Health-related quality of life before and during chemotherapy in patients with early-stage breast cancer

Monique Binotto, Tomás Reinert, Gustavo Werutsky, Facundo Zaffaroni, Gilberto Schwartsmann, Monique Binotto, Tomás Reinert, Gustavo Werutsky, Facundo Zaffaroni, Gilberto Schwartsmann

Abstract

Objectives: Identify the main changes in the health-related quality of life (HRQoL) of women diagnosed with breast cancer (BC) undergoing chemotherapy.

Methods: Prospective cohort study that included 33 women diagnosed with clinical stages I-III BC and who underwent adjuvant chemotherapy. HRQoL was assessed using the EORTC QLQ-C30 and EORTC QLQ-BR23 instruments 1 week before the start of chemotherapy and during the third month of chemotherapy.

Results: There was a decline in the HRQoL scores of patients during treatment. Therefore, chemotherapy alters the patient's perceptions of their HRQoL since there is a decrease in global health status/quality of life (QoL) and functional scales such as physical functioning, role functioning, emotional functioning, social functioning, body image, sexual function and sexual enjoyment. We also observed an increase in side effects related to the systemic therapy, fatigue, nausea and vomiting, insomnia, appetite loss and diarrhoea, despite a decrease in breast symptoms and arm symptoms.

Conclusions: HRQoL was negatively affected during chemotherapy. Even though HRQoL assessment is a useful method for optimising patients' care, its implementation into clinical practice remains a challenge. Since side effects are very often underestimated, we consider that the evaluation of HRQoL parameters should be done for BC patients treated with chemotherapy.

Keywords: breast cancer; cancer; health-related quality of life; patient-reported outcomes.

Conflict of interest statement

The authors have no conflicts of interest to declare.

© the authors; licensee ecancermedicalscience.

Figures

Figure 1.. Comparison of HRQoL between study…
Figure 1.. Comparison of HRQoL between study segments in global health status/QoL and functional scales (EORTC QLQ-C30).

References

    1. Jemal A, Vineis P, Bray F. The Cancer Atlas. 2nd. Atlanta: American Cancer Society; 2014. [ ]
    1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–E386. doi: 10.1002/ijc.29210.
    1. Anampa J, Makower D, Sparano JA. Progress in adjuvant chemotherapy for breast cancer: an overview. BMC Med. 2015;13:195. doi: 10.1186/s12916-015-0439-8.
    1. Chopra I, Kamal KM. A systematic review of quality of life instruments in long-term breast cancer survivors. Health Qual Life Outcomes. 2012;10:14. doi: 10.1186/1477-7525-10-14.
    1. Ferreira RG, Franco LF de R. Efeitos colaterais decorrentes do tratamento quimioterápico no câncer de mama: revisão bibliográfica. Rev da Univ Val do Rio Verde. 2017.
    1. Stanton AL, Rowland JH, Ganz PA. Life after diagnosis and treatment of cancer in adulthood: contributions from psychosocial oncology research. Am Psychol. 2015;70:159–174. doi: 10.1037/a0037875.
    1. WHOQOL Group. Development of the WHOQOL: rationale and current status. Int J Ment Health. 1994;23:24–56. doi: 10.1080/00207411.1994.11449286.
    1. Food and Drug Administration. Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims: draft guidance. Health Qual Life Outcomes. 2006;4:79. doi: 10.1186/1477-7525-4-79.
    1. Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med. 1993;118:622–629. doi: 10.7326/0003-4819-118-8-199304150-00009.
    1. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–376. doi: 10.1093/jnci/85.5.365.
    1. Michels FAS, Latorre M do RD de O, Maciel M do S. Validity, reliability and understanding of the EORTC-C30 and EORTC-BR23, quality of life questionnaires specific for breast cancer. Rev Bras Epidemiol. 2013;16:352–363. doi: 10.1590/S1415-790X2013000200011.
    1. Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649–655. doi: 10.1097/00000421-198212000-00014.
    1. Montazeri A. Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008;27:32. doi: 10.1186/1756-9966-27-32.
    1. Fanakidou I, Zyga S, Alikari V, et al. Mental health, loneliness, and illness perception outcomes in quality of life among young breast cancer patients after mastectomy: the role of breast reconstruction. Qual Life Res. 2018;27:539–543. doi: 10.1007/s11136-017-1735-x.
    1. Leinert E, Singer S, Janni W, et al. The impact of age on quality of life in breast cancer patients receiving adjuvant chemotherapy: a comparative analysis from the prospective multicenter randomized ADEBAR trial. Clin Breast Cancer. 2017;17:100–106. doi: 10.1016/j.clbc.2016.10.008.
    1. Gaton-Johansson F, Watkins CC, Kanu IK, et al. The effects of symptoms on quality of life during chemotherapy in african-american women with breast cancer. J Natl Black Nurses Assoc. 2015;26:7–16.
    1. Tachi T, Teramachi H, Tanaka K, et al. The impact of outpatient chemotherapy-related adverse events on the quality of life of breast cancer patients. PLoS One. 2015;10:e0124169. doi: 10.1371/journal.pone.0124169.
    1. Barbosa PA, Cesca RG, Pacífico TED, et al. Quality of life in women with breast cancer, after surgical intervention, in a city in the zona da mata region in Minas Gerais, Brazil. Rev Bras Saúde Matern Infant. 2017;17:385–399. doi: 10.1590/1806-93042017000200010.
    1. Perroud HA, Alasino CM, Rico MJ, et al. Quality of life in patients with metastatic breast cancer treated with metronomic chemotherapy. Futur Oncol. 2016;12:1233–1242. doi: 10.2217/fon-2016-0075.
    1. Ho SSM, So WKW, Leung DYP, et al. Anxiety, depression and quality of life in Chinese women with breast cancer during and after treatment: a comparative evaluation. Eur J Oncol Nurs. 2013;17:877–882. doi: 10.1016/j.ejon.2013.04.005.
    1. Pierrisnard C, Baciuchka M, Mancini J, et al. Body image and psychological distress in women with breast cancer: a French online survey on patients’ perceptions and expectations. Breast Cancer. 2018.
    1. Tang L, Fritzsche K, Leonhart R, et al. Emotional distress and dysfunctional illness perception are associated with low mental and physical quality of life in Chinese breast cancer patients. Health Qual Life Outcomes. 2017;15:231. doi: 10.1186/s12955-017-0803-9.
    1. Zhang Y, Fritzsche K, Leonhart R, et al. Dysfunctional illness perception and illness behaviour associated with high somatic symptom severity and low quality of life in general hospital outpatients in China. J Psychosom Res. 2014.
    1. Winters ZE, Haviland J, Balta V, et al. Integration of patient-reported outcome measures with key clinical outcomes after immediate latissimus dorsi breast reconstruction and adjuvant treatment. Br J Surg. 2013;100:240–251. doi: 10.1002/bjs.8959.
    1. Fayers P, Aaronson N, Bjordal K. The EORTC QLQ-C30 Scoring Manual. 3rd. Brussels: European Organisation for Research and Treatment of Cancer; 2001. [ ]
    1. Choi EK, Kim I-R, Chang O, et al. Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients. Psychooncology. 2014;23:1103–1110. doi: 10.1002/pon.3531.
    1. Browall M, Ahlberg K, Karlsson P, et al. Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women. Eur J Oncol Nurs. 2008;12:180–189. doi: 10.1016/j.ejon.2008.01.005.
    1. Kroenke CH, Kwan ML, Neugut AI, et al. Social networks, social support mechanisms, and quality of life after breast cancer diagnosis. Breast Cancer Res Treat. 2013;139:515–527. doi: 10.1007/s10549-013-2477-2.
    1. Lindau ST, Abramsohn EM, Baron SR, et al. Physical examination of the female cancer patient with sexual concerns: what oncologists and patients should expect from consultation with a specialist. CA Cancer J Clin. 2016;66:241–263. doi: 10.3322/caac.21337.
    1. Hall E, Cameron D, Waters R, et al. Comparison of patient reported quality of life and impact of treatment side effects experienced with a taxane-containing regimen and standard anthracycline based chemotherapy for early breast cancer: 6year results from the UK TACT trial (CRUK/01/001) Eur J Cancer. 2014;50:2375–2389. doi: 10.1016/j.ejca.2014.06.007.
    1. Jolly TA, Williams GR, Bushan S, et al. Adjuvant treatment for older women with invasive breast cancer. Women’s Heal. 2016;12:129–145. quiz 145–146.
    1. Savard J, Ivers H, Savard M-H, et al. Cancer treatments and their side effects are associated with aggravation of insomnia: results of a longitudinal study. Cancer. 2015;121:1703–1711. doi: 10.1002/cncr.29244.
    1. Laviano A, Koverech A, Seelaender M. Assessing pathophysiology of cancer anorexia. Curr Opin Clin Nutr Metab Care. 2017;20:340–345. doi: 10.1097/MCO.0000000000000394.
    1. Velikova G, Booth L, Smith AB, et al. Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol. 2004;22:714–724. doi: 10.1200/JCO.2004.06.078.

Source: PubMed

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