
differences in HRQoL following diagnosis of eBC did not indicate statistical
significance or minimally important difference, emphasizing that preservation of
HRQoL is an important and realistic goal among patients with eBC.
Collapse
Affiliation(s)
- Nadia A Nabulsi
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Khatija W Naing
- Division of Health Policy and Administration, University of Illinois at Chicago, Chicago, IL, USA
| | - Huiwen Deng
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Jenilee Cueto
- Formerly Patient & Health Impact, Pfizer, Inc., New York, NY, USA
| | - Alemseged A Asfaw
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Colin C Hubbard
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Jifang Zhou
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Inyoung Lee
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Gregory S Calip
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
- Flatiron Health, New York, NY, USA
| | - Ernest H Law
- Patient & Health Impact, Pfizer, Inc., New York, NY, USA
| |
Collapse
|
9
|
Lei YY, Ho SC, Cheung KL, Yeo VA, Lee R, Kwok C, Cheng A, Mo FKF, Yeo W. Higher Level of Sports Activities Participation during Five-Year Survival Is Associated with Better Quality of Life among Chinese Breast Cancer Survivors. Cancers (Basel) 2021; 13:cancers13236056. [PMID: 34885168 PMCID: PMC8656618 DOI: 10.3390/cancers13236056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/20/2021] [Accepted: 11/30/2021] [Indexed: 02/08/2023] Open
Abstract
Simple Summary Engaging in sports activities is strongly encouraged for cancer survivors. We aim to investigate the association between the level of sports activities participation post-diagnosis and quality of life (QoL) among Chinese women with early-stage breast cancer during the first five years of survival. Notably, we confirm in this work that regular participation in sports activities following cancer diagnosis may have a positive effect on patients’ QoL. Abstract Evidence about the association between the level of sports activities participation post-diagnosis and quality of life (QoL) among Chinese women with early-stage breast cancer is limited. A validated modified Chinese Baecke questionnaire was used to prospectively measure sports activities among a breast cancer cohort at four time-points: baseline and 18, 36, and 60 months after diagnosis (sports activities during the previous 12 months before each interview); QoL was measured at the same time. In total, 1289, 1125, and 1116 patients were included in the analyses at 18-, 36- and 60-month follow-up, respectively. The percentages of patients who belonged to no (0 metabolic equivalent of task (MET)-hours per week), low-level (<10 MET-hours/week), and high-level (≥10 MET-hours/week) sports activities group were 20.7%, 45.5%, and 33.8% at 18-month follow-up, respectively; the corresponding figures at 36 and 60 months differed slightly. Using data from the three follow-ups, generalized estimating equation (GEE) analyses showed that higher levels of sports activities participation were associated with better QoL in several items as well as fewer symptoms. The present findings in Chinese women with breast cancer provide important evidence on the beneficial effect of regular participation in sports activities following cancer diagnosis on patients’ QoL.
Collapse
Affiliation(s)
- Yuan-Yuan Lei
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong, China; (Y.-Y.L.); (K.L.C.); (V.A.Y.); (R.L.); (F.K.F.M.)
| | - Suzanne C. Ho
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong, China;
| | - Ka-Li Cheung
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong, China; (Y.-Y.L.); (K.L.C.); (V.A.Y.); (R.L.); (F.K.F.M.)
| | - Victoria A. Yeo
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong, China; (Y.-Y.L.); (K.L.C.); (V.A.Y.); (R.L.); (F.K.F.M.)
| | - Roselle Lee
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong, China; (Y.-Y.L.); (K.L.C.); (V.A.Y.); (R.L.); (F.K.F.M.)
| | - Carol Kwok
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, China; (C.K.); (A.C.)
| | - Ashley Cheng
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, China; (C.K.); (A.C.)
| | - Frankie K. F. Mo
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong, China; (Y.-Y.L.); (K.L.C.); (V.A.Y.); (R.L.); (F.K.F.M.)
- State Key Laboratory in Oncology in South China, Faculty of Medicine, Hong Kong Cancer Institute, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Winnie Yeo
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong, China; (Y.-Y.L.); (K.L.C.); (V.A.Y.); (R.L.); (F.K.F.M.)
- State Key Laboratory in Oncology in South China, Faculty of Medicine, Hong Kong Cancer Institute, The Chinese University of Hong Kong, New Territories, Hong Kong, China
- Correspondence: ; Tel.: +852-26322118
| |
Collapse
|
10
|
The Impact of Socioeconomic Determinants on the Quality of Life of Moroccan Breast Cancer Survivors Diagnosed Two Years Earlier at the National Institute of Oncology in Rabat. Obstet Gynecol Int 2021; 2021:9920007. [PMID: 34257668 PMCID: PMC8249154 DOI: 10.1155/2021/9920007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/11/2021] [Indexed: 01/30/2023] Open
Abstract
Introduction The objective of this study was to investigate the impact of socioeconomic determinants on the quality of life of Moroccan women with breast cancer two years after their diagnosis who are followed up at the National Institute of Oncology (INO) in Rabat. Methods This is a cross-sectional study that was conducted between May 2019 and September 2020. The sample size was 304 women. Data were collected using the EORTC QLQ-C30 and EORTC QLQ-BR 23 questionnaires in the Moroccan dialect. Results The mean age of participants was 53.5 ± 12.4 years, where the majority resided in urban areas and more than half were illiterate. Moreover, three-quarters of the survivors were not working, and almost all have basic medical coverage. Nearly one-third of the respondents had experienced discrimination from those around them, and nearly half attributed the decrease in income to their state of health. In addition, 38.2 percent of participants stated that they had great difficulty living on their monthly income after the illness, whereas more than half of the survivors had a good quality of life in terms of overall health (GHS/QOL). Besides, social function obtained the highest score, while emotional function obtained the lowest score. Furthermore, financial difficulty was the most distressing symptom. Indeed, income adjustment after the disease, discrimination, distance between home and treatment center, professional status, and medical coverage were correlated with GHS/QOL. Regression analysis revealed that income adjustment after illness and discrimination were significant predictors of GHS/QOL. Conclusion The data suggest establishing a financial support program and the development of education and awareness-raising policies to combat discrimination.
Collapse
|
11
|
Jackson I, Rowan P, Padhye N, Hwang LY, Vernon SW. Racial/ethnic differences in health-related quality of life among female breast cancer survivors: cross-sectional findings from the Medical Expenditure Panel Survey. Public Health 2021; 196:74-81. [PMID: 34161858 DOI: 10.1016/j.puhe.2021.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/25/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Breast cancer survivors have reported worse health-related quality of life (HRQoL) outcomes on some subscales when compared with members of the general population. However, the increased attention to breast cancer survivorship should have improved the HRQoL of these survivors. Our aim was to examine whether physical and mental component scores (PCS-12 and MCS-12) using the Short Form (SF-12) questionnaire were different for racial/ethnic minorities, specifically for Black and Hispanic women relative to White women. Furthermore, we stratified the data by age group to evaluate these racial/ethnic differences in HRQoL of breast cancer survivors. STUDY DESIGN Cross-sectional study. METHODS Pooled cross-sectional analyses using data from the Medical Expenditure Panel Survey between 2008 and 2016 were conducted. Pooled ordinary least squares (OLS) regression was used to examine the racial/ethnic differences in PCS-12 and MCS-12 scores of breast cancer survivors. Furthermore, stratified analyses by age group were conducted to evaluate racial/ethnic differences in HRQoL by the age of breast cancer survivors. RESULTS After adjusting for confounders, there was no association between race/ethnicity and PCS-12 scores. However, Hispanic breast cancer survivors had statistically significantly lower MCS-12 scores (by 1.9 points [95% confidence interval {CI}: -3.53 to -0.37]) when compared with White breast cancer survivors. For PCS-12, after stratifying by age, the adjusted analyses showed no significant differences in PCS-12 scores when White female breast cancer survivors were compared with the other racial/ethnic categories. On the other hand, Black female survivors aged <50 years had 4.3 points (95% CI: 0.46-8.13) higher MCS-12 scores when compared with their White counterparts, while Hispanic breast cancer survivors aged <50 years had 3.1 points (95% CI: -0.40-6.69) higher MCS-12 scores relative to White women. Furthermore, among female breast cancer survivors aged ≥50 years, Hispanic women had 3.2 points (95% CI: -4.98 to -1.40) lower MCS-12 scores than White women. CONCLUSION Our study generated findings showing the racial/ethnic differences in HRQoL of breast cancer survivors and presented results stratified by age group. These findings provide the much-needed rationale for targeted and racial/ethnic-specific HRQoL improvement strategies among breast cancer survivors.
Collapse
Affiliation(s)
- I Jackson
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas-Houston School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - P Rowan
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas-Houston School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA; Division of Management, Policy, and Community Health, The University of Texas-Houston School of Public Health, Houston, TX, USA
| | - N Padhye
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - L Y Hwang
- Department of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, University of Texas-Houston School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - S W Vernon
- University of Texas School of Public Health, Center for Health Promotion and Prevention Research, Division of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| |
Collapse
|
12
|
Trends in health-related quality of life of female breast cancer survivors using the Medical Expenditure Panel Survey (MEPS), 2008-2016. Qual Life Res 2021; 30:3547-3558. [PMID: 34052940 DOI: 10.1007/s11136-021-02895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE In recent years, breast cancer detection and treatment have advanced. As a result, increased attention to breast cancer survivorship should have improved their health-related quality of life (HRQoL). Our aim was to examine the trends in the HRQoL of female breast cancer survivors between 2008 and 2016, to determine whether or not the increased focus on survivorship has translated into improved HRQoL. Furthermore, stratified analyses were conducted by race/ethnicity and age group and these were compared to a similar group of women without a breast cancer history. METHODS Repeated cross-sectional analyses using the Medical Expenditure Panel Survey between 2008 and 2016 were conducted. Pooled ordinary least squares (OLS) regression was used to examine the trends in physical component scores (PCS-12) and mental component scores (MCS-12) among breast cancer survivors and a similar population of women without a breast cancer history. Analyses stratified by race/ethnicity and age group were also conducted. RESULTS Among breast cancer survivors, after adjusting for confounders, there was no change in PCS-12 scores over time, but the MCS-12 scores increased by 0.27 points (95% CI 0.09-0.45). Those without a history of breast cancer had mean PCS-12 scores that were 0.13 points greater each year (95% CI 0.02-0.24) while their mean MCS-12 scores were 0.10 (95% CI 0.00-0.21) points greater each year. After stratifying by race/ethnicity, Hispanic breast cancer survivors had a small increase in PCS-12 (β: 0.65; 95% CI 0.01-1.29), and MCS-12 scores (β: 0.70; 95% CI 0.06-1.33) over time. Similar small effects were found when stratified by age group, both among breast cancer survivors and those without a history of breast cancer. The younger age group (< 50 years) reported poorer MCS-12 than the older population (age 50 years and above). CONCLUSION Our study generated findings showing the trends in the HRQoL of breast cancer survivors and compared these to a similar population of women without a history of breast cancer. This paper highlights the importance of focusing on the mental health of young breast cancer survivors to improve their prospects at a good quality of life post-breast cancer diagnosis and treatment.
Collapse
|
13
|
Longitudinal change of quality of life in the first five years of survival among disease-free Chinese breast cancer survivors. Qual Life Res 2021; 30:1583-1594. [PMID: 33447955 DOI: 10.1007/s11136-020-02729-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE This study aimed to investigate changes of QoL during the first 5 years of survival among disease-free Chinese breast cancer survivors. METHODS A prospective cohort study enrolled 1462 Chinese women with early-stage breast cancer, and longitudinally visited those patients at four time-points, namely baseline (T0), 18- (T1), 36- (T2), and 60-month (T3) after diagnosis. This study included 992 patients who were disease-free during the first 5 years of survival and who had completed QoL assessments at all four time-points. RESULTS The score of global health status/QoL improved gradually (T1, T2, T3 > T0; P < 0.001 for overall comparisons). Social functioning score significantly improved when compared to that of T0 (T1, T2, T3 > T0; P < 0.001 for overall comparisons). In contrast, cognitive functioning score decreased (T0 > T1, T2, T3; P < 0.001 for overall comparisons). Scores of physical functioning, role functioning and emotional functioning showed a fluctuated picture, with the highest score achieved at T1. In symptoms profile, most of them scored lowest at T1 (best QoL). Multivariate analysis showed that several characteristics significantly correlated to changes in QoL from T0 to T3. For instance, patients with higher education had better recovery of physical functioning, role functioning, and social functioning. CONCLUSION During the first 5 years of survival, patients' global health status/QoL improved over time, social functioning consistently improved, but cognitive functioning steadily deteriorated. Most of functioning domains and symptoms improved at 18-month follow-up, but such improvements were not maintained and even deteriorated at 36- and 60-month post-diagnosis. This study suggested that some interventions should be investigated during such period.
Collapse
|
14
|
Siembida EJ, Reeve BB, Zebrack BJ, Snyder MA, Salsman JM. Measuring health-related quality of life in adolescent and young adult cancer survivors with the National Institutes of Health Patient-Reported Outcomes Measurement Information System ® : Comparing adolescent, emerging adult, and young adult survivor perspectives. Psychooncology 2020; 30:303-311. [PMID: 33073416 DOI: 10.1002/pon.5577] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/10/2020] [Accepted: 10/13/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Our knowledge of symptom burden and functioning among adolescent and young adult (AYA; diagnosed ages 15-39) cancer survivors has been hindered by variability in health-related quality of life (HRQOL) measurement associated with developmental and disease heterogeneity among AYAs. We aimed to examine the variability in domain-specific aspects of HRQOL as a function of cancer type and developmental stage to clarify commonalities and differences using the NIH Patient-Reported Outcome Measurement Information System® . METHODS Five hundred seventy-two AYAs were recruited by an online research panel using stratified sampling (treatment status: on vs. off; developmental stage: adolescents, emerging adults, young adults). Participants completed questionnaires that included sociodemographic characteristics, clinical history, and the adult version of the Patient-Reported Outcomes Measurement Information System® -29 (PROMIS-29). Generalized linear models were run for each HRQOL domain and included treatment status, developmental stage, and cancer type (hematologic vs. solid tumor) and their interactions as independent variables. RESULTS There were no significant differences in any HRQOL domain by cancer type, and few significant differences were observed in PROMIS domains between developmental groups among on-treatment AYA survivors. In contrast, off-treatment emerging adults and young adults reported significantly higher symptoms and worse functioning compared to adolescents (all ps ≤ 0.003). CONCLUSIONS AYAs diagnosed in different developmental stages, particularly among off-treatment survivors, experienced diverse constellations of symptoms and functioning, and developmental stage was a more critical predictor of HRQOL than cancer type. These results suggest that supportive care interventions developed for AYA cancer survivors must be tailored and flexible by developmental stage and treatment status.
Collapse
Affiliation(s)
- Elizabeth J Siembida
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Brad J Zebrack
- School of Social Work, University of Michigan, Ann Arbor, Missouri, USA
| | - Mallory A Snyder
- Office of Research and National Laboratories, The University of Chicago, Illinois, Chicago, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine & the Wake Forest Baptist Comprehensive Cancer Center, North Carolina, Winston-Salem, USA
| |
Collapse
|
15
|
Mothers’ Attitudes toward the Use of Complementary and Alternative Medicine in Children with Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.104870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Children who have cancer suffer from a wide range of symptoms and side-effects of disease and treatment, and such conditions have harmful effects on the quality of life of a child and family. So, the families of such children turn to complementary and alternative medicine treatments for children with cancer. Objectives: Therefore, this study aimed at determining the mothers’ attitudes toward the use of complementary and alternative medicine in children with cancer. Methods: This cross-sectional research was conducted from January 2018 to January 2019 in the oncology section of Yazd Shahid Sadooghi Hospital in a nonrandom and convenience sampling method on 150 mothers of children with cancer. The instruments of data collection include demographic information questionnaires and a 6-part questionnaire to evaluate mothers’ performance. To investigate the face and content validity of the questionnaire, the opinions of 10 experts were considered, and to investigate the reliability of the questionnaire, the test-retest method was used, and the intraclass correlation coefficient (ICC) was reportedly 0.80. After completing the questionnaires, the collected data were analyzed, using SPSS 23 by utilizing descriptive statistics, including mean, standard deviation (SD), frequency, and percent. Results: Overall, 83.34% of mothers mentioned praying as a way of complementary and alternative medicine, 67.34% used complementary and alternative medicine to increase child recovery chance, 74% reported general child recovery, 20% reported the occurrence of side-effects following the use of complementary and alternative medicine, 67.33% introduced their friends as their information source, 33.6% avoided informing the physician regarding the use of complementary and alternative medicine, and 76% maintained that due to the objection of physicians, they avoided informing him/her. Conclusions: The use of complementary and alternative medicine is common among mothers but due to the occurrence of side-effects, using invalid information sources and hiding it from a physician, the oncologists must provide a suitable opportunity for asking and answering to guide mothers for correct performance in the use of complementary and alternative medicine.
Collapse
|
16
|
Panda N, Solsky I, Hawrusik B, Liu G, Reeder H, Lipsitz S, Desai EV, Lowery KW, Miller K, Gadd MA, Lubitz CC, Smith BL, Specht M, Onnela JP, Haynes AB. Smartphone Global Positioning System (GPS) Data Enhances Recovery Assessment After Breast Cancer Surgery. Ann Surg Oncol 2020; 28:985-994. [PMID: 32812109 DOI: 10.1245/s10434-020-09004-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/18/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE We sought to determine whether smartphone GPS data uncovered differences in recovery after breast-conserving surgery (BCS) and mastectomy, and how these data aligned with self-reported quality of life (QoL). METHODS In a prospective pilot study, adult smartphone-owners undergoing breast surgery downloaded an application that continuously collected smartphone GPS data for 1 week preoperatively and 6 months postoperatively. QoL was assessed with the Short-Form-36 (SF36) via smartphone delivery preoperatively and 4 and 12 weeks postoperatively. Endpoints were trends in daily GPS-derived distance traveled and home time, as well as SF36 Physical (PCS) and Mental Component Scores (MCS) comparing BCS and mastectomy patients. RESULTS Thirty-one patients were included. Sixteen BCS and fifteen mastectomy patients were followed for a mean of 201 (SD 161) and 174 (107) days, respectively. There were no baseline differences in demographics, PCS/MCS, home time, or distance traveled. Through 12 weeks postoperatively, mastectomy patients spent more time at home [e.g., week 4: 16.7 h 95% CI (14.3, 19.6) vs. 11.0 h (9.4, 12.9), p < 0.001] and traveled shorter distances [e.g., week 4: 52.5 km 95% CI (36.1, 76.0) vs. 107.7 km (75.8-152.9), p = 0.009] compared with BCS patients. There were no significant QoL differences throughout the study as measured by the MCS [e.g., week 4 difference: 7.83 95% CI (- 9.02, 24.7), p = 0.362] or PCS [e.g., week 4 difference: 8.14 (- 6.67, 22.9), p = 0.281]. GPS and QoL trends were uncorrelated (ρ < ± 0.26, p > 0.05). CONCLUSIONS Differences in BCS and mastectomy recovery were successfully captured using smartphone GPS data. These data may describe currently unmeasured aspects of physical and mental recovery, which could supplement traditional and QoL outcomes to inform shared decision-making.
Collapse
Affiliation(s)
- Nikhil Panda
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. School of Public Health, Boston, MA, USA. .,Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
| | - Ian Solsky
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. School of Public Health, Boston, MA, USA.,Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Becky Hawrusik
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. School of Public Health, Boston, MA, USA
| | - Gang Liu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Harrison Reeder
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stuart Lipsitz
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. School of Public Health, Boston, MA, USA
| | - Eesha V Desai
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. School of Public Health, Boston, MA, USA
| | - Kurt W Lowery
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. School of Public Health, Boston, MA, USA
| | - Kate Miller
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. School of Public Health, Boston, MA, USA
| | - Michele A Gadd
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Carrie C Lubitz
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Barbara L Smith
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Michelle Specht
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Jukka-Pekka Onnela
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. School of Public Health, Boston, MA, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alex B Haynes
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. School of Public Health, Boston, MA, USA.,Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
17
|
Ruiz-Casado A, Álvarez-Bustos A, de Pedro CG, Méndez-Otero M, Romero-Elías M. Cancer-related Fatigue in Breast Cancer Survivors: A Review. Clin Breast Cancer 2020; 21:10-25. [PMID: 32819836 DOI: 10.1016/j.clbc.2020.07.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/12/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023]
Abstract
Fatigue has been the most distressing and frequent symptom in breast cancer (BC) survivors after treatment. Although fatigue can occur in other cancer survivors, women with a history of BC might share some distinctive features. The present study aimed to recapitulate the knowledge about risk factors and correlates of cancer-related fatigue (CRF) in BC survivors after oncologic therapy. An electronic data search was conducted in PubMed using the terms "fatigue," "breast," "cancer," and "survivors." Records were included if they were original articles, available in English, had used a quantitative scale, had > 100 participants, and had excluded women with BC relapse. BC survivors were required to have finished their treatments ≥ 2 months before, except for hormonal therapy. The physiopathology and other interventions were considered beyond the scope of our review. The correlates were subsequently classified into 7 main categories: (1) sociodemographic data, (2) physical variables, (3) tumor- and treatment-related variables, (4) comorbidities, (5) other symptoms, (6) psychological issues, and (7) lifestyle factors. Fatigue was consistently greater in younger, obese, and diabetic women. Women reporting fatigue often communicated symptoms such as pain, depression, insomnia, and cognitive dysfunction. Coping strategies such as catastrophizing could play an important role in the persistence of fatigue. However, tumor characteristics, previous treatments received, and physical activity were not consistently reported. CRF was a strong predictor of the quality of life of BC survivors after treatment. In conclusion, we found CRF was a frequent and serious symptom that severely affects the quality of life of BC survivors after treatment. Health practitioners require more awareness and information about CRF.
Collapse
Affiliation(s)
- Ana Ruiz-Casado
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain.
| | | | - Cristina G de Pedro
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Marta Méndez-Otero
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - María Romero-Elías
- Department of Sport Sciences, Sport Research Centre, Miguel Hernandez University of Elche, Alicante, Spain
| |
Collapse
|
18
|
Cheng L, Kotronoulas G. How effective are self-management interventions in promoting health-related quality of life in people after primary treatment for breast cancer? A critical evidence synthesis. Eur J Oncol Nurs 2020; 47:101776. [PMID: 32570063 DOI: 10.1016/j.ejon.2020.101776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Self-management interventions (SMIs) are designed to empower people living beyond breast cancer and help them adjust to a new normal. This structured review aimed to critically appraise and synthesise up-to-date evidence on the effectiveness of SMIs to promote health-related quality of life (HRQoL) in people with breast cancer in the post-treatment period. METHODS According to PRISMA statement guidelines, MEDLINE, EMBASE and CINAHL were searched for peer-reviewed publications of randomised controlled trials of SMIs. Pre-specified selection criteria were applied to all retrieved records. Methodological quality and risk of bias were evaluated by using the Caldwell framework and Cochrane Collaboration Risk of Bias tool, respectively. Findings were integrated into a narrative critical evidence synthesis. RESULTS Nine eligible trials were identified that tested nine SMIs. Five SMIs were based on cognitive behaviour therapy (CBT). Eight SMIs targeted recipients' decision-making and taking-action skills. Across trials, gains in one to four domains of HRQoL were reported. SMIs predominantly promoted recipients' physical and functional well-being, regardless of methodological quality or self-management skills applied, but effect sizes were consistently small. SMIs were mainly prescribed for 12 weeks, but optimal dosage cannot be confirmed currently. SMIs informed by CBT and/or offered through recipient education were marginally more effective. Evidence derived from moderate-to-good quality trials. CONCLUSIONS SMIs are potentially effective after primary treatment for breast cancer, although effect sizes are small and inconsistent across HRQoL domains. More rigorous development and testing is required, while co-production from the early development stages or at the refinement phase is recommended.
Collapse
Affiliation(s)
- Lin Cheng
- Nursing & Health Care, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Grigorios Kotronoulas
- Nursing & Health Care, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
| |
Collapse
|
19
|
Villarreal-Garza C, Platas A, Miaja M, Fonseca A, Mesa-Chavez F, Garcia-Garcia M, Chapman JA, Lopez-Martinez EA, Pineda C, Mohar A, Galvez-Hernandez CL, Castro-Sanchez A, Martinez-Cannon BA, Barragan-Carrillo R, Muñoz-Lozano JF, Goss P, Bargallo-Rocha JE, Aguilar D, Cardona S, Canavati M. Young Women With Breast Cancer in Mexico: Results of the Pilot Phase of the Joven & Fuerte Prospective Cohort. JCO Glob Oncol 2020; 6:395-406. [PMID: 32142405 PMCID: PMC7113130 DOI: 10.1200/jgo.19.00264] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2020] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The pilot-phase report of the Joven & Fuerte prospective cohort broadly characterizes and assesses the needs of Mexican young women with breast cancer (YWBC). PATIENTS AND METHODS Women age ≤ 40 years with nonmetastatic primary breast cancer were consecutively accrued from 2 hospitals. Data were collected at the first/baseline oncology visit and 2 years later using a sociodemographic survey, European Organisation for Research and Treatment of Cancer Quality-of-Life (QOL) Questionnaire Core 30 (QLQ-C30) and Breast Cancer-Specific QOL Questionnaire (QLQ-BR23), Hospital Anxiety and Depression Scale (HADS), Female Sexual Functioning Index (FSFI), Sexual Satisfaction Inventory, and patients' medical records. Pearson χ2 and 2-sided t tests were used for statistical analysis. An unadjusted P value < .05 was considered significant. RESULTS Ninety patients were included, all with government health care coverage. Most had low monthly household incomes (98%) and at least a high school education (59%). There was a considerable prevalence of unpartnered patients (36%) and unmet parity (25%). Patients' most common initial symptom was a palpable mass (84%), and they were most frequently diagnosed with stage III disease (48%), with 51% having had a physician visit ≤ 3 months since detection but 39% receiving diagnosis > 12 months later. At baseline, 66% of patients were overweight/obese, and this proportion had significantly increased by 2 years (P < .001). Compared with baseline, global QLQ-C30 had improved significantly by 2 years (P = .004), as had HADS-Anxiety (P < .001). However, both at baseline and at 2 years, nearly half of patients exhibited FSFI sexual dysfunction. CONCLUSION These preliminary findings demonstrate that YWBC in Mexico have particular sociodemographic and clinicopathologic characteristics, reinforcing the necessity to further describe and explore the needs of these young patients, because they may better represent the understudied and economically vulnerable population of YWBC in limited-resource settings.
Collapse
Affiliation(s)
- Cynthia Villarreal-Garza
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Alejandra Platas
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Melina Miaja
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Alan Fonseca
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
| | - Fernanda Mesa-Chavez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Marisol Garcia-Garcia
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Judy-Anne Chapman
- Canadian Cancer Trials Group, Queen’s University, Kingston, ON, Canada (retired)
| | - Edna A. Lopez-Martinez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Claudia Pineda
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
| | - Alejandro Mohar
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Carmen L. Galvez-Hernandez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Andrea Castro-Sanchez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
| | - Bertha-Alejandra Martinez-Cannon
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Regina Barragan-Carrillo
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Jose F. Muñoz-Lozano
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | | | - Juan E. Bargallo-Rocha
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Dione Aguilar
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Servando Cardona
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Mauricio Canavati
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| |
Collapse
|
20
|
Perry LM, Hoerger M, Seibert K, Gerhart JI, O'Mahony S, Duberstein PR. Financial Strain and Physical and Emotional Quality of Life in Breast Cancer. J Pain Symptom Manage 2019; 58:454-459. [PMID: 31163258 PMCID: PMC6708751 DOI: 10.1016/j.jpainsymman.2019.05.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/12/2019] [Accepted: 05/20/2019] [Indexed: 10/26/2022]
Abstract
CONTEXT Few studies have examined the association between financial strain and quality of life outcomes in breast cancer. OBJECTIVES To examine the association between financial strain and key elements of physical and emotional quality of life among women with breast cancer. METHODS Across three geographically diverse samples (census regions: Northeast = 13.2%, Midwest = 26.8%, South = 35.5%, West = 17.4%; international = 7.1%), 309 women with a history of breast cancer completed online surveys including measures of financial strain, depression, anxiety, symptom burden, and perceived health. The third sample (N = 134) also reported financial toxicity that specifically documents financial strain because of medical care costs. Primary analyses assessed the association between financial strain and measures of emotional and physical quality of life. Sensitivity analyses examined associations using the measure of financial toxicity. All analyses were controlled for key covariates. RESULTS Results showed that 37.5% of women experienced financial strain (Samples 1-3), varying from 12.1% among older, married, and college-educated women to 81.0% among women who were younger, unmarried, and lacked a college education. In addition, 26.1% reported treatment-specific financial toxicity (Sample 3). Financial strain was associated with more severe symptoms of depression (P < 0.001) and anxiety (P < 0.001) and worse physical symptom burden (P < 0.001) and perceived health (P < 0.001). Observed effects were sustained in sensitivity analyses using the financial toxicity measure. CONCLUSIONS The present investigation illustrates the importance of financial strain in breast cancer. Healthcare systems are encouraged to expand interdisciplinary palliative and supportive care services that have the expertise necessary to help financially strained patients navigate the cancer care continuum.
Collapse
Affiliation(s)
| | | | | | | | - Sean O'Mahony
- Rush University Medical Center, Chicago, Illinois, USA
| | - Paul R Duberstein
- Rutgers University School of Public Health, Piscataway, New Jersey, USA
| |
Collapse
|
21
|
Leysen L, Lahousse A, Nijs J, Adriaenssens N, Mairesse O, Ivakhnov S, Bilterys T, Van Looveren E, Pas R, Beckwée D. Prevalence and risk factors of sleep disturbances in breast cancersurvivors: systematic review and meta-analyses. Support Care Cancer 2019; 27:4401-4433. [DOI: 10.1007/s00520-019-04936-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 06/11/2019] [Indexed: 01/31/2023]
|
22
|
Mai TTX, Choi JH, Lee MK, Chang YJ, Jung SY, Cho H, Lee ES. Prognostic Value of Post-diagnosis Health-Related Quality of Life for Overall Survival in Breast Cancer: Findings from a 10-Year Prospective Cohort in Korea. Cancer Res Treat 2019; 51:1600-1611. [PMID: 30999723 PMCID: PMC6790846 DOI: 10.4143/crt.2018.426] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 04/10/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose We aimed to evaluate health-related quality of life (HRQOL) at 1-year post-diagnosis in breast cancer (BC) patients and its association with overall survival using data from the National Cancer Center Hospital. Materials and Methods Data of a BC cohort were first obtained between 2004 and 2006 and followed up. HRQOL was assessed using EORTC QLQ-C30 and BC specific module QLQ-BR23 few days after diagnosis and 1 year after that. We examined and compared the difference in the two HRQOL scores measured for each patient by the patient’s current survival status. The Cox proportional hazards model was fitted to evaluate the impact of HRQOL on survival, with adjustment for baseline HRQOL and other factors. Results Of 299 enrolled patients, 206 responded at 1-year post-diagnosis (80.6%) and were followed up for 11.6 years on average. At 1-year post-diagnosis, survivors had better HRQOL scores than those who died, although their health status was similar at baseline. Survivors reported significant increase 1 year after diagnosis in global health status and emotional scales. Between the groups, functional scales such as physical, role, and emotional were significantly different. Functional scales, including physical (adjusted hazard ratio [aHR], 0.70), role (aHR, 0.68), emotional (aHR, 0.72), and symptom scales, including fatigue (aHR, 1.34), dyspnea (aHR, 1.29), appetite loss (aHR, 1.24) were significantly associated with overall survival. Patients who were less worried about future health had favorable survival(aHR, 0.83). Conclusion Besides treatment-related symptoms, non-medical aspects at 1-year post-diagnosis, including functional well-being and future perspective, are predictive of long-term survival. Intervention to enhance physical, role, and emotional support for women soon after their BC diagnosis might help to improve disease survival outcomes afterwards.
Collapse
Affiliation(s)
- Tran Thi Xuan Mai
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Jin Hyuk Choi
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Myung Kyung Lee
- College of Nursing, Kyungpook National University, Daegu, Korea
| | - Yoon Jung Chang
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Hospice and Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - So-Youn Jung
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Hyunsoon Cho
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eun Sook Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| |
Collapse
|
23
|
Khanali Mojen L, Rassouli M, Eshghi P, Zendedel K, Akbari Sari A, Heravi Karimooi M, Tahmasebi M, Shirin Abadi Farahani A. Pediatric Palliative Care in Iran: Applying Regionalization of Health Care Systems. Asian Pac J Cancer Prev 2018; 19:1303-1311. [PMID: 29802691 PMCID: PMC6031829 DOI: 10.22034/apjcp.2018.19.5.1303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Establishing palliative care services is a priority in the health system of Iran. Considering the necessity of integrating these services into the health system, this study aimed to explore the stakeholders’ perceptions about the provision of a conceptual framework for palliative care services for children with cancer according to the health system in of Iran. Methods: The present qualitative study was conducted through in-depth semi-structured interviews held with 29 participants including palliative care specialists, policy-makers, health care providers, the parents of children with cancer selected through purposive sampling, between August 2016 and February 2017. Interviews continued until saturation of data. All interviews were recorded, transcribed and analyzed using MAXQDA10 software. Results: The codes extracted from interviews produced the main theme “ classes of palliative care services” with the two main categories “comprehensive care” including, strengthening family shelter, maintaining the child in a familiar environment, achieving stability and “establishing social justice” including, easy access to services, financial relief and quality care. Conclusion: Presenting a framework based on level of palliative care services, the findings of this study paves the way for integrating these services into Iranian health system.
Collapse
Affiliation(s)
- Leila Khanali Mojen
- Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Abstract
OBJECTIVE To summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer. DESIGN Systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468). METHODS According to the PRISMA guidelines, databases of MEDLINE (PubMed), Embase and PsycINFO were systematically searched using the following terms and synonyms: breast cancer, quality of life and Asia. Articles reporting on HRQL using EORTC-QLQ-C30, EORTC-QLQ-BR23, FACT-G and FACT-B questionnaires in Asian patients with breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the quality assessment scale for cross-sectional studies or the Newcastle-Ottawa Quality Assessment Scale for cohort studies. RESULTS Fifty-seven articles were selected for this qualitative synthesis, of which 43 (75%) were cross-sectional and 14 (25%) were longitudinal studies. Over 75 different determinants of HRQL were studied with either the EORTC or FACT questionnaires. Patients with comorbidities, treated with chemotherapy, with less social support and with more unmet needs have poorer HRQL. HRQL improves over time. Discordant results in studies were found in the association of age, marital status, household income, type of surgery, radiotherapy and hormone therapy and unmet sexuality needs with poor global health status or overall well-being. CONCLUSIONS In Asia, patients with breast cancer, in particular those with other comorbidities and those treated with chemotherapy, with less social support and with more unmet needs, have poorer HRQL. Appropriate social support and meeting the needs of patients may improve patients' HRQL.
Collapse
Affiliation(s)
- Peh Joo Ho
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Sofie A M Gernaat
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Surgery, National University of Singapore, Singapore
| | - Helena M Verkooijen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Imaging Division, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
25
|
Park B, Lee MH, Kong SY, Lee ES. Psychosocial Health of Disease-Free Breast Cancer Survivors Compared with Matched Non-cancer Controls. Cancer Res Treat 2018; 51:178-186. [PMID: 29621874 PMCID: PMC6333996 DOI: 10.4143/crt.2017.585] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 04/03/2018] [Indexed: 01/17/2023] Open
Abstract
PURPOSE The present study investigated the psychosocial health of disease-free breast cancer survivors who receive health examinations compared to matched non-cancer controls in a community setting. Materials and Methods We used baseline data from the Health Examinee cohort, which is composed of subjects participating in health. The disease-free breast cancer survivors were defined as those who were ≥ 2 years from initial diagnosis of breast cancer who had completed treatment. Females without a history of cancer were randomly selected at 1:4 ratio by 5-year age groups, education, and household income as a comparison group. We analyzed results from the Psychosocial Well-being Index-Short Form (PWI-SF) as a psychosocial health measurement. RESULTS A total of 347 survivors of breast cancer and 1,388 matched controls were included. Total scores on the PWI-SF were lower in breast cancer survivors than matched non-cancer controls (p=0.006), suggesting a lower level of psychosocial stress in breast cancer survivors. In comparison to the control group, prevalence of drinking, smoking and obesity were lower, while exercising for ≥ 150 min/wk was higher in breast cancer survivors (p < 0.05). These findings suggest that breast cancer survivors have better health behaviors than their noncancer controls. After adjusting for other sociodemographic variables, breast cancer survivors were 36% less likely to be included in the stress group (odds ratio, 0.64; 95% confidence interval, 0.42 to 0.98). CONCLUSION The disease-free breast cancer survivors resuming daily life demonstrated better psychosocial health status compared to matched non-cancer controls.
Collapse
Affiliation(s)
- Boyoung Park
- Department of Medicine, Hanyang University College of Medicine, Seoul, Korea.,National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Moo Hyun Lee
- Center for Breast Cancer, Hospital, National Cancer Center, Goyang, Korea.,Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
| | - Sun-Young Kong
- Research Institute, National Cancer Center, Goyang, Korea.,Department of Laboratory Medicine, Hospital, National Cancer Center, Goyang, Korea
| | - Eun Sook Lee
- National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Center for Breast Cancer, Hospital, National Cancer Center, Goyang, Korea.,Research Institute, National Cancer Center, Goyang, Korea
| |
Collapse
|
26
|
Alexander K, Conley YP, Levine JD, Cooper BA, Paul SM, Mastick J, West C, Miaskowski C. Cytokine Gene Polymorphisms Associated With Various Domains of Quality of Life in Women With Breast Cancer. J Pain Symptom Manage 2018; 55:334-350.e3. [PMID: 28947144 PMCID: PMC5794537 DOI: 10.1016/j.jpainsymman.2017.09.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 12/18/2022]
Abstract
CONTEXT Little is known about the phenotypic and molecular characteristics associated with various domains of quality of life (QOL) in women after breast cancer surgery. OBJECTIVES In a sample of women with breast cancer (n = 398), purposes were as follows: to identify latent classes with distinct trajectories of QOL from before surgery through six months after surgery and to evaluate for differences in demographic and clinical characteristics, as well as for polymorphisms in cytokine genes, between these latent classes. METHODS Latent class analyses were done to identify subgroups of patients with distinct QOL outcomes. Candidate gene analyses were done to identify cytokine gene polymorphisms associated with various domains of QOL (i.e., physical, psychological, spiritual, social). RESULTS One latent class was identified for the psychological and spiritual domains. Two latent classes were identified for the social domain and overall QOL scores. Three latent classes were identified for the physical domain. For the physical and social domains, as well as for the overall QOL scores, distinct phenotypic characteristics (i.e., younger age, poorer functional status, higher body mass index, and receipt of adjuvant chemotherapy) and a number of cytokine gene polymorphisms (CXCL8, NFKB2, TNFSF, IL1B, IL13, and NFKB1) were associated with membership in the lower QOL classes. CONCLUSIONS Findings suggest that women experience distinctly different physical well-being, social well-being, and total QOL outcomes during and after breast cancer surgery. The genetic associations identified suggest that cytokine dysregulation influences QOL outcomes. However, specific QOL domains may be impacted by different cytokines.
Collapse
Affiliation(s)
| | | | - Jon D Levine
- University of California, San Francisco, California, USA
| | - Bruce A Cooper
- University of California, San Francisco, California, USA
| | - Steven M Paul
- University of California, San Francisco, California, USA
| | - Judy Mastick
- University of California, San Francisco, California, USA
| | - Claudia West
- University of California, San Francisco, California, USA
| | | |
Collapse
|
27
|
Predictors of the course of quality of life during therapy in women with primary breast cancer. Qual Life Res 2017; 26:2201-2208. [PMID: 28386772 DOI: 10.1007/s11136-017-1570-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Multimodal therapies affect the quality of life (QoL) of patients with primary breast cancer (PBC). The objectives of this prospective study were to explore the changes in QoL from diagnosis to conclusion of adjuvant therapy and to identify predictive factors of QoL. METHODS Before surgery (t1), before onset of adjuvant treatment (t2) and after completion of adjuvant chemo- or radiotherapy (t3), patients with PBC (n = 759) completed the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire, Charlson Comorbidity Index, Patient Health Questionnaire and Perceived Involvement in Care Scales. Predictors of the course of global QoL were estimated using multinomial logistic regression. Effect estimates are odds ratios (OR) and their 95% confidence intervals (CIs). RESULTS Global QoL improved between t1 and t3, while physical functioning, emotional functioning and fatigue deteriorated. QoL before surgery was more often poor in patients <60 years (OR 2.2, 95% CI 1.5-3.1) and in those with comorbid mental illnesses (OR 8.6, CI 5.4-13.7). Forty-seven percentage reported good global QoL both at t1 and at t3. QoL improved in 28%, worsened in 10% and remained poor in 15%. Compared to patients with consistently good global QoL, a course of improving QoL was more often seen in patients who had received a mastectomy and in those with intense fear of treatment before surgery. A course of decreasing QoL was more often found in patients who were treated with chemotherapy. QoL stayed poor in patients with chemotherapy, mastectomy and intense fear. There was no evidence that radiotherapy, progressive disease or perceived involvement impact the course of QoL. CONCLUSIONS Younger age and comorbid mental illnesses are associated with poor QoL pre-therapeutically. QoL is more likely to stay or become poor in patients who receive chemotherapy.
Collapse
|
28
|
Distress and body image due to altered appearance in posttreatment and active treatment of breast cancer patients and in general population controls. Palliat Support Care 2017; 16:137-145. [DOI: 10.1017/s1478951517000062] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTObjective:Our objective was to evaluate long-term altered appearance, distress, and body image in posttreatment breast cancer patients and compare them with those of patients undergoing active treatment and with general population controls.Method:We conducted a cross-sectional survey between May and December of 2010. We studied 138 breast cancer patients undergoing active treatment and 128 posttreatment patients from 23 Korean hospitals and 315 age- and area-matched subjects drawn from the general population. Breast, hair, and skin changes, distress, and body image were assessed using visual analogue scales and the EORTC BR–23. Average levels of distress were compared across groups, and linear regression was utilized to identify the factors associated with body image.Results:Compared to active-treatment patients, posttreatment patients reported similar breast changes (6.6 vs. 6.2), hair loss (7.7 vs. 6.7), and skin changes (5.8 vs. 5.4), and both groups had significantly more severe changes than those of the general population controls (p < 0.01). For a similar level of altered appearance, however, breast cancer patients experienced significantly higher levels of distress than the general population. In multivariate analysis, patients with high altered appearance distress reported significantly poorer body image (–20.7, CI95% = –28.3 to –13.1) than patients with low distress.Significance of results:Posttreatment breast cancer patients experienced similar levels of altered appearance, distress, and body-image disturbance relative to patients undergoing active treatment but significantly higher distress and poorer body image than members of the general population. Healthcare professionals should acknowledge the possible long-term effects of altered appearance among breast cancer survivors and help them to manage the associated distress and psychological consequences.
Collapse
|
29
|
Abu Farha NH, Khatib MT, Salameh H, Zyoud SH. Cancer-related post-treatment pain and its impact on health-related quality of life in breast cancer patients: a cross sectional study in Palestine. ASIA PACIFIC FAMILY MEDICINE 2017; 16:7. [PMID: 29200943 PMCID: PMC5696967 DOI: 10.1186/s12930-017-0037-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/15/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Post-treatment pain has been suggested as an important indicator for health-related quality of life (HRQOL) in patients with breast cancer. Therefore, this study was performed to examine the association between pain and its impact on HRQOL among breast cancer patients in Palestine. Also, this study aimed to determine the QOL profile for breast cancer patients and stated the factors associated with QOL. METHODS A correlational cross-sectional study was conducted from May 2016 to November 2016 at Al-Watani Hospital and An-Najah National University Hospital in the Nablus district in Palestine. The five-level EuroQol five-dimensional instrument (EQ-5D-5L) was used to examine HRQOL. Pain severity and interference were assessed using the Brief Pain Inventory (BPI). Multiple linear regression analysis was performed to determine the most important variables related with HRQOL. RESULTS One hundred and seventy patients were involved in this study. Overall, all participants were female, with a mean ± SD for age of 51.71 ± 11.11 years. The reported HRQOL of this study was measured by using the median EQ-5D-5L index score, which was 0.67 (interquartile range: 0.51-0.84). There were moderate negative correlations between EQ-5D-5L index score and pain severity score (r = - 0.58, p value < 0.001), and pain interference score (r = - 0.604, p-value < 0.001). Furthermore, univariate analysis showed that age, marital status, employment status, income, current condition of cancer, and post-treatment pain were associated with quality of life (p-value < 0.05). Regression analysis revealed that patients with high income (p-value = 0.003), patients with lower pain severity score (p-value < 0.001), and lower pain interference score (p-value = 0.018) were independently associated with high QOL. CONCLUSIONS This is the first study to present important data regarding QOL by using the EQ-5D-5L instruments that may help healthcare providers to identify patients at risk of low QOL. Healthcare providers and health strategy makers should be alerted to low level HRQOL among breast cancer patients with low income level, patients with post-treatment pain, especially in the state of severe pain, and the state of pain interfering with daily life to improve their HRQOL.
Collapse
Affiliation(s)
- Nader H. Abu Farha
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Mohammed T. Khatib
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Husam Salameh
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- 0000 0004 0631 5695grid.11942.3fPoison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- 0000 0004 0631 5695grid.11942.3fDivision of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| |
Collapse
|
30
|
Lee MK. Disability and quality of life in community-dwelling elderly cancer survivors: Case-control study in the Korean population. Eur J Oncol Nurs 2016; 24:22-28. [PMID: 27697274 DOI: 10.1016/j.ejon.2016.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 07/20/2016] [Accepted: 08/06/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Advanced age is a significant risk factor for cancer and functional disabilities increase with age. The purpose of this case-control study of Korean individuals was to determine the effect of cancer and cancer treatment on functional disability and quality of life (QOL). Thus, we compared community-dwelling elderly cancer patients (ECPs) with individuals from the general elderly population (GEP) who never had diagnoses of cancer. METHODS We selected 1776 ECP who were at least 65 years-old from the 2008 Korean Community Health Survey data and used propensity score matching to randomly select 1766 individuals from the GEP who closely resembled the ECPs. Functional disability was measured using the Instrumental Activities of Daily Living (IADL) scale, and QOL was measured by the EuroQol Group EQ-5D. RESULTS ECPs were more dependent in preparation of food, doing laundry, and shopping (IADL scale), and in mobility and usual activities (EQ-5D). Although ECP had more problems with pain, discomfort, anxiety, and depression, they were more independent in self-care and handling of financial responsibilities. CONCLUSIONS ECPs had multiple physical and psychological symptoms that adversely affected functional disability and QOL, but higher functional ability, such as self-care and handling of financial responsibilities. Promotion of self-care by ECPs is pivotal for effective management in community practice.
Collapse
Affiliation(s)
- Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, 680 Gukchabosangro, Jung-gu, Daegu, 700-842, Republic of Korea.
| |
Collapse
|
31
|
An evaluation study of the determinants of future perspective and global Quality of Life in Spanish long-term premenopausal early-stage breast cancer survivors. Contemp Oncol (Pozn) 2016; 20:165-70. [PMID: 27358597 PMCID: PMC4925738 DOI: 10.5114/wo.2016.60073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 03/23/2016] [Indexed: 01/15/2023] Open
Abstract
Aim of the study Quality of life (QL) is important in premenopausal long-term breast cancer survivors. In this study we assessed QL and factors associated with future perspective and global QL in premenopausal early-stage long-term breast cancer survivors from Spain. Material and methods 243 premenopausal stage I-IIIA relapse-free breast cancer patients who had received surgery 5–20 years previously completed EORTC QLQ-C30 and QLQ-BR23 questionnaires once during follow-up. Univariate and multivariate logistic regression analyses were performed. Results QL mean scores were high in most areas (> 80 in functioning; < 20 in symptoms). The main factors for future perspective were emotional and social functioning, fatigue, breast symptom, and body image. The main factors for global QL were fatigue, pain and physical functioning, and emotional and social functioning. The best logistic model to explain future perspective associated high emotional and social functioning and low breast symptoms with a lower risk of low future perspective (R2 = 0.56). Higher scores in physical and emotional functioning and lower scores in fatigue were associated with a lower risk of low global QL (R2 = 0.50). Conclusions Psychological, social, and physical factors were found to be possible determinants of global QL and future perspective. QL in premenopausal early-stage long-term breast cancer survivors may benefit from multidisciplinary treatment.
Collapse
|
32
|
West C, Paul SM, Dunn L, Dhruva A, Merriman J, Miaskowski C. Gender Differences in Predictors of Quality of Life at the Initiation of Radiation Therapy. Oncol Nurs Forum 2016; 42:507-16. [PMID: 26302279 DOI: 10.1188/15.onf.507-516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE/OBJECTIVES To evaluate gender differences in quality of life (QOL), demographic, clinical, and symptom characteristics.
DESIGN Prospective, observational.
SETTING Two radiation oncology departments in northern California.
SAMPLE 185 patients before initiation of radiation therapy (RT).
METHODS At their RT simulation visit, patients completed a demographic questionnaire, a measure of QOL, and symptom-specific scales. Backward elimination regression analyses were conducted to determine the significant predictors of QOL
. MAIN RESEARCH VARIABLES QOL, gender, and 20 potential predictors
. FINDINGS In women, depressive symptoms, functional status, age, and having children at home explained 64% of the variance in QOL. In men, depressive symptoms, state anxiety, number of comorbidities, being a member of a racial or ethnic minority, and age explained 70% of the variance in QOL
. CONCLUSIONS Predictors of QOL differed by gender. Depressive symptom score was the greatest contributor to QOL in both genders.
. IMPLICATIONS FOR NURSING Nurses need to assess for QOL and depression at the initiation of RT. Knowledge of the different predictors of QOL may be useful in the design of gender-specific interventions to improve QOL.
Collapse
|
33
|
Challinor JM, Galassi AL, Al-Ruzzieh MA, Bigirimana JB, Buswell L, So WK, Steinberg AB, Williams M. Nursing's Potential to Address the Growing Cancer Burden in Low- and Middle-Income Countries. J Glob Oncol 2016; 2:154-163. [PMID: 28717695 PMCID: PMC5495453 DOI: 10.1200/jgo.2015.001974] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Julia M. Challinor
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Annette L. Galassi
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Majeda A. Al-Ruzzieh
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Jean Bosco Bigirimana
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Lori Buswell
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Winnie K.W. So
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Allison Burg Steinberg
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Makeda Williams
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| |
Collapse
|
34
|
Bourdon M, Blanchin M, Tessier P, Campone M, Quéreux G, Dravet F, Sébille V, Bonnaud-Antignac A. Changes in quality of life after a diagnosis of cancer: a 2-year study comparing breast cancer and melanoma patients. Qual Life Res 2016; 25:1969-79. [PMID: 26886927 DOI: 10.1007/s11136-016-1244-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 11/12/2022]
Abstract
PURPOSE Longitudinal studies addressing change in health-related quality of life (HRQoL) following a diagnosis of cancer have mainly focused on a single cancer type, and little is known about the differences in HRQoL over time according to the type of tumor. The current study aims to compare the change in HRQoL over 2 years following breast cancer or melanoma diagnosis and socio-demographic variables associated with HRQoL over time. METHODS Patients recently diagnosed with breast cancer (n = 215) or melanoma (n = 78) completed surveys within 1 month of diagnosis and 6, 12, and 24 months later. Multilevel modeling analyses were used to compare the evolution over time of HRQoL dimensions, as measured by the EORTC QLQ-C30, in both cancers. Longitudinal effect of socio-demographic variables on HRQoL was also assessed. RESULTS Consistent with the literature, both cancer patients experienced decreased HRQoL scores following the diagnosis before improving over time. However, our analyses revealed that this rebound effect may occur at diverse times over the course of the illness according to the type of cancer. In addition, HRQoL over time was positively associated with age and negatively related to living with a partner regardless of the type of cancer. CONCLUSIONS The results of the present study suggest that support in hospital units should be specific and depend on the cancer type.
Collapse
Affiliation(s)
- M Bourdon
- EA 4275-SPHERE methodS for Patients-centered outcomes and HEalth REsearch, Université de Nantes, UFR des Sciences Pharmaceutiques, 1 rue Gaston Veil, BP 53508, 44035, Nantes Cedex 1, France. .,Institut de Cancérologie de l'Ouest, Site René Gauducheau, Boulevard Jacques Monod, 44805, Saint Herblain Cedex, France.
| | - M Blanchin
- EA 4275-SPHERE methodS for Patients-centered outcomes and HEalth REsearch, Université de Nantes, UFR des Sciences Pharmaceutiques, 1 rue Gaston Veil, BP 53508, 44035, Nantes Cedex 1, France
| | - P Tessier
- EA 4275-SPHERE methodS for Patients-centered outcomes and HEalth REsearch, Université de Nantes, UFR des Sciences Pharmaceutiques, 1 rue Gaston Veil, BP 53508, 44035, Nantes Cedex 1, France
| | - M Campone
- Institut de Cancérologie de l'Ouest, Site René Gauducheau, Boulevard Jacques Monod, 44805, Saint Herblain Cedex, France
| | - G Quéreux
- Unité de Cancéro-dermatologie, Centre Hospitalier Universitaire de Nantes, 1 place Alexis-Ricordeau, 44093, Nantes Cedex 1, France
| | - F Dravet
- Institut de Cancérologie de l'Ouest, Site René Gauducheau, Boulevard Jacques Monod, 44805, Saint Herblain Cedex, France
| | - V Sébille
- EA 4275-SPHERE methodS for Patients-centered outcomes and HEalth REsearch, Université de Nantes, UFR des Sciences Pharmaceutiques, 1 rue Gaston Veil, BP 53508, 44035, Nantes Cedex 1, France
| | - A Bonnaud-Antignac
- EA 4275-SPHERE methodS for Patients-centered outcomes and HEalth REsearch, Université de Nantes, UFR des Sciences Pharmaceutiques, 1 rue Gaston Veil, BP 53508, 44035, Nantes Cedex 1, France.,Institut de Cancérologie de l'Ouest, Site René Gauducheau, Boulevard Jacques Monod, 44805, Saint Herblain Cedex, France
| |
Collapse
|
35
|
Brown DS, Trogdon JG, Ekwueme DU, Chamiec-Case L, Guy GP, Tangka FK, Li C, Trivers KF, Rodriguez JL. Health State Utility Impact of Breast Cancer in U.S. Women Aged 18-44 Years. Am J Prev Med 2016; 50:255-61. [PMID: 26775904 DOI: 10.1016/j.amepre.2015.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 07/08/2015] [Accepted: 07/18/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Breast cancer affects women's health-related quality of life negatively, but little is known about how breast cancer affects this in younger women aged 18-44 years. This study measures preference-based health state utility (HSU) values, a scaled index of health-related quality of life for economic evaluation, for younger women with breast cancer and compares these values with same-age women with other cancers and older women (aged ≥45 years) with breast cancer. METHODS Data from the 2009 and 2010 Behavioral Risk Factor Surveillance System were analyzed in 2014. The sample included 218,852 women; 7,433 and 18,577 had histories of breast and other cancers. HSU values were estimated using Healthy Days survey questions and a published mapping algorithm. Linear regression models for HSU were estimated by age group (18-44 and ≥45 years). RESULTS The adjusted breast cancer HSU impact was four times larger for younger women than for older women (-0.097 vs -0.024, p<0.001). For younger women, the effect of breast cancer on HSU was 70% larger than that of other cancers (-0.097 vs -0.057, p=0.024). CONCLUSIONS Younger breast cancer survivors reported lower HSU values than older survivors, highlighting the impact of breast cancer on the physical and mental health of younger women. The estimates may be used to evaluate quality-adjusted life-years or expectancy for prevention or treatment of breast cancer. This study also indicates that separate quality of life adjustments for women by age group are important for economic analysis of public health breast cancer interventions.
Collapse
Affiliation(s)
- Derek S Brown
- Brown School, Washington University in St. Louis, St. Louis, Missouri.
| | - Justin G Trogdon
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | | | - Gery P Guy
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| | | | - Chunyu Li
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| | | | - Juan L Rodriguez
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| |
Collapse
|
36
|
Trogdon JG, Ekwueme DU, Chamiec-Case L, Guy GP. Breast Cancer in Young Women: Health State Utility Impacts by Race/Ethnicity. Am J Prev Med 2016; 50:262-9. [PMID: 26775905 PMCID: PMC5841540 DOI: 10.1016/j.amepre.2015.09.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/14/2015] [Accepted: 09/24/2015] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Little is known about the effect of breast cancers on health-related quality of life among women diagnosed between age 18 and 44 years. The goal of this study is to estimate the effect of breast cancer on health state utility by age at diagnosis (18-44 years versus ≥45 years) and by race/ethnicity. METHODS The analytic sample, drawn from the 2009 and 2010 Behavioral Risk Factor Surveillance System and analyzed in 2013, included women diagnosed with breast cancer between age 18 and 44 years (n=1,389) and age ≥45 years (n=6,037). Health state utility values were estimated using Healthy Days variables and a published algorithm. Regression analysis was conducted separately by age at diagnosis and race/ethnicity. RESULTS The breast cancer health state utility decrement within 1 year from date of diagnosis was larger for women diagnosed at age 18-44 years than for women diagnosed at age ≥45 years (-0.116 vs -0.070, p<0.05). Within the younger age-at-diagnosis group, Hispanic women 2-4 years after diagnosis had the largest health state utility decrement (-0.221, p<0.01), followed by non-Hispanic white women within 1 year of diagnosis (-0.126, p<0.01). CONCLUSIONS This study is the first to report estimates of health state utility values for breast cancer by age at diagnosis and race/ethnicity from a nationwide sample. The results highlight the need for separate quality of life adjustments for women by age at diagnosis and race/ethnicity when conducting cost-effectiveness analysis of breast cancer prevention, detection, and treatment.
Collapse
Affiliation(s)
- Justin G Trogdon
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | | | - Linda Chamiec-Case
- Public Health Economics Program, RTI International, Research Triangle Park, North Carolina
| | - Gery P Guy
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| |
Collapse
|
37
|
Higher-intensity exercise helps cancer survivors remain motivated. J Cancer Surviv 2015; 10:524-33. [PMID: 26586495 DOI: 10.1007/s11764-015-0498-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 11/05/2015] [Indexed: 12/22/2022]
Abstract
PURPOSE The aim of the present study was to determine if exercise intensity impacts upon the psychosocial responses of breast and prostate cancer survivors to a rehabilitation program. METHODS Eighty-seven prostate and 72 breast cancer survivors participated in an 8-week exercise and supportive group psychotherapy intervention (n = 84) or control (n = 75) group. Intervention participants were randomized to low-to-moderate intensity exercise (LIG; n = 44; 60-65 % VO2peak, 50-65 % one repetition maximum (1RM)) or moderate-to-high intensity exercise (HIG; n = 40; 75-80 % VO2peak, 65-80 % 1RM) while controls continued usual care. Before and after the 8 weeks, all participants completed the Functional Assessment of Cancer Therapy-Breast or -Prostate to assess quality of life (QOL) and Behavioural Regulations of Exercise Version 2 for exercise motivation. Intervention participants also completed a follow-up assessment 4 months post-intervention. RESULTS All three groups improved in QOL from baseline to post-intervention, with no significant differences. From post-intervention to follow-up, the LIG and HIG similarly maintained QOL scores. Between baseline and post-intervention, both intervention arms improved their motivation to exercise compared to the controls (p = 0.004). At the 4-month follow-up, the HIG had maintained their overall exercise motivation (p < 0.001) and both domains of intrinsic motivation (identified regulation, p = 0.047; intrinsic regulation, p = 0.007); however, the LIG had regressed. CONCLUSIONS The structured intervention was successful at improving autonomous exercise motivation, regardless of exercise intensity. However, only those participants who had exercised at a higher intensity sustained their improvement. Intervention participation did not improve QOL more than controls. IMPLICATIONS FOR CANCER SURVIVORS Higher-intensity exercise is more likely to result in more sustainable increases in motivation to exercise among cancer survivors.
Collapse
|
38
|
Rohani C, Abedi HA, Omranipour R, Langius-Eklöf A. Health-related quality of life and the predictive role of sense of coherence, spirituality and religious coping in a sample of Iranian women with breast cancer: a prospective study with comparative design. Health Qual Life Outcomes 2015; 13:40. [PMID: 25889384 PMCID: PMC4392858 DOI: 10.1186/s12955-015-0229-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 03/03/2015] [Indexed: 01/21/2023] Open
Abstract
Background There is disagreement among studies of health-related quality of life (HRQoL) changes in breast cancer patients over time. Reportedly, assessment of HRQoL prior to diagnosis may be crucial to provide a clear point of comparison for later measurements. The aims of this study were (1) to investigate changes in HRQoL, sense of coherence (SOC), spirituality and religious coping in a group of women with breast cancer from the pre-diagnosis phase to 6 months later in comparison with a control group, and (2) to explore the predictor role of SOC, spirituality, and religious coping within the breast cancer group at the 6-month follow-up. Methods A sample of women with breast cancer (n = 162) and a matched control group (n = 210) responded to the following instruments on both occasions: the European Organization for Research and Treatment of Cancer QLQ-C30, the SOC Scale, the Spiritual Perspective Scale and the Brief Religious Coping Scale. A series of General Linear Model (GLM) Repeated Measures was used to determine changes between the groups over time. Also, Multiple Linear Regression analyses were applied to each of the HRQoL dimensions, as dependent variable at the 6 months follow-up. Results Physical and role function, fatigue, and financial difficulties were rated worse by the women with breast cancer during the first 6 months in comparison to the controls, which was both a statistically (p < 0.001) and clinically significant difference. Women had better scores for global quality of life (p < 0.001), and emotional functioning (p < 0.01) during the same period of time. The degree of SOC (p < 0.01) and baseline ratings of several dimensions of HRQoL (p < 0.05) were the most important predictors of HRQoL changes. Conclusions Collecting HRQoL data before a final diagnosis of breast cancer is important to identify women at risk of deterioration in HRQoL during and after treatment. Special attention should be paid to physical and role functioning impairment, fatigue, and financial difficulties experienced by these women. These results underscore that the degree of SOC may be more important as a predictor for HRQoL changes in this sample than spirituality and religious coping.
Collapse
Affiliation(s)
- Camelia Rohani
- Department of Health, Shahid Beheshti University of Medical Sciences School of Nursing and Midwifery, Valiasr st., Niayesh Crossroad, Tehran, 1985717443, Iran.
| | - Heidar-Ali Abedi
- Department of Nursing, Islamic Azad University Nursing and Midwifery School, Isfahan (Khorasgan) Branch, Isfahan, 8153653791, Iran.
| | - Ramesh Omranipour
- Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, 1419733141, Iran.
| | - Ann Langius-Eklöf
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Alle' 23, Huddinge, 14183, Sweden.
| |
Collapse
|
39
|
Sohl SJ, Levine B, Avis NE. Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS) scale for early post-treatment breast cancer survivors. Qual Life Res 2015; 24:205-12. [PMID: 24996392 PMCID: PMC4282954 DOI: 10.1007/s11136-014-0749-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The end of primary treatment for cancer patients is increasingly recognized as an important time of adjustment that may impact quality of life (QoL). A psychometrically sound QoL instrument that assesses the mix of acute and longer-term concerns present during this unique time has not yet been identified. This article evaluates the Quality of Life in Adult Cancer Survivors (QLACS) scale, originally developed for long-term (>5 years) cancer survivors, as an appropriate QoL measure for this transition period. METHODS Psychometric properties of the QLACS were evaluated in a sample of post-treatment breast cancer survivors 18-24 months post-diagnosis. This observational study consisted of women (n = 552) aged 25 years and older (mean = 55.4 years) who were diagnosed with stage I, II, or III breast cancer. The 47 items of the QLACS comprise 12 domains: seven domains are generic, and five are cancer specific. RESULTS The QLACS demonstrated adequate internal consistency (Cronbach's alpha for the 12 domains ranged from 0.79 to 0.91) and good convergent and divergent validity (assessed by comparison with the Functional Assessment of Cancer Therapy and other measures). CONCLUSIONS The QLACS appears to be consistent with other widely accepted measures in capturing QoL, while also allowing for more inclusive measurement of specific issues relevant to post-treatment cancer survivors. These data, in addition to previous data supporting use of the QLACS across different cancer sites, suggest that the QLACS is a promising comprehensive QoL measure appropriate for breast cancer survivors transitioning off active treatment.
Collapse
Affiliation(s)
- Stephanie J. Sohl
- Department of Medicine, Vanderbilt University School of Medicine, Sixth Floor, Suite 600, 2525 West End Avenue, Nashville, TN 37203-1738, USA
| | - Beverly Levine
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Medical Center Boulevard, Wake Forest School of Medicine, Winston-Salem, NC 27157-1063, USA
| | - Nancy E. Avis
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Medical Center Boulevard, Wake Forest School of Medicine, Winston-Salem, NC 27157-1063, USA
| |
Collapse
|
40
|
Cheema BS, Kilbreath SL, Fahey PP, Delaney GP, Atlantis E. Safety and efficacy of progressive resistance training in breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat 2014; 148:249-68. [DOI: 10.1007/s10549-014-3162-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 10/01/2014] [Indexed: 01/24/2023]
|
41
|
Patients' perspectives of care and surgical outcomes in Michigan: an analysis using the CAHPS hospital survey. Ann Surg 2014; 260:5-9. [PMID: 24646549 DOI: 10.1097/sla.0000000000000626] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the relationship between postoperative morbidity and mortality and patients' perspectives of care. BACKGROUND Priorities in health care quality research are shifting to place greater emphasis on patient-centered outcomes. Whether patients' perspectives of care correlate with surgical outcomes remains unclear. DESIGN Retrospective cohort study. METHODS Using data from the Michigan Surgical Quality Collaborative clinical registry (2008-2012), we identified 41,833 patients undergoing major elective general or vascular surgery. Our exposure variables were the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Total and Base Scores derived from the Hospital Value-Based Purchasing Patient Experience of Care Domain. Using multilevel, mixed-effects logistic regression models, we adjusted hospitals' rates of morbidity and mortality for patient comorbidities and case mix. We stratified reporting of outcomes by quintiles of hospitals' Total and Base Scores. RESULTS Risk-adjusted morbidity (13.6%-28.6%) varied widely across hospitals. There were no significant differences in risk-adjusted morbidity rates between hospitals with the lowest and highest HCAHPS Total Scores (24.5% vs 20.2%, P = 0.312). The HCAHPS Base Score, which quantifies sustained achievement or improvement in patients' perspectives of care, was not associated with a reduction in postoperative morbidity over the study period despite an overall decrease of 2.5% for all centers. We observed a similar relationship between HCAHPS Total and Base Scores and postoperative mortality. CONCLUSIONS AND RELEVANCE Patients' perspectives of care do not correlate with the incidence of morbidity and mortality after major surgery. Improving patients' perspectives and objective outcomes may require separate initiatives for surgeons in Michigan.
Collapse
|
42
|
Lee SJ, Ahn DH, Jung JH, Kim YR, Lee YJ. Short-term change of handgrip strength after trigger point injection in women with muscular pain in the upper extremities. Ann Rehabil Med 2014; 38:241-8. [PMID: 24855619 PMCID: PMC4026611 DOI: 10.5535/arm.2014.38.2.241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 10/16/2013] [Indexed: 12/03/2022] Open
Abstract
Objective To determine overall handgrip strength (HGS), we assessed the short-term change of HGS after trigger point injection (TPI) in women with muscular pain in the upper extremities by comparison with established pain scales. Methods The study enrolled 50 female patients (FMS with MPS group: 29 patients with combined fibromyalgia [FMS] and myofascial pain syndrome [MPS]; MPS group: 21 patients with MPS) who presented with muscular pain in the upper extremities at Konyang University Hospital. In addition, a total of 9 healthy women (control group) were prospectively enrolled in the study. We surveyed the three groups using the following established pain scales: the Fibromyalgia Impact Questionnaire (FIQ), the 36-Item Short Form Health Survey (SF-36), and the Short Form McGill Pain Questionnaire (MPQ). HGS was measured in both hands of study participants using a handgrip dynamometer. We performed TPI (0.5% lidocaine, total 10 mL, injected at the pain site of upper extremities). After 20 minutes, we remeasured the patient's HGS and MPQ score. Results ANOVA analysis was conducted among groups. Based on Tukey multiple comparison test, the majority of FIQ and SF-36 subscales, total FIQ and SF-36 scores, MPQ and HGS were significantly different between FMS with MPS and the other groups. There was no statistically significant difference between MPS and control groups. Higher HGS was positively associated with enhanced physical function, negatively associated with total FIQ and MPQ scores, and positively associated with the total SF-36 score calculated using Spearman correlation. Post-TPI MPQ decreased and HGS increased. In patient groups, a negative correlation was found between MPQ and HGS. Conclusion The HGS test might potentially be a complementary tool in assessing the short-term treatment effects of women with muscular pain in the upper extremities.
Collapse
Affiliation(s)
- Soo Jin Lee
- Department of Physical Medicine and Rehabilitation, Konyang University College of Medicine, Daejeon, Korea
| | - Dong Heun Ahn
- Department of Physical Medicine and Rehabilitation, Konyang University College of Medicine, Daejeon, Korea
| | - Ji Hun Jung
- Department of Physical Medicine and Rehabilitation, Konyang University College of Medicine, Daejeon, Korea
| | - Yong Rok Kim
- Department of Physical Medicine and Rehabilitation, Konyang University College of Medicine, Daejeon, Korea
| | - Young Jin Lee
- Department of Physical Medicine and Rehabilitation, Konyang University College of Medicine, Daejeon, Korea
| |
Collapse
|
43
|
Health-related quality of life during adjuvant radiotherapy in breast cancer. Qual Life Res 2013; 23:1363-9. [PMID: 24202638 DOI: 10.1007/s11136-013-0554-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2013] [Indexed: 01/20/2023]
Abstract
OBJECTIVE In this study, health- related quality of life (HRQoL) and its determinants were assessed in breast cancer patients undergoing postoperative adjuvant radiotherapy. The aim was to improve our understanding of patient's situation at the end of adjuvant treatment, as the return to every day life approaches after breast cancer surgery and adjuvant chemo- and radiotherapy. METHODS Health- related quality of life was measured by the 15D instrument. Self-administered questionnaires were distributed to patients undergoing postoperative radiotherapy. Out of 389 consecutive breast cancer patients, 273 comprised the final study group. The results were compared to 15D results for an age-standardized sample of the female general population in Finland (n = 3,335). Determinants of HRQoL were assessed by a multivariate model. RESULTS In patients <53 years, but not in older patients, the total 15D score was lower than in age-standardized controls. Both younger and older patients differed significantly from the controls on specific 15D dimensions of sleeping, depression, distress, vitality, and sexual activity. When clinical and treatment variables were assessed by a multivariate model, depressive symptoms had a negative effect on HRQoL. Further, having undergone breast conserving surgery instead of mastectomy was associated with poorer HRQoL. CONCLUSIONS Impairment of HRQoL was observed during adjuvant radiotherapy in breast cancer. This finding calls for action to develop supportive and preventive means to smoothen the return to normal activities after completion of adjuvant treatment for breast cancer.
Collapse
|
44
|
Hsu T, Ennis M, Hood N, Graham M, Goodwin PJ. Quality of Life in Long-Term Breast Cancer Survivors. J Clin Oncol 2013; 31:3540-8. [DOI: 10.1200/jco.2012.48.1903] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose There is considerable interest in the quality of life (QOL) of long-term breast cancer (BC) survivors. We studied changes in QOL from time of BC diagnosis to long-term survivorship and compared QOL in long-term survivors to that of age-matched women with no history of BC. Patients and Methods In all, 535 women with localized BC (T1-3N0-1M0) were recruited from 1989 to 1996 and followed prospectively, completing QOL questionnaires at diagnosis and 1 year postdiagnosis. Between 2005 and 2007, those alive without distant recurrence were recontacted to participate in a long-term follow-up (LTFU) study. A control group was recruited from women presenting for screening mammograms, and both groups completed LTFU QOL questionnaires. Longitudinal change in BC survivors and differences between BC survivors and controls were assessed in eight broad categories with clinically significant differences set at 5% and 10% of the breadth of each QOL scale. Results A total of 285 patients with BC were included in the study, on average 12.5 years postdiagnosis. Longitudinally, clinically significant improvements were observed in overall QOL by 1 year postdiagnosis with further improvements by LTFU. Some clinically significant improvements over time were seen in all categories. A total of 167 controls were recruited. Deficits were observed in self-reported cognitive functioning (5.3% difference) and financial impact (6.3% difference) in BC survivors at LTFU compared with controls. Conclusion Long-term BC survivors show improvement in many domains of QOL over time, and they appear to have similar QOL in most respects to age-matched noncancer controls, although small deficits in cognition and finances were identified.
Collapse
Affiliation(s)
- Tina Hsu
- Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada
| | - Marguerite Ennis
- Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada
| | - Nicky Hood
- Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada
| | - Margaret Graham
- Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada
| | - Pamela J. Goodwin
- Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada
| |
Collapse
|
45
|
Moro-Valdezate D, Peiró S, Buch-Villa E, Caballero-Gárate A, Morales-Monsalve MD, Martínez-Agulló A, Checa-Ayet F, Ortega-Serrano J. Evolution of Health-Related Quality of Life in Breast Cancer Patients during the First Year of Follow-Up. J Breast Cancer 2013; 16:104-11. [PMID: 23593090 PMCID: PMC3625756 DOI: 10.4048/jbc.2013.16.1.104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 02/18/2013] [Indexed: 12/04/2022] Open
Abstract
Purpose The objective of this study was to describe the evolution of health-related quality of life (HRQOL) in a cohort of breast cancer patients over 1 year after surgery and to analyse the predictive ability of HRQOL measurement instruments. Methods Observational, multicenter and prospective study of a cohort of breast cancer patients, assessing HRQOL at 1, 6, and 12 months after surgery using three questionnaires: EuroQol-5D-3L, EORTC QLQ-C30, and EORTC QLQ-BR23. Results A total of 364 women participated in the study. Visual Analogue Scale (VAS) scores from the EuroQol improved (1 month vs. 1 year: 70 vs. 80; p<0.0001); however, the EuroQol score showed no significant change (0.81 vs. 0.83; p=0.1323). In contrast, Global Health Status on the EORTC QLQ-C30 improved (66.67 vs. 100.00; p<0.0001), as did all of this instrument's scales and most of its independent items. The EORTC QLQ-BR23 dimensions showed improvement, except for sexual functioning (100.00 vs. 86.67; p=0.0030) and future perspective (33.33 vs. 66.67; p<0.0001). Patients with good HRQOL outcomes at 1 month showed improved levels of HRQOL at 1 year; HRQOL measured at 1 month was predictive of HRQOL at 1 year. Conclusion HRQOL improved during the follow-up period. Likewise, HRQOL measurement instruments can predict early HRQOL.
Collapse
Affiliation(s)
- David Moro-Valdezate
- Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Ellsworth RE, Valente AL, Shriver CD, Bittman B, Ellsworth DL. Impact of lifestyle factors on prognosis among breast cancer survivors in the USA. Expert Rev Pharmacoecon Outcomes Res 2013; 12:451-64. [PMID: 22971032 DOI: 10.1586/erp.12.37] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Advances in diagnostic screening and adjuvant therapy have dramatically increased the number of breast cancer survivors in the USA, who may face changes in physical and mental health, social support, quality of life and economics. Women living with breast cancer are increasingly interested in lifestyle modification to decrease the risk of recurrence and mortality while increasing physical and emotional wellbeing. Although organizations such as the American Cancer Society support a healthy diet, frequent physical activity and stress reduction for decreasing breast cancer risk, studies examining the effects of lifestyle on clinical outcomes including survival and prognosis have been inconclusive. With the number of breast cancer survivors predicted to increase to 3.4 million by 2015, it is important to develop effective treatment paradigms that overcome barriers to behavioral modification to improve clinical outcomes and survivorship in breast cancer patients.
Collapse
Affiliation(s)
- Rachel E Ellsworth
- Clinical Breast Care Project, Henry M Jackson Foundation for the Advancement of Military Medicine, Windber, PA 15963, USA
| | | | | | | | | |
Collapse
|
47
|
Lee SH, Min YS, Park HY, Jung TD. Health-related quality of life in breast cancer patients with lymphedema who survived more than one year after surgery. J Breast Cancer 2012; 15:449-53. [PMID: 23346175 PMCID: PMC3542854 DOI: 10.4048/jbc.2012.15.4.449] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 10/26/2012] [Indexed: 01/22/2023] Open
Abstract
Purpose To identify the influence of lymphedema on health-related quality of life (HRQOL) more than 1 year after breast cancer surgery. Methods Ninety-six breast cancer patients who survived more than 1 year after surgery and 104 members of the general population were recruited. Patients were divided into 2 groups according to the presence of lymphedema. HRQOL was evaluated with the Short-Form 36-Item Health Survey. Results There were no statistically significant differences in any scales between groups: groups of breast cancer survivors with and without lymphedema. Compared with the general population, breast cancer survivors had lower quality of life scores in all scales, although the vitality and mental health scales did not differ from chance variation at the 5% level. Conclusion In this study, the presence of lymphedema in breast cancer patients who survived over 1 year after surgery might not affect the quality of life. However quality of life of breast cancer survivors is lower than in general population except for some mental health components.
Collapse
Affiliation(s)
- So Hyun Lee
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | | | | | | |
Collapse
|
48
|
Forsythe LP, Alfano CM, George SM, McTiernan A, Baumgartner KB, Bernstein L, Ballard-Barbash R. Pain in long-term breast cancer survivors: the role of body mass index, physical activity, and sedentary behavior. Breast Cancer Res Treat 2012; 137:617-30. [PMID: 23242613 DOI: 10.1007/s10549-012-2335-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 11/02/2012] [Indexed: 12/17/2022]
Abstract
Although pain is common among post-treatment breast cancer survivors, studies that are longitudinal, identify a case definition of clinically meaningful pain, or examine factors contributing to pain in survivors are limited. This study describes longitudinal patterns of pain in long-term breast cancer survivors, evaluating associations of body mass index (BMI), physical activity, sedentary behavior with mean pain severity and above-average pain. Women newly diagnosed with stages 0-IIIA breast cancer (N = 1183) were assessed, on average, 6 months (demographic/clinical characteristics), 30 months (demographics), 40 months (demographics, pain), 5 years (BMI, physical activity, and sedentary behavior), and 10 years (demographics, pain, BMI, physical activity, and sedentary behavior) post-diagnosis. This analysis includes survivors who completed pain assessments 40 months post-diagnosis (N = 801), 10 years post-diagnosis (N = 563), or both (N = 522). Above-average pain was defined by SF-36 bodily pain scores ≥1/2 standard deviation worse than age-specific population norms. We used multiple regression models to test unique associations of BMI, physical activity, and sedentary behavior with pain adjusting for demographic and clinical factors. The proportion of survivors reporting above-average pain was higher at 10 years than at 40 months (32.3 vs. 27.8 %, p < 0.05). Approximately one-quarter of survivors reported improved pain, while 9.0 % maintained above-average pain and 33.1 % reported worsened pain. Cross-sectionally at 10 years, overweight and obese survivors reported higher pain than normal-weight survivors and women meeting physical activity guidelines were less likely to report above-average pain than survivors not meeting these guidelines (p < 0.05). Longitudinally, weight gain (>5 %) was positively associated, while meeting physical activity guidelines was inversely associated, with above-average pain (OR, 95 % CI = 1.76, 1.03-3.01 and 0.40, 0.20-0.84, respectively) (p < 0.05). Weight gain and lack of physical activity place breast cancer survivors at risk for pain long after treatment ends. Weight control and exercise interventions should be tested for effects on long-term pain in these women.
Collapse
Affiliation(s)
- Laura P Forsythe
- Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
| | | | | | | | | | | | | |
Collapse
|
49
|
Charlier C, Van Hoof E, Pauwels E, Lechner L, Spittaels H, Bourgois J, De Bourdeaudhuij I. Treatment-related and psychosocial variables in explaining physical activity in women three weeks to six months post-treatment of breast cancer. PATIENT EDUCATION AND COUNSELING 2012; 89:171-177. [PMID: 22841589 DOI: 10.1016/j.pec.2012.06.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 06/15/2012] [Accepted: 06/29/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This study examined treatment-related and psychosocial variables in explaining total and leisure time physical activity in breast cancer survivors three weeks to six months post-treatment. METHODS A questionnaire was used to measure total and leisure time physical activity and relevant determinants among 464 breast cancer survivors (aged 18-65 years). RESULTS Personal control was an important overall determinant in explaining physical activity in breast cancer survivors. The impact of treatment-related variables and psychological functioning depended on the working status of the women. Fatigue and poor body image prevented non-working women from being sufficiently physically active. In working women, chemotherapy and arm problems negatively influenced physical activity, whereas therapy side-effects (headaches, hot flashes, feeling unwell) and poor body image positively influenced physical activity. Social support and coping strategies could not explain post-treatment physical activity levels. CONCLUSION Personal control, treatment-related variables and psychological functioning influenced physical activity after cancer treatment. Relations depended on the working status of the women. PRACTICE IMPLICATIONS Incorporating self-control methods in physical activity interventions after breast cancer could be helpful. Furthermore, interventions should be tailored to the experienced symptoms (fatigue, arm-problems, body image) and working status of women.
Collapse
Affiliation(s)
- Caroline Charlier
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | | | | | | | | | | | | |
Collapse
|
50
|
Jung HA, Park S, Cho JH, Kim S, Ko YH, Kim SJ, Kim WS. Prognostic relevance of pretreatment quality of life in diffuse large B-cell lymphoma patients treated with rituximab-CHOP: Results from a prospective cohort study. Ann Hematol 2012; 91:1747-56. [DOI: 10.1007/s00277-012-1516-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 06/12/2012] [Indexed: 11/12/2022]
|