scholarly journals The GIVIO trial on the impact of follow-up care on survival and quality of life in breast cancer patients

1995 ◽  
Vol 6 ◽  
pp. S41-S46 ◽  
Author(s):  
A. Liberati
Author(s):  
Marilot C. T. Batenburg ◽  
Wies Maarse ◽  
Femke van der Leij ◽  
Inge O. Baas ◽  
Onno Boonstra ◽  
...  

Abstract Purpose To evaluate symptoms of late radiation toxicity, side effects, and quality of life in breast cancer patients treated with hyperbaric oxygen therapy (HBOT). Methods For this cohort study breast cancer patients treated with HBOT in 5 Dutch facilities were eligible for inclusion. Breast cancer patients with late radiation toxicity treated with ≥ 20 HBOT sessions from 2015 to 2019 were included. Breast and arm symptoms, pain, and quality of life were assessed by means of the EORTC QLQ-C30 and -BR23 before, immediately after, and 3 months after HBOT on a scale of 0–100. Determinants associated with persistent breast pain after HBOT were assessed. Results 1005/1280 patients were included for analysis. Pain scores decreased significantly from 43.4 before HBOT to 29.7 after 3 months (p < 0.001). Breast symptoms decreased significantly from 44.6 at baseline to 28.9 at 3 months follow-up (p < 0.001) and arm symptoms decreased significantly from 38.2 at baseline to 27.4 at 3 months follow-up (p < 0.001). All quality of life domains improved at the end of HBOT and after 3 months follow-up in comparison to baseline scores. Most prevalent side effects of HBOT were myopia (any grade, n = 576, 57.3%) and mild barotrauma (n = 179, 17.8%). Moderate/severe side effects were reported in 3.2% (n = 32) of the patients. Active smoking during HBOT and shorter time (i.e., median 17.5 vs. 22.0 months) since radiotherapy were associated with persistent breast pain after HBOT. Conclusion Breast cancer patients with late radiation toxicity reported reduced pain, breast and arm symptoms, and improved quality of life following treatment with HBOT.


1997 ◽  
Vol 3 (1) ◽  
pp. 68-81
Author(s):  
Fatma M. El Sharkawi ◽  
Mahmoud F. Sakr ◽  
Hoda Y. Atta ◽  
Hafez M. Ghanem

The impact of breast cancer therapy on the quality of life [QL] of Egyptian women was studied. Patients were divided into four groups:1:mastectomy alone;2:surgery plus radiotherapy;3:surgery plus chemotherapy;and 4:triple modality. The results revealed that all the four domains of QL of women having adjuvant therapy [groups 2, 3, or 4] were significantly altered compared to those who underwent mastectomy alone. Triple modality adversely affected global QL the most compared to radiotherapy or chemotherapy;radiotherapy had significantly less effect on QL compared to chemotherapy. Triple modality predicted the worst QL. QL measures should be incorporated with the traditional end points for evaluation of treatment and patients given health education on the effects of each therapy


2016 ◽  
Vol 01 (04) ◽  
pp. 025-028
Author(s):  
Monica Irukulla ◽  
Rama Vaghmare ◽  
Deepa Joseph ◽  
Syed Ahmed ◽  
Jyothi Jonnadula ◽  
...  

AbstractIntroduction: Comorbidities are common among cancer patients and with an aging population are becoming more prevalent. These can potentially affect the stage at diagnosis, treatment and outcomes of people with cancer. Despite the intimate relationship between comorbidity and cancer, there is limited consensus on how to record, interpret or manage comorbidities in the context of cancer. Addressing the impact of comorbid conditions in cancer patients warrants improvement in the evidence base from which to make treatment decisions for those with comorbidities.Methods: In this prospective study, 64 patients with breast cancer, underwent QOL assessment using FACT –B questionnaire at three time points- pre-radiation and three and six months post radiation.Results: 29(46%) patients had comorbidities of which 23 (35%) had cardiovascular comorbidities and 6 had other comorbidities. The co-morbidities were negatively associated with multiple domains of quality of life, including physical functioning, general health, bodily pain. Patients with diabetes and hypertension had significantly lower scores in physical functioning in comparison to patients without diabetes and hypertension, but improved after treatment. In majority of patients the overall scores were less in patients with co-morbidities compared to patients without any co-morbidity.Conclusion: Comorbidities can significantly affect the quality of life in patients with comorbidities. Hence greater research into the QOL issues for better patient care and symptom management especially during the transitioning phase from active care to follow up will help clinicians improve the quality of care and interdisciplinary co-ordination.


2021 ◽  
Author(s):  
Carolina Salvador ◽  
Phyllis Mark ◽  
Teri Hoenemeyer ◽  
Victoria McDonald

Abstract Background: Mindfulness interventions are effective at improving psychological distress and quality of life in cancer patients. Few mindfulness programs for cancer recovery exist in major cities throughout the Southeastern United States. The primary objective of this study was to assess the feasibility of a modified mindfulness-based stress reduction (MBSR) program for breast cancer patients in Birmingham, Alabama. The secondary objective was to estimate the effectiveness of the modified program by examining changes in patients’ mindfulness skills and quality of life. Methods: This study was a prospective, quasi-experimental feasibility study conducted over 10 months within a university hospital in Birmingham, Alabama. Feasibility was achieved if 80% of eligible patients screened chose to enroll in the study and 70% of enrolled patients attended all 8 program sessions. Program effectiveness was estimated by changes in mindfulness and quality of life indicators. These indicators were measured by validated scales administered at pretest, posttest, and 8-week follow-up and assessed with a non-parametric Friedman test. The program curriculum followed a modified version of Dr. Jon Kabat-Zinn’s MBSR program. Program sessions included sitting meditation, hatha/restorative yoga, and a body-focused attention practice called body scan. There were 3 groups of 2-5 patients.Results: The sample consisted of 12 patients. Forty-four percent (12/27) of eligible patients enrolled in the study, failing to meet recruitment success criteria of 80%; two out of 12 enrolled patients completed all 8 program sessions, resulting in 16.7% (2/12) retention, which fell below the retention success criteria of 70%. However, more than half (66.7%) of participants completed at least 7 sessions. Between baseline and 8-week follow-up, patients demonstrated statistically significant improvements in distress, general wellbeing, and fatigue-related quality of life.Conclusions: Feasibility objectives were not achieved. However, a large majority of participants (66.7%) completed 7 of the 8 program sessions. Program effectiveness was promising for distress, fatigue, and wellbeing. Results warrant further research on MBSR programs for breast cancer patients in Alabama. Future programs should investigate how to increase overall recruitment numbers, focusing on introducing mindfulness concepts to inexperienced populations. Studies should consider hosting sessions in community locations or via telemedicine to improve accessibility.


Author(s):  
G. Marchioro ◽  
F. Barbato ◽  
G. Azzarello ◽  
O. Vinante

Background. The psychological discomfort associated to breast-cancer diagnosis and related treatments is universally recognized. However homogeneous modalities of intervention are lacking. The questionnaires are the most employed tools to analyze pre-morbidity personality traits and the quality of life of cancer patients, but they lack valid indicators of the patients' overall quality of life. On the other hand, counseling along with administered psychological tests allows listening and mutual relationship between patient and examiner. The aim of this study was to evaluate the impact of the Rorschach test, a multidimensional method of collecting data on personality functioning, as an instrument to assess mood disorders, object relation, self-image and quality of life in breast cancer patients. Methods. 135 consecutive women affected by operable breast cancer underwent psychological counseling and the Rorschach test within 2–4 weeks after surgery. Results of the test were interpreted according to the structural and experiential approaches. The discrimination between “compact” and “noncompact” tables makes it possible to study the changes of patients identity during the illness, while the Experienced Stimulation and Experience Actual indices, providing information about the patient's coping to therapeutic approach, were calculated according to the Exner system. The records from a sample of 60 healthy women, equally distributed in three age groups (< 50, 50–59, > 60) coming from the same Italian region (regional sample) and the results from 736 nonpatient Italian subjects (national sample) were used as controls. Results. Quantitative results were comparable within groups, except for parameters of cognitive characteristics regulating the approach to reality (G, G+, F+, Anat, Ban). No patient fulfilled the parameter configuration corresponding to depressive disorder, but alexithymia with a state reaction interpreted as an adjustment disorder with depressive mood was recorded. This trait was correlated with lower educational levels and increasing age.


2002 ◽  
Vol 20 (20) ◽  
pp. 4242-4248 ◽  
Author(s):  
Winkle Kwan ◽  
Jeremy Jackson ◽  
Lorna M. Weir ◽  
Carol Dingee ◽  
Greg McGregor ◽  
...  

PURPOSE: To determine the prevalence of and contributing factors for chronic arm morbidity including lymphedema in breast cancer patients after treatment and to assess the impact of arm morbidity on quality of life (QOL). PATIENTS AND METHODS: A four-question screening questionnaire was developed and mailed to a random sample of 744 breast cancer patients treated curatively in two cancer centers from 1993 to 1997. Patients were without recurrence and at least 2 years from diagnosis. Respondents were classified as with or without arm-related symptoms on the basis of the survey. Stratified random samples from each group were then invited for a detailed assessment of their symptoms and signs, including the presence of lymphedema. Their QOL was assessed by the European Organization for Research and Treatment of Cancer QOL Questionnaire C-30 and by a detailed arm problem questionnaire that assessed various aspects of daily arm functioning. RESULTS: Approximately half of all screened patients were symptomatic and 12.5% of all assessed patients had lymphedema. Axillary dissection (AD) and axillary radiotherapy (RT) after dissection were statistically significantly related to the occurrence of arm symptoms (odds ratio for AD = 3.3, P < .001; odds ratio for RT = 3.1, P < .001). Symptomatic patients and patients with lymphedema both had impaired QOL compared with asymptomatic patients. CONCLUSION: Treatment for breast cancer is associated with considerable arm morbidity, which has a negative impact on QOL. Arm morbidity should be carefully monitored in future studies involving local treatment modalities for breast cancer.


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