Assessment of quality of life in patients with breast cancer receiving chemotherapy

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1 Research Article Assessment of quality of life in patients with breast cancer receiving * ABSTRACT Aim: The aim of the study is to assess the quality of life (QoL) in patients with breast cancer receiving. Methods: A total of 100 cancer patients were included in the present analysis. With the aid of nurses, the questionnaires were filled out during the interview. Each question had an equal value and the QoL was quantified as the sum of the scores for all domains. The 30 items of QLQ-C30 are multidimensional, made up of 30 items. Functional scale and symptom scale were computed using t-test method. Results: Of the selected 48 patients, 9 patients were in the age group of years, 10 patients were in the group of years, 13 patients were in the age of group years, 7 patients were in the age group of years, and 9 patients were in the age group of years. 0 patients are underweight, 6 patients were normal in their body mass index, 16 were overweight, and remaining 26 patients were obese. From the total of 48 patients with breast cancer interviewed using the European Organization for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ) C-30, it was found that symptoms scale was higher before and which became low after. Conclusion: Patients with breast cancer were interviewed using EORTC QLQ C-30 questionnaire, and according to the interview, the scores QoL were high in breast cancer patients after. KEY WORDS: Breast cancer, Chemotherapy, Quality of life, European Organization for Research and Treatment of Cancer Quality of life Questionnaire C-30 INTRODUCTION Cancer can be defined as diseases in which a group of abnormal cells grows uncontrollably by disregarding the normal rules of cell division. Normal cells are constantly subject to signals, resulting in uncontrolled growth and proliferation. If this proliferation is allowed to continue and spread, it can be fatal. In fact, almost 90% of cancerrelated deaths are due to tumors spreading a process called metastasis. [1-6] Breast cancer is a malignant tumor that starts in the cells of the breast. Malignant cancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. [6] TYPES OF BREAST CANCER Ductal carcinoma in situ (DCIS) It is a non-invasive, precancerous condition in which abnormal cells are found in the lining of a breast Access this article online Website: jprsolutions.info ISSN: duct. The incidence increases in all ages but more in women older than 50 years. [5] In some cases, DCIS may become invasive cancer and metastasize to other tissues, although it is not known at this time how to predict which lesions will become invasive. [9] Invasive (infiltrating) Ductal Carcinoma It is the most common cell type, comprising 70 80% of all case. An associated DCIS is frequently present and come do necrosis may occur in both invasive areas and areas of intraductal carcinoma. [6] Lobular Carcinoma in situ (LCIS) It is a condition in which abnormal becomes invasive cancer; however, having LCIS in one breast increases the risk of developing breast cancer in either breast. [8] Invasive Lobular Carcinoma It is the second most common type of invasive breast cancer accounting for 8 14% of all breast cancers. Patients with infiltrating lobular carcinoma are, especially, prone to have bilateral carcinoma. [8] Department of Pharmacy Practice, Vels Institute of Science, Technology and Advanced Studies, Pallavaram, Chennai, Tamil Nadu, India *Corresponding author:, Assistant professor, Department of Pharmacy Practice, School of Pharmaceutical Sciences, Vels Institute of Science, Technology and Advanced Studies, Velannagar, P.V. Vaithiyalingam Road, Pallavaram, Chennai , Tamil Nadu, India. Phone: pallavi.sps@velsuniv.ac.in Received on: ; Revised on: ; Accepted on:

2 In inflammatory Breast Cancer It is a rare and aggressive form of breast cancer with unknown etiology and generally poor outcome. The breast looks red and swollen and feels warm. The redness and warmth occur because the cancer cells block the lymph vessels in the skin. [7] Tubular Carcinoma It is also known as a well-differentiated carcinoma. The frequency of auxiliary lymph node metastases is approximately 10%, lower than that of ductal carcinoma. [8] MATERIAL AND METHODS Site of the Study The study was carried out in Dr. Kamakshi Memorial Hospital from November 2015 April Department Selected for the Study in the Hospital Patients selected for the study were inpatient and outpatient from the Oncology Department at Dr. Kamakshi Memorial Hospital. Study Design Design of data entry format (pro forma) A separate data entry format (pro forma) for incorporating patient detail was designed. The format contains detail such as name, age, diagnosis, and past medical history (PMH) the same in the appendix. Pro forma 1: Patient informed consent form Pro forma 2: Patient details - name, age, sex, occupation, body mass index (BMI), social history, and PMH. Pro forma 3: Score details (European Organization for Research and Treatment of Cancer QoL Questionnaire [EORTC QLQ] C30) - pain, rest, trouble in sleeping, lack of appetite, nauseated, and vomiting. Patient Selection Patient inclusion criteria The following criteria were included in the study: Patient above the age of 18 of the female gender, patient diagnosed with solid tumors according to the pathology report and clinical examination, and patient planning to receive. Patient Exclusion Criteria The following criteria were excluded from the study: The patients below 18 are not included in the study and patient having cancer diagnosis <2 months and other previous or concurrent malignancies. Methodology This study was a cross-sectional. A total of 100 cancer patients were included in the present analysis. The study was conducted in the hospital. Before being asked the subjects to participate and fill out quality of life (QoL) questionnaire, a formal consent was obtained from all of them. With some modification, the EORTC QLQ-C30 was used to measure QoL in the patients. The test consisted of 30 questions and had arranged into 4 domains (a) physical, role, cognitive, emotional, and social functioning demographic data as well as cancer/ treatment information; (b) patient s general conditions and patient s physical activities; (c) social status and occupational function; and (d) sleep pattern. With the aid of nurses, the questionnaires were filled out during the interview. Each question had an equal value and the QoL was quantified as the sum of the scores for all domains. Statistical analysis was performed. The 30 items of QLQ-C30 are multidimensional, made up of 30 item. The score is transformed into scales. The first phase involved the presentation of the descriptive statistics. Functional scale and symptom scale were computed using t-test method. RESULTS AND DISCUSSION In this study, 48 patients with breast cancer were selected. The patients were asked to fill the (EORTC QLQ C-30 Version 03) questionnaires, before the treatment of and after the 8 days of treatment of. Of the selected 48 patients, 9 patients (18.7%) were in the age group of years, 10 patients (20.8%) were in the group of years, 13 patients (27%) were in the age of group years, 7 patients (14.5%) were in the age group of years, and 9 patients (18.7%) were in the age group of years [Table 1]. Of the selected 48 patients, 6 patients (12.5%) were having habits other than smoking and alcohol and the rest 42 patients (87.5%) do have any social habits [Table 2]. Of the selected 48 patients, 12 patients were the teacher, 6 patients were government servants, and remaining 30 were housewives. It indicates that there were more housewives suffering from breast cancer [Table 3]. Of the selected 48 patients, 0 patients are underweight, 6 patients were normal in their BMI, 16 were overweight, and remaining 26 patients were obese. It indicates that the risk of breast cancer is more among the obese patients than the normal or overweight patients [Table 4]. A total of 48 patients with breast cancer were interviewed using EORTC QLQ C-30, and according to the interview, the scores are transformed into point scales. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. Thus, a high score 198

3 for a functional scale represents a high/healthy level of functioning. A high score for the global health status/ QoL represents a high QoL. A high score for a symptom scale/item represents a high level of symptomatology/ problems [Table 5 and 6, Figures 1 and 2]. The total of functional and the symptom scale of both before and after 8 days of was computed by t-test method, and significances were found in both the scale, the P value of functional scale was <0.0001, and the P value of symptom scale was < [Figures 3 and 4]. DISCUSSION Breast cancer is the most common disease among women worldwide. Approximately 57,650 women were diagnosed with in situ breast cancer during Table 1: Age wise distribution Age in years (18.7) (20.8) (27) (14.5) (18.7) Table 2: Distribution based on social habits Social habit Smoker/alcoholic 0 (0) Others 6 (12) None 42 (88) Table 3: Distribution based on occupation Occupation Teacher 12 (25) Government jobs 6 (12.5) Housewives 30 (62.5) Table 4: Distribution based on BMI BMI Category Number of patients (%) 19 Underweight 0 (0) Normal 6 (12.5) Overweight 16 (33.3) 30 Obese 26 (54.1) BMI: Body mass index Figure 1: Mean deviation of before and after Figure 2: Standard deviation of before and after 199

4 Table 5: Mean and standard deviation before Functional scale Items Mean score Standard deviation Physical Role Cognitive 20, Emotional Social Global quality of life Fatigue 10, 12, Nausea and vomiting Pain 9, Dyspnea Insomnia Appetite loss Constipation Diarrhea Financial difficulties Figure 3: Functional scale of before and after Table 6: Mean and standard deviation after Functional scale Items Mean score Standard deviation Physical Role Cognitive 20, Emotional Social Global quality of life Fatigue 10, 12, Nausea and vomiting Pain 9, Dyspnea Insomnia Appetite loss Constipation Diarrhea Financial difficulties QoL surveys are important in health care. Cancer affects in different aspects of QoL, and currently, breast cancer is a major problem in world. The initial stages of treatment and the months at which the treatment are completed are the most difficult times for patients in both physical and emotional aspects, and during this time, the QoL of breast cancer patients can occur easily. In this study was designed to find out the QoL in cancer patients undergoing, were we selected patients with breast cancer.. The patients were asked to fill the EORTC QLQ C-30 Version 03 questionnaires, before the treatment of and after 8 days of treatment of. Of the selected 48 patient, we found out breast cancer mostly affected the patients at the age group of years. The results also indicate that breast cancer mostly affected the housewife or to the obese women. Patients with breast cancer were interviewed using Figure 4: Symptom scale of before and after 8 days of EORTC QLQ C-30 questionnaire, and according to the interview, the scores QoL were high in breast cancer patients after. CONCLUSION Maximum numbers of patients in the age group of years were affected with breast cancer. Maximum number of patients have none social habits. In this study, it was found out that there were more housewives affected with breast cancer. More number of patients was found out was having obesity. It was found that the mean deviation and standard deviation of after were more as compared to before the. In our study, t-test significances were found, and the p value was < QoL was high in breast cancer patients after. REFERENCES 1. Abeloff MD, Wolff AC, Weber BL, Armitage JO, Lichter AS, et al. Cancer of the Breast. 4 th ed. Philadelphia, PA: Elsevier; p Van Dongen JA, Bartelink H, Fentiman IS, Lerut T, Mignolet F, Olthuis G, et al. Randomized clinical trial to assess the value of breast-conserving therapy in stage I and II breast cancer. J Natl Cancer Inst 1992;11: Paraskevi T. Quality of life outcomes in patients with breast cancer. Oncol Rev 2012;6:e2. 4. Hillner BE, Ingle JN, Chlebowski RT, Gralow J, Yee GC, 200

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