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Teshome R, Yang I, Woldetsadik E, Girma E, Higgins M, Wells J. Pre- and Post-Treatment Quality of Life Among Patients with Advanced Stage Cervical Cancer at Tikur Anbessa Specialized Hospital, Ethiopia. Cancer Manag Res 2024; 16:311-323. [PMID: 38646146 PMCID: PMC11032665 DOI: 10.2147/cmar.s451124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/28/2024] [Indexed: 04/23/2024] Open
Abstract
Background The development of health concepts beyond traditional markers of illness and death has made the evaluation of quality of life (QoL) crucial to patient care. Yet, there is little research evaluating the pre- and post-treatment QoL of cervical cancer survivors in Ethiopia. Objective This study aimed to assess the pre- and post-treatment QoL of women diagnosed with advanced-stage cervical cancer. Methods and Materials A cohort design was conducted at the Tikur Anbessa Specialized Hospital Oncology Center. A total of 166 cervical cancer patients were recruited consecutively. Data was collected through interviews with standardized questionnaires before and after treatment. The Wilcoxon rank test was used to assess the significant differences in pre-treatment and post-treatment quality of life. Additionally, the Mann-Whitney U-test was also employed. Statistical significance was determined with p-values <0.05 and a 95% confidence interval. Results Women who were in stages IVA and IVB were 24.7% and 10.2%, respectively. Both the global health scale (66.67 [47.92-75] to 83.33 [66.67-83.33]) and the functional domain QoL (66.67 [40-80] to 70 [46.67-86.66]) showed statistically significant improvements from pre-treatment to post-treatment QoL. Women under the age of 45 were found to have higher global health QOL (P < 0.001) and functional domain QOL (P = 0.029). Women presented in stages II and III had comparatively higher global health QoL (P = 0.008) and functional domain QoL (P = 0.021). Conclusion Global health QOL and the majority of functional quality of life significantly improved following six months of cancer treatment. But there was no discernible change in terms of sexual enjoyment, sexual function, or activity. Age, marital status, the duration since diagnosis, the stage of the cancer, and the presence of comorbidities were the factors that affected the improvement of post-treatment quality of life.
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Affiliation(s)
- Roza Teshome
- Department of Midwifery, School of Nursing & Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Irene Yang
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Edom Woldetsadik
- Department of Oncology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eshetu Girma
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Melinda Higgins
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Jessica Wells
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Pasek M, Suchocka L, Osuch-Pęcak G, Muzykiewicz K, Iwańska E, Kaducakowa H, Goździalska A, Goździalska M. Longitudinal Health-Related Quality of Life Study among Cervical Cancer Patients Treated with Radiotherapy. J Clin Med 2021; 10:jcm10020226. [PMID: 33435192 PMCID: PMC7827660 DOI: 10.3390/jcm10020226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/29/2020] [Accepted: 01/06/2021] [Indexed: 11/16/2022] Open
Abstract
Quality of life studies in medicine, particularly in oncology, have become a basic tool used to assess patient's performance in different types of cancer and different modalities of treatment. The aim of this study was a subjective evaluation of the quality of life in cervical cancer patients treated with radiotherapy. The study has a longitudinal character and comprises four stages: before treatment, at the end of treatment, 5 months and 5 years after treatment. Standardized questionnaires such as EORTC QoL C30, HADS (European Organisation for Research and Treatment of Cancer Quality of life C30 Hospital Anxiety and Depression Scale) and the authors demographic-clinical assessment survey were the study tools. Physical functioning was assessed as the highest before treatment and depreciated to the lowest value 5 years after treatment. Emotional functioning was the lowest before treatment and then decreased again in the fourth stage of the assessment. Global quality of life was the lowest in the fourth stage of the study. Memory and concentration were fairly good at every stage of the study, with the highest score at the end of the treatment. At stages 3 and 4, the respondent's social functioning was the best, followed by the ability to fulfil their social role. General health and quality of life were assessed by the respondents on a level slightly above average, though five years after treatment the score was slightly below average.
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Affiliation(s)
- Małgorzata Pasek
- Department of Nursing, Faculty of Health, University of Applied Sciences in Tarnow, 33-100 Tarnow, Poland
- Correspondence:
| | - Lilia Suchocka
- Faculty of Education and Psychology, Jan Kochanowski University of Kielce, 25-029 Kielce, Poland;
| | - Grażyna Osuch-Pęcak
- National Oncology Institute Maria Sklodowska Curie-National Research Institute, Hospital of the National Institute of Oncology—Krakow Branch Poland, 31-115 Krakow, Poland; (G.O.-P.); (K.M.); (E.I.)
| | - Konrad Muzykiewicz
- National Oncology Institute Maria Sklodowska Curie-National Research Institute, Hospital of the National Institute of Oncology—Krakow Branch Poland, 31-115 Krakow, Poland; (G.O.-P.); (K.M.); (E.I.)
| | - Ewa Iwańska
- National Oncology Institute Maria Sklodowska Curie-National Research Institute, Hospital of the National Institute of Oncology—Krakow Branch Poland, 31-115 Krakow, Poland; (G.O.-P.); (K.M.); (E.I.)
| | - Helena Kaducakowa
- Department of Nursing, Faculty of Health, Catholic University in Ruzomberok, 034 01 Ružomberok, Slovakia;
| | - Anna Goździalska
- Faculty of Health and Medical Studies, A.F. Modrzewski Krakow University, 30-705 Krakow, Poland;
| | - Magdalena Goździalska
- Student’s Science Society of the Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, 02-091 Warsaw, Poland;
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Sultan A, Taj S, Choudhary V, Parganiha A. Predictive role of socio-demographic and chronotype on health-related quality of life of cancer patients from southeastern India. BIOL RHYTHM RES 2020. [DOI: 10.1080/09291016.2020.1816050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Armiya Sultan
- Chronobiology and Animal Behavior Laboratory, School of Studies in Life Sciences, Pandit Ravishankar Shukla University, Raipur, India
| | - Saba Taj
- Chronobiology and Animal Behavior Laboratory, School of Studies in Life Sciences, Pandit Ravishankar Shukla University, Raipur, India
| | - Vivek Choudhary
- Regional Cancer Center, Dr. B.R. Ambedkar Memorial Hospital, Raipur, India
| | - Arti Parganiha
- Chronobiology and Animal Behavior Laboratory, School of Studies in Life Sciences, Pandit Ravishankar Shukla University, Raipur, India
- Center for Translational Chronobiology, Pandit Ravishankar Shukla University, Raipur, India
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Kyei KA, Yakanu F, Donkor A, Kitson-Mills D, Opoku SY, Yarney J, Tagoe SN, Addo MK, Anarfi KK, Abakuri E, Agyri K. Quality of life among cervical cancer patients undergoing radiotherapy. Pan Afr Med J 2020; 35:125. [PMID: 32637023 PMCID: PMC7320782 DOI: 10.11604/pamj.2020.35.125.18245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/27/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction There has been an increasing rate of the incidence and mortality of cervical cancer in Ghana. Cancer and the treatment's side effects have adverse effects on the patients and this affects patient's well-being and lifestyle during and after radiotherapy. The study sought to assess the impact of demographic and clinical characteristics on Quality of Life (QoL) among cervical cancer patients undergoing radiotherapy in Ghana. Methods A cross sectional quantitative study design was carried out on 120 cervical cancer patients who were conveniently sampled from the study site. The data was collected between the months of December, 2017 and February, 2018. QoL was measured using the FACT-G questionnaire. The mean scores of QoL were determined, whiles the chi-square test was used to determine the impact of socio-demographic and clinical characteristics on the QoL of the patients. Results The mean age of the patients was 56.8 years. Majority of the patients reported stable QoL. The social well-being of the older patients was more affected than other patients. The unmarried, widows and patients who underwent surgery with radiotherapy were emotionally affected. Majority (56%) of the participants had stable QoL whiles 22% each had poor and good QoL. Significant association was found among 35-39 age group with physical well-being and overall QoL (p=0.017 and 0.029) respectively. Conclusion There is a need to embrace a QoL assessment instrument in the study site so as to help the oncology team in the identification and addressing of specific indicators that affect the QoL of cervical cancer patients.
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Affiliation(s)
- Kofi Adesi Kyei
- Department of Radiography, School of Biomedical and Allied Health Sciences, College of Health Science, University of Ghana, Accra, Ghana.,National Centre for Radiotherapy and Nuclear Medicine, Accra, Ghana.,School of Health Sciences, Walden University, Minneapolis, USA
| | - Frederick Yakanu
- Department of Radiography, School of Biomedical and Allied Health Sciences, College of Health Science, University of Ghana, Accra, Ghana
| | - Andrew Donkor
- Department of Radiography, School of Biomedical and Allied Health Sciences, College of Health Science, University of Ghana, Accra, Ghana.,Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | | | - Samuel Yaw Opoku
- National Centre for Radiotherapy and Nuclear Medicine, Accra, Ghana
| | - Joel Yarney
- Department of Radiography, School of Biomedical and Allied Health Sciences, College of Health Science, University of Ghana, Accra, Ghana
| | - Samuel Nii Tagoe
- Department of Radiography, School of Biomedical and Allied Health Sciences, College of Health Science, University of Ghana, Accra, Ghana
| | - Michael Kwabeng Addo
- Department of Radiography, School of Biomedical and Allied Health Sciences, College of Health Science, University of Ghana, Accra, Ghana
| | - Kwabena Kwarko Anarfi
- Department of Radiography, School of Biomedical and Allied Health Sciences, College of Health Science, University of Ghana, Accra, Ghana
| | - Eric Abakuri
- Department of Radiography, School of Biomedical and Allied Health Sciences, College of Health Science, University of Ghana, Accra, Ghana
| | - Kofi Agyri
- Department of Radiography, School of Biomedical and Allied Health Sciences, College of Health Science, University of Ghana, Accra, Ghana
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Sabulei C, Maree JE. An exploration into the quality of life of women treated for cervical cancer. Curationis 2019; 42:e1-e9. [PMID: 31170799 PMCID: PMC6556867 DOI: 10.4102/curationis.v42i1.1982] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 02/14/2019] [Accepted: 03/02/2019] [Indexed: 12/21/2022] Open
Abstract
Background Cervical cancer mainly occurs among women from the developing world, and women face unique challenges in terms of their disease and treatment. Most women present with advanced cervical cancer and receive the standard curative treatment with external beam radiotherapy and brachytherapy with or without chemotherapy. Objectives To describe the quality of life (QOL) of women treated for cervical cancer during treatment (M0), at 6 months after completing treatment (M6) and at 12 months after treatment (M12). Methods A cross-sectional design, calculated sample size (n = 153) and convenience sampling were used. Data were collected through structured interviews, and the EORTC QLQ-C30 and EORTC QLQ CX24 served as data collection instruments. Descriptive statistics were used to analyse the data, and the Kruskal–Wallis H test was used to compare the mean responses across the groups (p ≤ 0.05). Results The mean age of the respondents was 50.6 years (standard deviation [SD] 11.9). The global health status improved significantly in contrast with the functional scores. Financial difficulties were rampant, especially during the treatment phase. Insomnia and urinary frequency were the most cumbersome problems and remained so even after treatment. Conclusions Despite an improvement in the global health, cervical cancer and its treatment had a negative influence on the QOL in all domains of lives of these women. Assessing the QOL of patients during treatment and follow-up visits would allow nurses to develop interventions to address distressing problems timeously. In addition, Africa’s nurses should assess social functioning and develop programmes to prevent social dysfunction.
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Affiliation(s)
- Caroline Sabulei
- Department of Nursing Education, University of the Witwatersrand, Johannesburg.
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Rahman Z, Singh U, Qureshi S, Nisha, Srivastav K, Nishchal A. Assessment of Quality of Life in Treated Patients of Cancer Cervix. J Midlife Health 2017; 8:183-188. [PMID: 29307981 PMCID: PMC5753500 DOI: 10.4103/jmh.jmh_40_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Aim: The aim of the study was to assess the quality of life (QoL) in women suffering from cancer cervix before and after the treatment, to study various factors affecting the QoL in these women, and to evaluate the impact of treatment modalities on the QoL. Materials and Methods: Women with cervical cancer attending Department of Obstetrics and Gynecology and Department of Radiotherapy who met the eligibility criteria were interviewed with a structured questionnaire of QoL, the European Organization for Research and Treatment of Cancer QLQ30, and its Cervical Cancer Module (Cx24). The baseline observations were recorded when the patient first reported, second evaluation was done at 3 months posttreatment, and the third evaluation at 6 months posttreatment. QoL domains along with sociodemographic and clinicopathological variables were analyzed. Results: A total of ninety patients were included for analysis, of which 5 were lost to follow up. A statistically significant improvement was found in physical, emotional function, pain, fatigue, and vaginal symptoms of the participants; however, there was no significant improvement in social, cognitive, or role functioning, body image, sexual activity, or sexual enjoyment. Vaginal and sexual function worsened significantly. Multivariate analysis showed that young women and those with a higher level of education had better QoL. Stage and type of cancer had little impact on the general QoL, but participants with earlier stage and well-differentiated cancer had better cancer cervix-specific QoL. Conclusion: The QoL of the participants in terms of physical (P = 0.04) and emotional functioning (P = 0.001) improved with treatment. Women with a higher level of education and early stage of disease had better QoL.
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Affiliation(s)
- Zakia Rahman
- Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Uma Singh
- Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sabuhi Qureshi
- Department of Gynaecological Oncology, Super Speciality Cancer Institute, Lucknow, Uttar Pradesh, India
| | - Nisha
- Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Kirti Srivastav
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anil Nishchal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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Development of protocol for the management of cervical cancer symptoms in resource-constrained developing countries. Support Care Cancer 2014; 23:581-600. [PMID: 25223351 DOI: 10.1007/s00520-014-2427-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 09/02/2014] [Indexed: 12/20/2022]
Abstract
Cervical cancer is the commonest malignancy of women in economically emerging countries. Patients have distressing symptoms from presentation through follow-up or end of life. Cervical cancer imposes significant burden on health care system due to distressing symptoms and associated loss of quality-adjusted life years (QALY). Multitude of drugs and surgical measures in various combinations can relieve these distressing symptoms and various clinical conditions. The protocols and guidelines for alleviation or relief of symptoms by general pharmacological and surgical measures form an important policy subject in planning cervical cancer management program. These protocol and guidelines are based on the mechanism of action of drugs, extrapolation from management of similar symptoms, and clinical situations arising out of other non-cancerous conditions and experience of health care professionals. Therefore, rigorous evaluation of effectiveness of supportive health care services in developing countries is the need of hour. However, evaluation of such protocol and guidelines are not feasible in emerging economies due to resource constraint. Industrialized affluent nations are also not able to implement and further support care guidelines despite its recognition as an integral part of multidisciplinary management of cancer. Aforementioned factors have created blind spot zone of management purview of cervical cancer. Hence, we attempt to develop protocol for management of adverse events of cervical cancer. Symptoms' and medical conditions' management guidelines evolved on the basis of empirical clinical practice in community and premier oncology centers in resource-constrained developing countries has been presented in this short report. This report should not be an end in itself but has to attract attention of policy-makers, academicians, researchers, and practitioners toward advancing supportive care needs of cancer patients in low- and middle-income countries (LMIC).
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