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Bøhn SKH, Svendsen K, Balto A, Gjelsvik YM, Myklebust TÅ, Børøsund E, Eriksen HR, Meland A, Østby K, Nes LS, Kiserud CE, Reinertsen KV, Ursin G. Health-related quality of life among women diagnosed with in situ or invasive breast cancer and age-matched controls: a population-based study. J Patient Rep Outcomes 2024; 8:105. [PMID: 39298004 DOI: 10.1186/s41687-024-00781-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 08/27/2024] [Indexed: 09/21/2024] Open
Abstract
PURPOSE A breast cancer (BC) diagnosis may negatively affect health-related quality of life (HRQoL). However, there are few comparisons of HRQoL at several time points for women with BC, and particular when subdivided into invasive and in situ tumors. The purpose of this study was to investigate various aspects of HRQoL in women recently diagnosed with invasive BC or ductal carcinoma in situ (in situ) compared to age-matched BC free controls in a population-wide sample recruited through the Cancer Registry of Norway. METHODS This cross-sectional study utilized HRQoL data collected in 2020-2022 from a digital survey including 4117 cases (3867 women with invasive BC and 430 with in situ) and 2911 controls. HRQoL was assessed ≥ 21 days after diagnosis, using EORTC QLQ-C30. This includes scores assessing global quality of life (gHRQoL) and HRQoL functions and symptoms. Multivariable regression analyses were used to compare HRQoL between cases and controls and to identify factors associated with gHRQoL and fatigue. Additionally, HRQoL 14 months after diagnosis was analyzed in 1989 of the included cases and in 1212 of the controls. Score differences of ≥ 10 points were considered clinically relevant and thus presented in the results. RESULTS Invasive BC cases had lower gHRQoL, role- and social functioning in addition to more fatigue than controls. In situ cases had lower role-and social functioning than controls. Invasive BC cases scored worse than in situ on all domains, but the differences were not considered clinically relevant. Physical activity was associated with better gHRQoL and less fatigue in invasive BC, in situ and controls. Both invasive BC and in situ cases improved their role- and social functioning scores from diagnosis to 14 months follow-up, however no improvement was seen for fatigue. CONCLUSION Women with invasive BC and in situ reported lower role- and social functioning scores than controls right after diagnosis with improvements 14 months after diagnosis. Physical activity was associated with better gHRQoL and less fatigue and should, whenever possible, play a key role in the care for BC patients.
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Affiliation(s)
- Synne K H Bøhn
- Unit for Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Karianne Svendsen
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway.
- The Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - A Balto
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Ylva Maria Gjelsvik
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Tor Åge Myklebust
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Hege R Eriksen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - A Meland
- Department of Social Sciences, Norwegian School of Sport Sciences, Oslo, Norway
| | - K Østby
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - L Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cecilie E Kiserud
- Unit for Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Kristin V Reinertsen
- Unit for Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - G Ursin
- Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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Joaquim A, Amarelo A, Antunes P, Garcia C, Leão I, Vilela E, Teixeira M, Duarte B, Vieira M, Afreixo V, Capela A, Viamonte S, Costa H, Helguero LA, Alves A. Effects of a Physical Exercise Program on Quality of Life and Physical Fitness of Breast Cancer Survivors: the MAMA_MOVE Gaia After Treatment Trial. PSYCHOL HEALTH MED 2024; 29:964-987. [PMID: 37644639 DOI: 10.1080/13548506.2023.2240074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/18/2023] [Indexed: 08/31/2023]
Abstract
To assess the effects of a group class physical exercise program on health-related quality of life (HRQOL), physical fitness and activity, and safety in early breast cancer women after treatment, a double-phase trial [16-week control phase (CP) followed by a 16-week intervention phase (IP)] was designed. Outcomes were evaluated at baseline (T1), 8 (T2) and 16 (T3) weeks (CP), and 24 (T4) and 32 (T5) weeks (IP). The primary endpoint was global health status. Out of 82 enrolled patients, 37 completed the IP. Global health status decreased (-10,1; 95% CI -19.8 to -0.4; p = 0.040) during the CP and stabilized during the IP. Physical and sexual functioning increased during the IP (p = 0.008; p = 0.017), while cardiorespiratory fitness increased in the CP (p = 0.004). Upper limb strength and lower limb functionality increased during both phases [CP: p < 0.0001, p = 0.001 (surgical and nonsurgical arm), p = 0.028; IP: p < 0.0001, p = 0.002, p = 0.009]. Body mass index decreased in the IP (p = 0.026). Waist circumference increased in the CP (p = 0.001) and decreased in the IP (p = 0.010); sedentary behaviours and moderate and vigorous physical activity did not change. Adherence to 70% of the sessions was reported in 54% of patients. No serious adverse events related to the intervention were reported. In conclusion, the physical exercise program was able to prevent the decline in global health status and to improve other domains of HRQOL and physical fitness. As physical exercise is not the standard of care in many countries, the implementation of group class programs might be an option.
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Affiliation(s)
- Ana Joaquim
- Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
- Medical Oncology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Anabela Amarelo
- Medical Oncology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Pedro Antunes
- Research Center in Sport Sciences, Health, and Human Development (CIDESD), University of Beira Interior, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Catarina Garcia
- Research Center in Sport Sciences, Health, and Human Development (CIDESD), University of Maia, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Inês Leão
- Medical Oncology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Eduardo Vilela
- Cardiology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Madalena Teixeira
- Cardiology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Bárbara Duarte
- ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Micael Vieira
- Solinca Classic, SA, SC Fitness, SA, Lisbon, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
| | - Vera Afreixo
- Department of Mathematics; University of Aveiro, Center for Research & Development in Mathematics and Applications (CIDMA), University of Aveiro
| | - Andreia Capela
- Medical Oncology Department; Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Sofia Viamonte
- Department of Medical Sciences, University of Aveiro Centro de Reabilitação Do Norte, Centro Hospitalar Vila Nova de Gaia/Espinho, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO), Portugal
| | - Horácio Costa
- Department of Plastic Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Department of Medical Sciences, University of Aveiro, Portugal
| | - Luisa A Helguero
- Department of Medical Sciences, University of Aveiro, Institute of Biomedicine of Aveiro (IBIMED), University of Aveiro, Aveiro, Portugal
| | - Alberto Alves
- Research Center in Sport Sciences, Health, and Human Development (CIDESD), University of Maia, ONCOMOVE® - Associação de Investigação de Cuidados de Suporte Em Oncologia (AICSO)
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Gjerset GM, Skaali T, Seland M, Thorsen L. Health-Related Quality of Life, Fatigue, Level of Physical Activity, and Physical Capacity Before and After an Outpatient Rehabilitation Program for Women Within Working Age Treated for Breast Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:948-956. [PMID: 35974293 PMCID: PMC10234893 DOI: 10.1007/s13187-022-02211-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 06/02/2023]
Abstract
The aims were to examine changes in patient-reported outcome measures (PROMs), level of physical activity (LPA), and physical capacity from before to after an outpatient rehabilitation program (ORP) for women with breast cancer (BC). Further aims were to explore the proportions of patients with clinically relevant improvements defined as ≥ 10% beneficial change in the scores of PROMs and variables associated with such improvements.A total of 270 women within working age (< 67 years) who recently (< 1.5 years) had completed primary therapy for BC with curative intent were included. The ORP consisted of seven weekly group sessions with patient education, group conversations, and PA. The patients completed questionnaires measuring health-related quality of life (HRQoL), fatigue and LPA before (T0), immediately after (T1), and 6 months after (T2) the program, and were physically tested at T0 and T1. The mean age of the patients was 50.4 years (SD 7.3) and the mean time since diagnosis was 10.6 months (SD 2.6). All patients had undergone surgery and 94% radiotherapy, and 96% had received chemotherapy and/or hormonal therapy.Physical-, role-, emotional-, cognitive-, and social function, global health, and fatigue significantly improved from T0 to T1. Physical-, role-, and cognitive function, and fatigue significantly improved from T1 to T2. LPA and physical capacity significantly improved from T0 to T1. More than 40% of the patients had a clinically relevant improvement in role-, social function, and fatigue symptoms, from T0 to T1. Low level of education was associated with an improvement in emotional function, and living alone was associated with an improvement in mental fatigue.HRQoL, fatigue, LPA, and physical capacity improved in women within working age recently treated for BC who participated in an ORP.
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Affiliation(s)
- Gunhild M Gjerset
- Unit for Psychosocial Oncology, Coping and Rehabilitation, Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 4953 Nydalen, 0424, Oslo, Norway.
- National Advisory Unit On Late Effects After Cancer Treatment, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.
| | - Tone Skaali
- Unit for Psychosocial Oncology, Coping and Rehabilitation, Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 4953 Nydalen, 0424, Oslo, Norway
| | - Mette Seland
- Unit for Psychosocial Oncology, Coping and Rehabilitation, Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 4953 Nydalen, 0424, Oslo, Norway
| | - Lene Thorsen
- National Advisory Unit On Late Effects After Cancer Treatment, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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Miret C, Orive M, Sala M, García-Gutiérrez S, Sarasqueta C, Legarreta MJ, Redondo M, Rivero A, Castells X, Quintana JM, Garin O, Ferrer M. Reference values of EORTC QLQ-C30, EORTC QLQ-BR23, and EQ-5D-5L for women with non-metastatic breast cancer at diagnosis and 2 years after. Qual Life Res 2023; 32:989-1003. [PMID: 36630024 PMCID: PMC10063520 DOI: 10.1007/s11136-022-03327-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE To obtain reference norms of EORTC QLQ-C30, EORTC QLQ-BR23, and EQ-5D-5L, based on a population of Spanish non-metastatic breast cancer patients at diagnosis and 2 years after, according to relevant demographic and clinical characteristics. METHODS Multicentric prospective cohort study including consecutive women aged ≥ 18 years with a diagnosis of incident non-metastatic breast cancer from April 2013 to May 2015. Health-related quality of life (HRQoL) questionnaires were administered between diagnosis and beginning the therapy, and 2 years after. HRQoL differences according to age, comorbidity and stage were tested with ANOVA or Chi Square test and multivariate linear regression models. RESULTS 1276 patients were included, with a mean age of 58 years. Multivariate models of EORTC QLQ-C30 summary score and EQ-5D-5L index at diagnosis and at 2-year follow-up show the independent association of comorbidity and tumor stage with HRQoL. The standardized multivariate regression coefficient of EORTC QLQ-C30 summary score was lower (poorer HRQoL) for women with stage II and III than for those with stage 0 at diagnosis (- 0.11 and - 0.07, p < 0.05) and follow-up (- 0.15 and - 0.10, p < 0.01). The EQ-5D-5L index indicated poorer HRQoL for women with Charlson comorbidity index ≥ 2 than comorbidity 0 both at diagnosis (- 0.13, p < 0.001) and follow-up (- 0.18, p < 0.001). Therefore, we provided the reference norms at diagnosis and at the 2-year follow-up, stratified by age, comorbidity index, and tumor stage. CONCLUSION These HRQoL reference norms can be useful to interpret the scores of women with non-metastatic breast cancer, comparing them with country-specific reference values for this population.
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Affiliation(s)
- Carme Miret
- Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB), 08193, Bellaterra, Barcelona, Spain
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, i Universitat Pompeu Fabra, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Miren Orive
- Departamento Psicología Social, Facultad Farmacia, UPV/EHU, Vitoria-Gasteiz, Araba, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Maria Sala
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, i Universitat Pompeu Fabra, Barcelona, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
| | - Susana García-Gutiérrez
- Osakidetza Basque Health Service, Research Unit, Galdakao-Usansolo University Hospital, Galdakao, Bizkai, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Cristina Sarasqueta
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
- Biodonostia Health Research Institute, Donostia University Hospital, Donostia, Gipuzkoa, Spain
| | - Maria Jose Legarreta
- Osakidetza Basque Health Service, Research Unit, Galdakao-Usansolo University Hospital, Galdakao, Bizkai, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Maximino Redondo
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
- Research and Innovation Unit, Hospital Costa del Sol, Marbella, Spain
| | - Amado Rivero
- Servicio de Evaluación y Planificación del Servicio Canario de la Salud (SESCS), Tenerife, Spain
| | - Xavier Castells
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, i Universitat Pompeu Fabra, Barcelona, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
| | - José M Quintana
- Osakidetza Basque Health Service, Research Unit, Galdakao-Usansolo University Hospital, Galdakao, Bizkai, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Olatz Garin
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Montse Ferrer
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003, Barcelona, Spain.
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
- Departament de Medicina i Ciències de la Vida, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
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Kaur MN, Yan J, Klassen AF, David JP, Pieris D, Sharma M, Bordeleau L, Xie F. A Systematic Literature Review of Health Utility Values in Breast Cancer. Med Decis Making 2022; 42:704-719. [PMID: 35042379 PMCID: PMC9189726 DOI: 10.1177/0272989x211065471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Health utility values (HUVs) are important inputs to the cost-utility analysis of breast cancer interventions. PURPOSE Provide a catalog of breast cancer-related published HUVs across different stages of breast cancer and treatment interventions. DATA SOURCES Systematic searches of MEDLINE, MEDLINE In-Process, EMBASE, Web of Science, CINAHL, PsycINFO, EconLit, and Cochrane databases (2005-2017). STUDY SELECTION Studies published in English that reported mean or median HUVs using direct or indirect methods of utility elicitation for breast cancer. DATA EXTRACTION Independent reviewers extracted data on a preestablished and piloted form; disagreements were resolved through discussion. DATA ANALYSIS Mixed-effects meta-regression using restricted maximum likelihood modeling was conducted for intervention type, stage of breast cancer, and typical clinical and treatment trajectory of breast cancer patients to assess the effect of study characteristics (i.e., sample size, utility elicitation method, and respondent type) on HUVs. DATA SYNTHESIS Seventy-nine studies were included in the review. Most articles (n = 52, 66%) derived HUVs using the EQ-5D. Patients with advanced-stage breast cancer (range, 0.08 to 0.82) reported lower HUVs as compared with patients with early-stage breast cancer (range, 0.58 to 0.99). The meta-regression analysis found that undergoing chemotherapy and surgery and radiation, being diagnosed with an advanced stage of breast cancer, and recurrent cancer were associated with lower HUVs. The members of the general public reported lower HUVs as compared with patients. LIMITATIONS There was considerable heterogeneity in the study population, health states assessed, and utility elicitation methods. CONCLUSION This review provides a catalog of published HUVs related to breast cancer. The substantial heterogeneity in the health utility studies makes it challenging for researchers to choose which HUVs to use in cost-utility analyses for breast cancer interventions.
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Affiliation(s)
- Manraj N Kaur
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Jiajun Yan
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Anne F Klassen
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Justin P David
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Dilshan Pieris
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Manraj Sharma
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Louise Bordeleau
- Department of Oncology, Division of Medical Oncology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Gong J, Han J, Lee D, Bae S. A Meta-Regression Analysis of Utility Weights for Breast Cancer: The Power of Patients' Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249412. [PMID: 33333997 PMCID: PMC7765456 DOI: 10.3390/ijerph17249412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 06/12/2023]
Abstract
To summarize utility estimates of breast cancer and to assess the relative impacts of study characteristics on predicting breast cancer utilities. We searched Medline, Embase, RISS, and KoreaMed from January 1996 to April 2019 to find literature reporting utilities for breast cancer. Thirty-five articles were identified, reporting 224 utilities. A hierarchical linear model was used to conduct a meta-regression that included disease stages, assessment methods, respondent type, age of the respondents, and scale bounds as explanatory variables. The utility for early and late-stage breast cancer, as estimated by using the time-tradeoff with the scales anchored by death to perfect health with non-patients, were 0.742 and 0.525, respectively. The severity of breast cancer, assessment method, and respondent type were significant predictors of utilities, but the age of the respondents and bounds of the scale were not. Patients who experienced the health states valued 0.142 higher than did non-patients (P <0.001). Besides the disease stage, the respondent type had the highest impact on breast cancer utility.
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Affiliation(s)
- Jiryoun Gong
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (J.G.); (J.H.)
| | - Juhee Han
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (J.G.); (J.H.)
| | - Donghwan Lee
- Department of Statistics, Ewha Womans University, Seoul 03760, Korea;
| | - Seungjin Bae
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (J.G.); (J.H.)
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Marinho EDC, Custódio IDD, Ferreira IB, Crispim CA, Paiva CE, Maia YCDP. Relationship between food perceptions and health-related quality of life in a prospective study with breast cancer patients undergoing chemotherapy. Clinics (Sao Paulo) 2018; 73:e411. [PMID: 30517281 PMCID: PMC6238818 DOI: 10.6061/clinics/2018/e411] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 07/04/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To correlate the perceptions related to dietary intake with the domains and subscales of health-related quality of life (HRQL) in women with breast neoplasms receiving chemotherapy. METHODS In this prospective study, 55 women with breast cancer were followed up during chemotherapy at three different times (T0, T1, T2). Before chemotherapy, perceptions related to food consumption were evaluated. HRQL was analyzed with the EORTC QLQ-C30 and Br23 instruments 21 days after each investigated cycle. The differences (T2-T0) in the subscales and HRQL domains were correlated with the differences (T2-T0) in the appetite scores. Spearman's correlation was used to verify a possible correlation between differences in functional and overall HRQL domains (T2-T0) and differences in appetite scores for certain foods and between the differences in some subscales of EORTC QLQ-C30 and Br23 (T2-T0) and differences in appetite scores for certain food groups (T2-T0). RESULTS Correlations between pain and appetite for bitter taste and between an increased appetite for juices and pain intensification or fatigue were identified, and pain was correlated with an appetite for starchy foods. An appetite for vegetables, legumes and meat/eggs was correlated with physical function. The only significant correlation with social functions occurred between the appetite for sweet foods and these functions. We found a correlation between overall health, emotional function, social function and physical function and the appetite for juices. CONCLUSION Chemotherapy alters the individual's relationship with food and, consequently, the individual's HRQL.
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Affiliation(s)
- Eduarda da Costa Marinho
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal de Uberlandia, Uberlandia, MG, BR
| | | | - Isabela Borges Ferreira
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal de Uberlandia, Uberlandia, MG, BR
- Faculdade de Medicina, Universidade Federal de Uberlandia, Uberlandia, MG, BR
| | - Cibele Aparecida Crispim
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal de Uberlandia, Uberlandia, MG, BR
- Faculdade de Medicina, Universidade Federal de Uberlandia, Uberlandia, MG, BR
| | - Carlos Eduardo Paiva
- Divisão Mama & Ginecologia, Departamento de Oncologia Clinica, Grupo de Pesquisa em Cuidados Paliativos e Qualidade de Vida (GPQual), Fundacao Pio XII - Hospital de Cancer de Barretos, Barretos, SP, BR
| | - Yara Cristina de Paiva Maia
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal de Uberlandia, Uberlandia, MG, BR
- Faculdade de Medicina, Universidade Federal de Uberlandia, Uberlandia, MG, BR
- *Corresponding author. E-mail:
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Traore BM, El Fakir S, Charaka H, Benaicha N, Najdi A, Zidouh A, Bennani M, Errihani H, Mellass N, Benider A, Bekkali R, Nejjari C. Evolution of quality of life in patients with breast cancer during the first year of follow-up in Morocco. BMC Cancer 2018; 18:109. [PMID: 29402232 PMCID: PMC5800277 DOI: 10.1186/s12885-018-4008-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 01/18/2018] [Indexed: 11/13/2022] Open
Abstract
Background Quality of life has an important place in the future of patients with breast cancer. The objective of this study is to assess the evolution of the patient’s quality of life with breast cancer in Morocco after a year of follow-up. Methods This study involved the patients with breast cancer with all types of treatment as determined by their physicians. Patient’s quality of life was assessed with the Moroccan Arabic version of QLQ- EORTC QLQ C30 and EORTC-BR23 questionnaires. Data were analyzed using SPSS Version 20 software. Results Regarding EOTRC questionnaires QLQ C-30, there was a significant improvement in global health status and all scales of the functional dimension except the social functional where there was a trend towards improvement and the financial impact of the disease where the situation has deteriorated. Quality of life was improved for most symptom-sized scales dimension of EORTC QLQ- C30 with the exception of diarrhea where it was observed degradation. Most of the EORTC QLQ-scales BR23 questionnaires showed a favorable trend in the quality of life except those of sexual functioning, sexual enjoyment, hair loss and the side effects of systemic therapy. Conclusion The quality of life of the patient is significantly improved after 1 year of follow up. Quality of life instruments can be useful in the early identification of patients whose score low on functional scales and symptoms.
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Affiliation(s)
- B M Traore
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco.
| | - S El Fakir
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco
| | - H Charaka
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco
| | - N Benaicha
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco
| | - A Najdi
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco
| | - A Zidouh
- Fondation Lalla Salma Prevention and Treatment of Cancers, Rabat, Morocco
| | - M Bennani
- Fondation Lalla Salma Prevention and Treatment of Cancers, Rabat, Morocco
| | - H Errihani
- National Institute of Oncology, Rabat, Morocco
| | - N Mellass
- Department ofOncology, University Hospital Center Hassan II Fez, Fez, Morocco
| | - A Benider
- Oncology Center Ibn Rochd, Casablanca, Morocco
| | - R Bekkali
- Fondation Lalla Salma Prevention and Treatment of Cancers, Rabat, Morocco
| | - C Nejjari
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco
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9
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Stein RC, Dunn JA, Bartlett JMS, Campbell AF, Marshall A, Hall P, Rooshenas L, Morgan A, Poole C, Pinder SE, Cameron DA, Stallard N, Donovan JL, McCabe C, Hughes-Davies L, Makris A. OPTIMA prelim: a randomised feasibility study of personalised care in the treatment of women with early breast cancer. Health Technol Assess 2016; 20:xxiii-xxix, 1-201. [PMID: 26867046 DOI: 10.3310/hta20100] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There is uncertainty about the chemotherapy sensitivity of some oestrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancers. Multiparameter assays that measure the expression of several tumour genes simultaneously have been developed to guide the use of adjuvant chemotherapy for this breast cancer subtype. The assays provide prognostic information and have been claimed to predict chemotherapy sensitivity. There is a dearth of prospective validation studies. The Optimal Personalised Treatment of early breast cancer usIng Multiparameter Analysis preliminary study (OPTIMA prelim) is the feasibility phase of a randomised controlled trial (RCT) designed to validate the use of multiparameter assay directed chemotherapy decisions in the NHS. OBJECTIVES OPTIMA prelim was designed to establish the acceptability to patients and clinicians of randomisation to test-driven treatment assignment compared with usual care and to select an assay for study in the main RCT. DESIGN Partially blinded RCT with adaptive design. SETTING Thirty-five UK hospitals. PARTICIPANTS Patients aged ≥ 40 years with surgically treated ER-positive HER2-negative primary breast cancer and with 1-9 involved axillary nodes, or, if node negative, a tumour at least 30 mm in diameter. INTERVENTIONS Randomisation between two treatment options. Option 1 was standard care consisting of chemotherapy followed by endocrine therapy. In option 2, an Oncotype DX(®) test (Genomic Health Inc., Redwood City, CA, USA) performed on the resected tumour was used to assign patients either to standard care [if 'recurrence score' (RS) was > 25] or to endocrine therapy alone (if RS was ≤ 25). Patients allocated chemotherapy were blind to their randomisation. MAIN OUTCOME MEASURES The pre-specified success criteria were recruitment of 300 patients in no longer than 2 years and, for the final 150 patients, (1) an acceptance rate of at least 40%; (2) recruitment taking no longer than 6 months; and (3) chemotherapy starting within 6 weeks of consent in at least 85% of patients. RESULTS Between September 2012 and 3 June 2014, 350 patients consented to join OPTIMA prelim and 313 were randomised; the final 150 patients were recruited in 6 months, of whom 92% assigned chemotherapy started treatment within 6 weeks. The acceptance rate for the 750 patients invited to participate was 47%. Twelve out of the 325 patients with data (3.7%, 95% confidence interval 1.7% to 5.8%) were deemed ineligible on central review of receptor status. Interviews with researchers and recordings of potential participant consultations made as part of the integral qualitative recruitment study provided insights into recruitment barriers and led to interventions designed to improve recruitment. Patient information was changed as the result of feedback from three patient focus groups. Additional multiparameter analysis was performed on 302 tumour samples. Although Oncotype DX, MammaPrint(®)/BluePrint(®) (Agendia Inc., Irvine, CA, USA), Prosigna(®) (NanoString Technologies Inc., Seattle, WA, USA), IHC4, IHC4 automated quantitative immunofluorescence (AQUA(®)) [NexCourse BreastTM (Genoptix Inc. Carlsbad, CA, USA)] and MammaTyper(®) (BioNTech Diagnostics GmbH, Mainz, Germany) categorised comparable numbers of tumours into low- or high-risk groups and/or equivalent molecular subtypes, there was only moderate agreement between tests at an individual tumour level (kappa ranges 0.33-0.60 and 0.39-0.55 for tests providing risks and subtypes, respectively). Health economics modelling showed the value of information to the NHS from further research into multiparameter testing is high irrespective of the test evaluated. Prosigna is currently the highest priority for further study. CONCLUSIONS OPTIMA prelim has achieved its aims of demonstrating that a large UK clinical trial of multiparameter assay-based selection of chemotherapy in hormone-sensitive early breast cancer is feasible. The economic analysis shows that a trial would be economically worthwhile for the NHS. Based on the outcome of the OPTIMA prelim, a large-scale RCT to evaluate the clinical effectiveness and cost-effectiveness of multiparameter assay-directed chemotherapy decisions in hormone-sensitive HER2-negative early breast would be appropriate to take place in the NHS. TRIAL REGISTRATION Current Controlled Trials ISRCTN42400492. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 10. See the NIHR Journals Library website for further project information. The Government of Ontario funded research at the Ontario Institute for Cancer Research. Robert C Stein received additional support from the NIHR University College London Hospitals Biomedical Research Centre.
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Affiliation(s)
- Robert C Stein
- Department of Oncology, University College London Hospitals, London, UK
| | - Janet A Dunn
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Amy F Campbell
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Peter Hall
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Leila Rooshenas
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | | | - Sarah E Pinder
- Research Oncology, Division of Cancer Studies, King's College London, London, UK
| | - David A Cameron
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK
| | - Nigel Stallard
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Christopher McCabe
- Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
| | - Luke Hughes-Davies
- Oncology Centre, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundations Trust, Cambridge, UK
| | - Andreas Makris
- Department of Clinical Oncology, Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood, UK
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10
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Shouman AE, Abou El Ezz NF, Gado N, Ibrahim Goda AM. Quality of life in breast cancer sufferers. Int J Health Care Qual Assur 2016; 29:721-32. [PMID: 27477929 DOI: 10.1108/ijhcqa-05-2015-0057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose - The purpose of this paper is to measure health-related quality of life (QOL) among patients with early stage cancer breast under curative treatment at department of oncology and nuclear medicine at Ain Shams University Hospitals. Identify factors affecting QOL among these patients. Design/methodology/approach - A cross-sectional study measured QOL among early stage female breast cancer (BC) patients and determined the main factors affecting their QOL. Three interviewer administered questionnaires were used. Findings - The physical domain mostly affected in BC patients and the functional domain least. Socio-demographic factors that significantly affected BC patients QOL scores were patient age, education, having children and family income. Specific patient characteristics include caregiver presence - a factor that affected different QOL scores. Age at diagnosis, affection in the side of the predominant hand, post-operative chemotherapy and difficulty in obtaining the medication were the disease-related factors that affected QOL scores. Originality/value - The final model predicting QOL for early stage female BC patients included age, education and difficulty in obtaining the medication as determinants for total QOL score. Carer presence was the specific patient characteristic that affected different QOL scores.
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Affiliation(s)
| | | | - Nivine Gado
- Department of Oncology and Nuclear medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amal Mahmoud Ibrahim Goda
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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11
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Jeffery DD, Barbera L, Andersen BL, Siston AK, Jhingran A, Baron SR, Reese JB, Coady DJ, Carter J, Flynn KE. Self-Reported Sexual Function Measures Administered to Female Cancer Patients: A Systematic Review, 2008-2014. J Psychosoc Oncol 2015; 33:433-66. [PMID: 25997102 DOI: 10.1080/07347332.2015.1046012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A systematic review was conducted to identify and characterize self-reported sexual function (SF) measures administered to women with a history of cancer. Using 2009 PRISMA guidelines, we searched electronic bibliographic databases for quantitative studies published January 2008-September 2014 that used a self-reported measure of SF, or a quality of life (QOL) measure that contained at least 1 item pertaining to SF. Of 1,487 articles initially identified, 171 were retained. The studies originated in 36 different countries with 23% from US-based authors. Most studies focused on women treated for breast, gynecologic, or colorectal cancer. About 70% of the articles examined SF as the primary focus; the remaining examined QOL, menopausal symptoms, or compared treatment modalities. We identified 37 measures that assessed at least one domain of SF, eight of which were dedicated SF measures developed with cancer patients. Almost one third of the studies used EORTC QLQ modules to assess SF, and another third used the Female Sexual Function Inventory. There were few commonalities among studies, though nearly all demonstrated worse SF after cancer treatment or compared to healthy controls. QOL measures are better suited to screening while dedicated SF questionnaires provide data for more in depth assessment. This systematic review will assist oncology clinicians and researchers in their selection of measures of SF and encourage integration of this quality of life domain in patient care.
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Koul R, Tse R, Karreman E, Dubey A, Tai P. Overall Quality of Life Assessment in the Patients Undergoing External Beam Radiation in Outpatient Radiation Oncology Department. Int J Hematol Oncol Stem Cell Res 2015; 9:122-7. [PMID: 26261696 PMCID: PMC4529678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 02/16/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The impact of treatment on cancer patients' quality of life (QoL) has been the focus of a variety of longitudinal studies in English literature for past decade. The measurement of patient-reported outcomes which includes health-related quality of life is a new important initiative which has emerged and grown over the past three decades. Following the development of reliable and valid self-reported questionnaires, health-related quality of life has been assessed in tens of thousands of patients and a wide variety of cancers. With growing information, feedback and experience, the quality of the health-related QOL studies has improved a lot. We expect in near future more methodologically robust studies will be done in a scientific way to answer unanswered questions. METHODS As part of a Dean's summer project, a survey was undertaken to facilitate a more complete description of the quality of life experience in patients with histological diagnosis of cancer undergoing external beam radiation as an outpatient at Allan Blair Cancer Center, Regina, Canada. The questionnaires had two major components: depression and global QOL. The depression was measured by the Zung Self-Rating Depression Scale which is a short self-administered survey to quantify the depression status of a patient. RESULTS Overall, only the equation associated with the outcome of QoL - Physical well-being was significant. That data indicated that only the variable of age was a significant predictor. A positive relationship was present indicating higher levels of depression when patients received chemotherapy or narcotics. Breast cancer patients were less depressed than lung cancer patients. CONCLUSION Cancer and its related treatment is an important health issue influencing QoL. The study has revealed that the use of chemotherapy and narcotics has a significant impact on the quality of life (QoL).
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Affiliation(s)
- Rashmi Koul
- Radiation Oncologist, Department of Radiation Oncology, Allan Blair Cancer Center, 4101 Dewdney Ave, Regina, SK, Canada S4T7T1
| | - Richard Tse
- Regina Qu’Appelle Health Region, Regina, SK, Canada
| | | | - Arbind Dubey
- Radiation Oncologist, Department of Radiation Oncology, Allan Blair Cancer Center, 4101 Dewdney Ave, Regina, SK, Canada S4T7T1
| | - Patricia Tai
- Radiation Oncologist, Department of Radiation Oncology, Allan Blair Cancer Center, 4101 Dewdney Ave, Regina, SK, Canada S4T7T1
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13
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Yıldız İ, Varol U, Alacacıoğlu A. Assessment of the Quality of Life in Turkish Breast Cancer Patients. THE JOURNAL OF BREAST HEALTH 2014; 10:216-221. [PMID: 28331674 DOI: 10.5152/tjbh.2014.2012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 06/06/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Breast cancer significantly influences the quality of life (QoL) in women. The aim of this study was to assess the QoL in breast cancer patients and to determine the factors that have an effect on the QoL. MATERIALS AND METHODS We used sociodemographic data questionnaire, European Cancer Research and Treatment Organization QLQ-C30 questionnaire and linear regression analysis to determine the factors that affect the QLQ-C30 global health score, functional score, and symptom score. RESULTS This study included 113 patients with a median age of 50.61 years (range: 17-80 years). Half of the patients used complementary and alternative treatments, 45.5% used painkillers, and 19.4% used antidepressants. The most important factors related to the global health score were the place of birth, use of painkillers, and employment status. The most important factors related to the functional status were the disease stage at the time of diagnosis and the information status about the disease. The most important factors related to symptom status were age, the disease stage at the time of diagnosis, the information status about the disease, and psychiatric referral. CONCLUSION The findings indicated the consistency and strength of the relationship between clinical and sociodemographic factors and the QoL in breast cancer patients. Psychological support, when necessary, and the use of painkillers and antidepressants may improve the QoL in breast cancer patients.
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Affiliation(s)
- İbrahim Yıldız
- Clinic of Medical Oncology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Umut Varol
- Clinic of Medical Oncology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Ahmet Alacacıoğlu
- Clinic of Medical Oncology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
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