Qualidade de vida em mulheres com neoplasias de mama em quimioterapia

Global quality of life in breast cancer: systematic review and meta-analysis

BACKGROUND

Breast cancer (BC) is the most common cancer among women worldwide. We conducted a systematic review and meta-analysis to cover the existing research gap and contribute to existing knowledge to provide both researchers and clinicians with a better profile on the topic and consequently help improve the quality of life (QoL) of patients with BC.

METHODS

A comprehensive review of original articles published in English from January 2000 to October 2021 from databases including Embase, Scopus, PubMed and Web of Science was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

RESULTS

Based on the meta-regression which examined a total of 9012 patients with BC, the QoL score calculated by EORTC QLQ-C30 was 64.72 (95% CI 59.24 to 70.20), while the score obtained from FACT-B was 84.39 (95% CI 64.24 to 104.54) and the scores from QLQ-BR23 and SF-36 were 66.33 (95% CI 62.76 to 69.90) and 57.23 (95% CI 47.65 to 66.82), respectively. A meta-analysis affirmed a significant direct relationship between the QoL score of patients with BC and their age (p=0.03). The results also revealed that the QoL scores of patients who had completed treatment were higher than those who were currently under treatment.

CONCLUSION

The present systematic review identified several factors that affect the QoL of women with BC worldwide and provided several implications for developing policy interventions to effectively improve the QoL of women with BC. In this way, clinicians can sufficiently give advice to their patients with the purpose of improving their QoL. PROSPERO registration number CRD42022309791.

Effects of Pilates method on quality of life, fatigue and sleep quality among breast cancer women receiving hormone therapy - Two-arm randomized clinical trial

OBJECTIVE

To analyze the effect of the Pilates method on the quality of life, fatigue, and sleep quality of patients undergoing adjuvant clinical treatment with hormone therapy for breast cancer.

METHODS

A randomized two-arm clinical trial with 34 breast cancer women that were randomized into two groups: a) Intervention group, who performed 16 weeks of mat Pilates; b) Control group, who maintained their daily routine activities and received three educational sessions. The questionnaires for each variable were applied before the intervention, after the intervention, and six months after the end of the intervention. Quality of life was assessed by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30), fatigue by the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), and sleep quality by the Pittsburgh Sleep Quality Index.

RESULTS

The fatigue variable presented a time effect (p = 0.034) regardless of the analyzed group, in which a difference was found between baseline and the post-intervention period (p = 0.037). The variable sleep showed an effect of time (p = 0.025), presenting a difference between the baseline period and six months, with improvement for all participants (p = 0.004). Global health also showed a positive change also for all participants, with an isolated effect of time (p = 0.024).

CONCLUSION

Interventions based on the Pilates method may bring positive results in quality of life, fatigue, and sleep quality in patients undergoing adjuvant treatment for breast cancer, but further studies on the subject are needed to prove the results in a larger number of patients.

First use of antineoplastic agents in women with breast cancer in the state of Rio de Janeiro, Brazil

Context: Breast cancer is the most common cancer, except for non-melanoma skin cancer, among women in Brazil and worldwide. Breast cancer treatment involves surgery, radiotherapy and chemotherapy, which is used in 70% of patients. This study analyzes the utilization of antineoplastic agents among women undergoing their first round of chemotherapy in Brazil's public health system (SUS) in the state of Rio de Janeiro. Methods: Data from the SUS Outpatient Information System's authorizations for high-complexity outpatient procedures (APACs) billed between January 2013 and December 2019 were extracted, and three datasets were created: all type 1 and type 2 APACs (including all chemotherapy procedures performed); all type 1 APACs; and first type 1 APACs (containing data only for the first round of breast cancer chemotherapy). Names of antineoplastic agents were standardized to enable the subsequent classification of therapy regimens, mitigating limitations related to data quality. Absolute and relative frequencies were used to describe sociodemographic, clinical and treatment characteristics, therapy regimen and supportive drugs. Results: We analyzed 23,232 records of women undergoing their first round of chemotherapy. There was a progressive increase in the number of procedures over time. Women were predominantly white, lived in the capital and close to the treatment center. Most had stage 3 cancer at diagnosis (50.51%) and a significant proportion had regional lymph node invasion (37.9%). The most commonly used chemotherapy regimens were TAC (docetaxel, doxorubicine, cyclophosphamide) (21.05%) and and cyclophosphamide (17.71%), followed by tamoxifen (15.65%) and anastrozole (12.94%). Supportive drugs were prescribed to 386 women and zoledronic acid was predominant (59.58%). Conclusion: The findings point to important bottlenecks and possible inequities in access to treatment and medicine utilization for breast cancer patients in Brazil. Efforts to improve breast cancer treatment and prevention should not only focus on interventions at the individual level but address the disease as a public health problem. The study focused on women undergoing their first round of treatment, providing valuable insight into patient and treatment characteristics to inform policy decisions.

Quality of Life and Associated Factors Among Adult Cancer Patients Undergoing Chemotherapy Treatment at Amhara National, Regional State, Ethiopia, 2021

Background

In cancer, quality of life (QoL) is an important patient-reported metric; evaluating how patients feel physically and emotionally while fighting the disease could lead to better treatment. Despite its therapeutic effects, chemotherapy treatment causes a plethora of side effects that can affect QoL. Factors affecting the QoL of cancer patients undergoing chemotherapy treatment in Ethiopia have not been thoroughly investigated. As a result, this study assesses QoL and associated characteristics among adult cancer patients receiving chemotherapy at Amhara Region, Ethiopia in 2021.

Martials and Methods

From February 15 to May 15, 2021, an institutional based cross-sectional study was done in Amhara region. Three hundred fourteen patients were included in the study. The data was gathered using Amharic version of European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ C-30) through a face-to-face interview. Epi Data 4.6 was used to enter the data, which was then exported to SPSS version 23 for statistical analysis. Multivariable logistic regression analysis was used to determine the relationship between independent and dependent variables. The statistical significance was determined by a p-value of less than .05.

Result

Cancer patients in Amhara Region had a 44.32 average QoL. Emotional functioning AOR 1.01 (1.0-1.04), social functioning AOR 1.02 (1.01-1.03), nausea and vomiting AOR 0.95 (0.93-0.98), pain AOR 0.95 (0.93-0.98), financial difficulty 0.97 (0.95-0.99), education AOR 4.3 (1.49-12.32), underweight AOR 0.45 (0.24-0.84),  > 5th cycle of chemotherapy AOR 4 (1.78-9.11), stage IV cancer AOR 0.21 (0.06-0.71), comorbidity AOR 0.28 (0.14-0.57), anxiety AOR 0.32 (0.12-0.84), and depression AOR 0.29 (0.13-0.63) were all significantly associated with QoL in multivariable logistic regression.

Conclusion

Adult cancer patients receiving chemotherapy in the Amhara region had a poor QoL. Emotional functioning, social functioning, nausea and vomiting, pain, financial difficulty, education, body mass index, cancer stage, chemotherapy cycle, comorbidity, anxiety, and depression all had association with QoL. To improve the QoL of cancer patients, QoL assessments, proper symptom management, nutritional support, and integration of psycho-oncology treatment should be considered.

Quality of life and its influencing factors among breast cancer patients at Tikur Anbessa specialised hospital, Addis Ababa, Ethiopia

Background

Quality of life (QoL) has become an important measure for evaluating cancer patients’ treatment and prognosis. Breast cancer patients are at an increased risk of experiencing poor QoL during active treatment of cancer. This study aimed to assess QoL and it’s influencing factors among breast cancer patients using the newly updated breast cancer specific tool of the European Organisation for Research and Treatment of Cancer EORTC Breast Cancer Specific Quality of Life Questionnaire QLQ-BR45.

Methods

An institutional based crossectional study was conducted with 248 breast cancer patients at Tikur Anbessa Specialized Hospital (TASH). Descriptive statistics, one-way analysis of variance (ANOVA), and linear regression were used to describe and analyze the data.

Results

The participant’s Global health status/QoL mean score was 65.6. Among the functional scales, future perspective scored the lowest (57.1, SD ± 37.3). The highest mean score on the symptom scales/items were financial difficulties (50, SD ± 38.6), followed by appetite loss (37.4, SD ± 36.4) and fatigue (34.3, SD ± 27.1) while the lowest symptom score was diarrhoea (6.4 ± 18.4). EORTC QLQ-BR45, future perspective (mean = 57.1, SD ± 37.3) and upset by hair loss (41.8, SD ± 34.6) were the most affected functioning and symptoms scales respectively. An increased stage of tumor was associated with more pain (P = 0.041), appetite loss (P = 0.042), and arm symptoms (P = 0.003). Patients who had no comorbidity had better physical (P < 0.001), cognitive (P = 0.013), and social (P = 0.009) function.

Conclusion

These specific functional scales and symptoms should be assessed individually to address unmet needs. Clinicians could design psychosocial interventions to improve these function and to reduce symptoms.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12885-022-09921-6.

Effects of belly dancing intervention on sexual function and body image in breast cancer patients undergoing hormone therapy - randomized clinical trial

Abstract Introduction: Breast cancer is a public health problem because of its high incidence. Its often-mutilating treatment can cause serious problems with regard to body image and sexual function in these women. Belly dancing is a possible option to improve the femininity of these women. Objective: The aim of this two-arm randomized study was to determine the effect of practicing belly dancing on sexual function and body image in breast cancer patients undergoing adjuvant hormone therapy in Santa Catarina, Brazil. Methods: The study randomized 24 women (60 ± 10.4 years old) diagnosed with breast cancer, 11 in the intervention group (IG) and 13 in the control group (CG). A questionnaire was used to evaluate personal and clinical characteristics, body image (BIBCQ), and sexual function (FSFI). Results: On the body image scale, in the domains of body stigma (p = 0.002) and body concerns (p = 0.017), significant intergroup differences were found, with better body image for the IG in the post-intervention period when compared to the CG. In sexual function, no significant differences were found. Conclusion: Belly dancing as physical exercise helps improve body image in patients with breast cancer undergoing adjuvant treatment with hormone therapy.

Efeito da dança do ventre na função sexual e imagem corporal de pacientes em hormonioterapia para o câncer de mama - ensaio clínico randomizado

Resumo Introdução: O câncer de mama é um problema para a saúde pública devido ao alto número de incidência. Seu tratamento muitas vezes mutilador pode trazer sérios problemas na imagem corporal e na função sexual dessas mulheres. A dança do ventre vem como uma opção passível para melhorar a feminilidade dessas mulheres. Objetivo: Analisar o efeito da prática da dança do ventre na função sexual e na imagem corporal de pacientes em tratamento adjuvante de hormonioterapia para o câncer de mama em Santa Catarina. Métodos: O ensaio clínico randomizado de dois braços foi realizado com 24 mulheres (60 ± 10,4 anos) diagnosticadas com câncer de mama, sendo 11 no grupo de intervenção (GI) e 13 no grupo controle (GC). Utilizou-se um questionário avaliando características pessoais e clínicas, imagem corporal BIBCQ e função sexual FSFI. Resultados: Na escala de imagem corporal, nos domínios estigma corporal (p = 0,002) e preocupações com o corpo (p = 0,017), foram encontradas diferenças significativas intergrupo, com melhor imagem corporal para o GI no período pós-intervenção quando comparado ao GC. Na função sexual não foram encontradas diferenças significativas. Conclusão: Percebe-se a importância do exercício físico como a dança do ventre a fim de auxiliar na melhora da imagem corporal de pacientes com câncer de mama em tratamento adjuvante com hormonioterapia.

The Effect of the Mobile Application-Based Symptom Monitoring Process on the Symptom Control and Quality of Life in Breast Cancer Patients

OBJECTIVE

Patients with breast cancer receiving chemotherapy experience many symptoms. This study set out to determine the effect of the mobile application-based symptom monitoring process on symptom control and quality of life in breast cancer patients.

DATA SOURCES

The research sample consisted of 57 patients who applied to an outpatient chemotherapy unit of a university hospital. The patients in the intervention group reported symptoms starting from the first day when they received chemotherapy with Msemptom and until the 15th day after chemotherapy. After evaluation of the daily symptom reports of the patients, the patients were instructed via text message to report symptoms as moderate, severe, or very severe symptoms. After the application, the median of the Memorial Symptom Assessment Scale (MSAS)-physical subscale score of the patients in the control group was found to be statistically significantly higher than in the intervention group (P = .028). It was also found that after application, the medians of the European Organization for Research and Treatment of Cancer-Quality of Life (EORTC-QLQC30), symptom scale and nausea-vomiting score (P = .012), QLQ-BR23 Module sexual function (P = .024), and sexual pleasure subscale score (P = .026) were statistically significantly higher than patients in the intervention group.

CONCLUSION

The process of symptom monitoring with mobile applications is especially effective in controlling physical symptoms.

IMPLICATIONS FOR NURSING PRACTICE

It is recommended to expand mobile application-based symptom monitoring process in breast cancer patients and to support the patients in using this application-based process.

The Impact of AC and AC-T Chemotherapy's Toxicities on Quality of Life Among Women with Breast Cancer in Ethiopia: A Prospective Patient-Reported Outcomes Study

PURPOSE

The study aimed to evaluate the quality of life patterns and the effects of AC and AC-T chemotherapy's toxicities on QoL among Ethiopian women with breast cancer.

METHODS

QoL was measured at baseline and at every end of two cycles, for the median of 8 cycles among 146 breast cancer women on AC and AC-T chemotherapy, using EORTC QLQ-C30 and BR23 instruments. The effect of QoL score, socio-demographic, and clinical variables at baseline were adjusted for the effect of chemotherapy's toxicities on QoL.

RESULTS

Overall QoL, all functional scales (except cognitive functioning, body image, future perspectives, and sexual functioning) and symptom scales (except dyspnea, insomnia, pain score, arm, and breast symptoms) of EORTC QLQ-C30 and BR23 deteriorated significantly both clinically and statistically, in particular, during the first two cycles of chemotherapy. After the end of cycle 2 or 4, except for cognitive, social functioning, and financial difficulties of the patients, almost all other QoL dimensions were improved towards pretreatment score by the end of cycle 8. In addition to age, educational status, and tumor stage, the Global Health Status (-10.55≤B≤-7.71, P≤0.013), and the functional scales (-25.320≤B≤-6.351, P≤0.033) of EORTC QLQ-C30 and BR23 were significantly affected at least by one of the AC and AC-T chemotherapy's toxicity such as grade≥2 fatigue, dysgeusia, constipation, dry mouth, vomiting, oral mucositis, skin hyperpigmentation and/or peripheral neuropathy than their lower grade. Grade≥2 fatigue, dysgeusia, oral mucositis, constipation, peripheral neuropathy, anemia arthralgia/myalgia, dry mouth, diarrhea, constipation, and/or skin hyperpigmentation were positively predicted for the deterioration of symptoms scale of EORTC QLQ-C30 and BR23 (4.819≤B≤26.451, P≤0.043).

CONCLUSION

Quality of life among Ethiopian breast cancer patients on AC and AC-T regimens significantly deteriorated particularly during the first two cycles of chemotherapy. In addition to the age, tumor stage and educational status of the patients, grade≥2 fatigue, dysgeusia, constipation, oral mucositis, dry mouth, peripheral neuropathy, and skin hyperpigmentation due to AC and AC-T chemotherapy were frequently associated with deterioration of different scales/items QoL. Hence, devising different strategies to improve the deteriorated QoL due to chemotherapy's toxicities particularly during the first two cycles has paramount importance.

Pilates and dance to patients with breast cancer undergoing treatment: study protocol for a randomized clinical trial - MoveMama study

Background

Breast cancer is a global public health issue. The side effects of the clinical treatment can decrease the quality of life of these women. Therefore, a healthy lifestyle is essential to minimize the physical and psychological side effects of treatment. Physical activity has several benefits for women with breast cancer, and Pilates solo and belly dancing can be an enjoyable type of physical activity for women with breast cancer undergoing clinical treatment. The purpose of this study is to provide a Pilates solo and a belly dance protocol (three times per week/16 weeks) for women undergoing breast cancer treatment and compare its effectiveness with that in the control group.

Methods

The participants will be allocated to either the intervention arm (Pilates solo or belly dance classes three times per week for 16 weeks) or a control group (receipt of a booklet on physical activity for patients with breast cancer and maintenance of habitual physical activity routine). The Pilates solo and belly dance classes will be divided into three stages: warmup and stretching, the main stage, and relaxation. Measurements of the study outcomes will take place at baseline; postintervention; and 6, 12, and 24 months after the end of the intervention (maintenance period). The data collection for both groups will occur with a paper questionnaire and tests covering general and clinical information. The primary outcome will be quality of life (EORT QLQ-C30 and EORT QLQ-BR23), and secondary outcomes will be physical aspects such as cardiorespiratory fitness (6-min walk test and cycle ergometer), lymphedema (sum of arm circumference), physical activity (IPAQ short version), disabilities of the arm (DASH), range of motion (goniometer test), muscular strength (dynamometer test) and flexibility (sit and reach test), and psychological aspects such as depressive symptoms (Beck Depression Inventory), body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg), fatigue (FACT-F), pain (VAS), sexual function (FSFI), and sleep quality (Pittsburgh Sleep Quality Index).

Discussion

In view of the high prevalence of breast cancer among women, the implementation of a specific protocol of Pilates solo and belly dancing for patients with breast cancer is important, considering the necessity to improve their physical and psychological quality of life. Pilates solo and belly dancing are two types of physical activity that involve mental and physical concentration, music, upper limb movements, femininity, and social involvement. An intervention with these two physical activities could offer options of supportive care to women with breast cancer undergoing treatment, with the aim being to improve physical and psychological quality of life.

Trial registration

ClinicalTrials.gov, NCT03194997. Registration date 12 August 2017. Universal Trial Number (World Health Organization), U1111-1195-1623.

Health-related quality of life and its predictors among patients with breast cancer at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Background

Breast cancer is the second most prevalent malignancy in Ethiopia and severely affects patients’ health-related quality of life (HRQOL). We aimed to assess HRQoL, factors influencing HRQoL, and utilities among breast cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

Methods

A hospital-based cross-sectional study was conducted in Tikur Anbessa Specialized Hospital from December 2017 to February, 2018. A total of 404 breast cancer patients were interviewed using the validated Amharic version of the European Organization for Research and Treatment of Cancer module (EORTC QLQ-C30), EORTC QLQ-BR23, and Euro Quality of Life Group’s 5-Domain Questionnaires 5 Levels (EQ-5D-5 L) instruments. Mean scores and mean differences of EORTC- QLQ-C30 and EORTC- QLQ-BR23 were calculated. One-way ANOVA test was employed to determine the significance of mean differences among dependent and independent variables while stepwise multivariate logistic regression was used to identify factors associated with the global quality of life (GQOL). Coefficients and level specific utility values obtained from a hybrid regression model for the Ethiopian population were used to compute utility values of each health state. Data was analyzed using SPSS version 23.

Results

The mean age of patients was 43.94 ± 11.72 years. The mean score for GQoL and visual analog scale was 59.32 ± 22.94 and 69.94 ± 20.36, respectively while the mean utility score was 0.8 ± 0.25. Predictors of GQoL were stage of cancer (AOR = 7.94; 95% CI: 1.83–34.54), cognitive functioning (AOR = 2.38; 95% CI: 1.32–4.31), pain (AOR = 7.99; 95% CI: 4.62–13.83), financial difficulties (AOR = 2.60; 95% CI: 1.56–4.35), and future perspective (AOR = 2.08; 95% CI: 1.24–3.49).

Conclusions

The overall GQoL of breast cancer patients was moderate. Targeted approaches to improve patients’ HRQoL should consider stage of cancer, cognitive functioning, pain, financial status and worries about the patient’s future health. This study also provides estimates of EQ-5D utility scores that can be used in economic evaluations.

Health-Related Quality of Life Among Vietnamese Breast Cancer Women

The aim of the study was to investigate health-related quality of life among Vietnamese breast cancer women who were treated at National Cancer Hospital, Hanoi, Vietnam, in 2018. Information about physical functioning, Role Physical, Bodily Pain, General Health, vitality, Social Functioning, Role Emotional, and Mental Health of 200 patients with breast cancer was collected through face-to-face interview, using short form-36 questionnaire. We found that the older patients (older than 50 years) had higher score of Mental Health than patients at age 50 and lower (P < .05). The patients who had better economic status had significantly higher score of Vitality (P < .05). Patients who were married and living with their partners/husband had better quality of life in General Health (P<0.05). The patients who had less than 6 months of treatment had better physical functioning score (P < .05) than the patients who had treatment longer than 6 months. Patients with caring supports from family members had higher scores of Bodily Pain, Social Functioning, Role Emotional, and Mental Health. Patients who have stressed feelings had significantly lower scores of all domains, except for Physical Functioning. The participants who usually stay up late reported lower scores of all components except for Physical Functioning and Role Physical. In conclusion, it is needed to develop psychosocial services, enhance early screening, and diagnose for the women in Vietnam.

Quality of life and functional capacity during the treatment of hematologic neoplasms

Abstract Introduction: Cancer is a serious pathology with a high incidence and complex diagnoses. Emotional and environmental factors, the deleterious effects of these, and lifestyle affect different outcomes. Objective: Investigate the association between quality of life and functional capacity during treatment for hematologic cancer. Methods: A cross-sectional study with intentional sampling of patients of both sexes with hematologic neoplasms, interviewed in 2016. Quality of life (QF) was measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. For the definition of functional capacity in basic and instrumental activities of daily life, the Katz Index and the Lawton Scale, respectively, were used. Data were analyzed by correlations and comparisons of means tests. Results: The 52 participants presented an average QF score of approximately 60.6. Among the functional scales, the worst result was in role functioning (46.8), while for symptoms, it was fatigue (48.1). The results of more expressive QF indicators were the strong correlation between role functioning and fatigue (r = -0.60), and a moderate correlation between social functioning and financial difficulties (r = -0.45). There was still an association between role functioning and functional incapacity in daily activities (p = 0.017). Fatigue was associated with incapacity for basic activities (p = 0.018), while insomnia was correlated with instrumental activities (p = 0.032). Conclusion: The association between lower QF scores and functional incapacity reflects the damaging effect of hematologic neoplasms on daily activities.

Experience of the spouse of a woman with breast cancer undergoing chemotherapy: a qualitative case study

Abstract Objective: To identify the meaning attributed to the experience of a spouse of a woman with breast cancer undergoing chemotherapy. Methods: Descriptive study, with a theoretical-methodological orientation based on medical anthropology and utilizing an ethnographic case study strategy. Data were collected through semi-structured interviews and participant observation. Results: The meanings revealed that the diagnosis cause suffering. Chemotherapy was seen as giving hope of healing the wife's cancer. During this process, the spouse had to deal with the strong adverse effects of the treatment and subordinate to his wife to reduce the conflict experienced by the couple, which violated the rules of his masculinity. Religion and family were important support networks on this path. Final considerations and implications for practice: The results showed the importance of considering cultural aspects of spouses when they are faced with disease in their wives. The way spouses deal with breast cancer will depend on their cultural systems. Nursing care must be comprehensive and extend to spouses whose wives have breast cancer.

The quality of life of Croatian women after mastectomy: a cross-sectional single-center study

Background

Measuring the quality of life (QoL) of women with breast cancer is an important aspect of measuring treatment success. In Croatia, no QoL studies have been carried out with a focus on patients after mastectomy. The aim of this study was to examine QoL 1 month and 1 year after mastectomy.

Methods

This cross-sectional single-center study of quality of life was conducted in 101 patients, 50 of whom had undergone a mastectomy 1 month prior, and 51 of whom had undergone a mastectomy 1 year prior. The study was conducted from July 2015 to June 2016. The questionnaires used in the study were developed by the European Organisation for Research and Treatment of Cancer (EORTC). The questionnaire EORTC QLQ-C30 assesses the QoL of cancer patients, and the questionnaire EORTC QLQ-BR23 is a disease-specific breast cancer module. A chi square test, Fisher’s exact test, Kolmogorov-Smirnov test, Student’s t-test and Mann-Whitney U test were performed in the statistical analysis using the statistical program SPSS (Inc. Released 2008. SPSS Statistics for Windows, Version 17.0. Chicago: SPSS Inc.).

Results

Patients who had undergone a mastectomy a year earlier placed a higher value on their health state than did those who had undergone a mastectomy a month earlier. The most affected values of functional status on the EORTC QLQ-C30 scale were emotional functioning (37.5 [95% CI 33.3–61.6]) and sexual functioning (16.67 [95% CI 0–33.3]) 1 month and 1 year after mastectomy, respectively. The most affected symptoms on the EORTC QLQ-C30 scale were hair loss 66.67 [95% CI 33.3–100]) and fatigue 33.33 [95% CI 24–44]) 1 month and 1 year after mastectomy, respectively.

Conclusion

In our study, both functional and symptom scales were more affected in women 1 month after mastectomy. QoL was considerably improved in women 1 year after the surgery compared to 1 month after mastectomy. The results of this study could contribute to the public awareness of the QoL of breast cancer patients.

Reconstrução mamária imediata versus não reconstrução pós-mastectomia: estudo sobre qualidade de vida, dor e funcionalidade

RESUMO Com a evolução das técnicas oncoplásticas que permitem a reconstrução da mama no mesmo instante da mastectomia, sem comprometer a segurança oncológica, torna-se pertinente investigar as implicações da reconstrução imediata com expansor ou prótese de silicone sobre a dor, a funcionalidade do membro superior homolateral à cirurgia e a qualidade de vida (QV) das mulheres. O objetivo deste estudo foi comparar a dor, a funcionalidade e a QV de mulheres submetidas à mastectomia radical modificada com reconstrução mamária imediata e sem reconstrução. Trata-se de um estudo transversal, comparativo e descritivo com abordagem quantitativa, que avaliou 22 voluntárias pós-mastectomia radical modificada, divididas igualmente em dois grupos, de acordo com a realização da reconstrução mamária imediata (RI) ou sem reconstrução (SR). As voluntárias responderam ao questionário sociodemográfico, clínico e de tratamento oncológico, a EVA, para mensurar a dor, DASH para avaliar a funcionalidade do membro superior e, para avaliar a QV, foi utilizado o questionário EORTC QLQ-C30 com seu módulo específico para o CA de mama. Houve alta prevalência de dor, moderada limitação funcional e satisfatória QV. No entanto, não foram encontradas diferenças significativas intergrupos para dor (p=0,586), funcionalidade (p=0,399) e QV (p>0,05). Para a amostra avaliada, fazer ou não a reconstrução da mama com expansor ou implante de silicone no ato da mastectomia não implicou sobre a dor, funcionalidade e QV.

The effects on anxiety and quality of life of breast cancer patients following completion of the first cycle of chemotherapy

OBJECTIVES

Breast cancer patients as part of their treatment need to undergo various forms of chemotherapy. This is considered as a burdensome experience for many patients often leading to significant levels of anxiety. The aim of the study was to explore the anxiety levels and any correlations to the quality of life of women with breast cancer that were undergoing chemotherapy.

METHODS

This was a cross-sectional study utilizing an explanatory sequential design. Data were collected from 355 women with breast cancer with the Self Anxiety Scale, the EORTC QLQ-C30, the EORTC QLQ-BR23 and sociodemographic questionnaires. Further insight to patients' experiences was given through 12 in-depth interviews.

RESULTS

Anxiety scores ranged between 24 and 75 (45.7 ± 10.11), with 44% reporting serious or/and intense anxiety. The results revealed statistically significant differences on patients' anxiety levels depending on their source of support. Overall, patients' global health-related quality of life was found to be low to average 55.91 ± 17.94. The results showed low emotional functioning (49.30 ± 29.12), low role functions (56.34 ± 27.50) and low sexual functioning (24.93 ± 20.75). Patients also reported experiencing problems with fatigue (49.04 ± 29.12), insomnia (44.32 ± 32.97), hair loss (48.25 ± 38.32) and arm symptoms (36.53 ± 23.71). Patients being solely supported by the family experienced higher anxiety levels (p < 0.001) and lower quality of life (p < 0.001). There was a statistically significant negative correlation between anxiety and quality of life (r = -0.623, p < 0.001). Statistically significant differences were also found in relation to demographics, anxiety and quality of life. The interviews provided further evidence on the impact of anxiety on patients' lives.

CONCLUSION

The time following the completion of the first cycle of chemotherapy is associated with anxiety and lower quality of life levels in breast cancer patients. Healthcare providers should consider the supportive healthcare needs from the beginning of chemotherapy in patients to optimize their conventional and supportive healthcare outcomes.

Quality of life in women with breast cancer, after surgical intervention, in a city in the zona da mata region in Minas Gerais, Brazil

Abstract Objectives: To evaluate health-related quality of life (HRQoL) in women with breast cancer, after surgical intervention, attended at the regional Oncology Referral Hospital in Juiz de Fora (MG). Methods: 121 women were evaluated and the European Organization for Research and Treatment of Cancer, Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLC 30 BR23) was applied. After the descriptive analysis, a multiple linear regression model was created. The SPSS 14 was used to build the database and to conduct the analysis. Results: the mean values of the EORTC QLC 30 BR23 showed a tendency for good HRQoL, thus, the functional scale showed the most impairment with the worst mean scores observed. There was statistical significance among the symptoms scale and obese women who underwent adjuvant radiotherapy and those who had a greater number of dissected lymph nodes. The subjective perceptions influenced all the EORTC QLC 30 BR23domains. Conclusions: after controlling the variable by functional hand, and time of surgery, the BMI variables, breast reconstruction, heavy feeling in the arm, range of motion (ROM) reduction of the shoulder, and the tight shirt-sleeve sensation proven capable of explaining HRQoL. HRQoL appears to be relatively good, but negatively influenced by subjective perceptions, in addition to treatment factors.

Quality of Life and Its Determinants in Adult Cancer Patients Undergoing Chemotherapy Treatment in Pakistan

Objective:

Cancer is a leading cause of death worldwide. Likewise, in Pakistan, it is a major health problem, with an approximate increase each year. Cancer treatment, particularly chemotherapy, produces a detrimental effect on individuals’ well-being. Since the past few years, quality of life (QOL) is considered as the primary goal of cancer treatment in patients’ survival. This study aimed to assess the QOL and its determinants in adult cancer patients undergoing chemotherapy treatment.

Methods:

An analytical cross-sectional design was employed to achieve the study objectives, utilizing consecutive sampling technique. A total of 150 adult (>19 years) cancer patients were recruited from a Tertiary Care Hospital in Karachi, Pakistan. The data were collected using the Functional Assessment of Cancer Therapy-General, a QOL questionnaire. Multiple linear regression was run to determine the effect of predictor variables, with a mean QOL score.

Results:

The overall mean score of QOL as 57.37. The domains of physical and emotional well-being were mainly affected by the chemotherapy treatment. Variables such as no previous hospitalization and no significant changes in life events were positively associated with the QOL. On the other hand, being female, unemployed, chemotherapy side effects (>1 week), impaired socialization, and discrimination by family/relatives were negatively associated with the QOL.

Conclusions:

The study findings suggested an overall low QOL among adult cancer patients undergoing chemotherapy treatment. It is recognized as a stressful treatment, which adversely affects the QOL of cancer patients. Interventions should focus on both the physical and psychological issues and need to be addressed to improve the QOL of adult cancer patients.