Quality of Life in Breast Cancer Patients—Not Enough Attention for Long-Term Survivors?

Background: Nutrition counseling in breast cancer (BC) patients show long-term adherence to a dietary pattern and effects on nutritional status and quality of life (QOL).Objective : We evaluated the effects of nutrition counseling for nutrients intake dan nutritional status improvement among breast cancer patients.Material and Methods: This research was conducted in a Pre-experimental design; one group pretest-postest design was conducted on 45 BC patients who underwent radiotherapy for five weeks in the Radiotherapy Unit, dr. Sardjito Hospital, Indonesia. Nutrition counseling was demonstrated by trained fieldworkers to 45 participants using a nutrition booklet for BC patients and a food model as an intervention technique. Continuous nutrition counseling was given three times: weeks 1, 3, and 5 of radiotherapy. We examined anthropometry, biochemical, physical, dietary, and Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire to obtain nutritional status.Results: Most of the participants had a body mass index (BMI) ≥25 kg/m2 (62.2%). After the participants were receiving nutrition counseling, there were increases in intake of energy, protein, carbohydrate, vitamin A, vitamin C, and vitamin E amounted 124.54 kcal, 8.12 g (p=0.01), 5.84 g, 234.43 mg, 0.042 mg, and 0.44 mg, respectively. Intake of fruits and vegetables improved on the first, third, and fifth week (1.44, 2.36, and 4.03 portion/day, respectively) (p=0.001). Handgrip strength (HGS) showed slight improvement (p=0.081). However, HGS ameliorated from 15.85 kgs in the early to 16.97 kgs in the end stage of therapy. Bodyweight decreased 0.28 kg; however, there are no changes in PG-SGA score, hemoglobin (Hb), and albumin levels.Conclusion: Nutrition counseling improves patients’ nutrition intake despite there is no significant alteration in nutritional status. In addition, nutrition counseling for breast cancer patients during radiotherapy is essential to maintain and improve nutrient intake and nutritional status. In the long-term period, it might be affected to improve quality of life.

Download Full-text

Long-term effects on Quality of life of a Multimodal Therapy in Breast Cancer patients with Fatigue

European Journal of Integrative Medicine ◽

10.1016/j.eujim.2021.101937 ◽

2021 ◽

Vol 48 ◽

pp. 101937

Author(s):

Falk Quittel ◽

Roland Zerm ◽

Marcus Reif ◽

Arndt Büssing ◽

Christoph Gutenbrunner ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Patients ◽

Multimodal Therapy ◽

Breast Cancer Patients ◽

Long Term Effects

Download Full-text

Follow-up study of a randomized clinical trial with quality of life diagnosis and therapy: Long-term quality of life of breast cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e20517 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e20517-e20517

Author(s):

Monika Klinkhammer-Schalke ◽

Patricia Lindberg ◽

Brunhilde Steinger ◽

Michael Koller ◽

Jeremy Wyatt ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Body Image ◽

Randomized Trial ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Diagnosis And Therapy

e20517 Background: To improve breast cancer patients` quality of life (QoL) as second relevant outcome of care, a clinical pathway with diagnosis and therapy of diseased QoL has been developed, implemented and tested in a randomized trial (RCT) as part of a complex intervention. More than 6 years after RCT, long-term QoL of survivors was assessed and separately analyzed in 2 cohorts: QoL-intervention + guideline treatment in the first postoperative year (GC+) and guideline treatment alone (GC). Methods: Both cohorts were part of a randomized trial with 2 x 100 primary breast cancer patients, surgically treated between 2004 - 2006, with QoL measurement every 3 months during the first year (EORTC QLQ-C30, BR23). In GC+ cohort, QoL was presented to coordinating physicians in a QoL-profile, including recommendations for treatment of diseased QoL (cutoff <50 points on scale 0 = bad, 100 = good) in 10 dimensions (global QoL, physical, role, emotional, cognitive, social functioning, arm symptoms, body image, pain, fatigue) and up to 5 targeted therapies to improve QoL. GC was treated according to S3 guideline. At follow-up >6 years after diagnosis (range of months since surgery: GC+ 74-94; GC 74-96), rates of diseased QoL in both cohorts were analyzed and compared with QoL 12 months postoperatively. Results: Long-term QoL was assessed in 66 patients of GC+ (mean age 64.7 (±10.9)) and 67 of GC (mean age 63.7 (±10.9)) (death GC+=13, GC=18; response rate 79%). In GC+, 48% of patients reported at least 1 QoL deficit at 12 months compared with 52% at 6-year follow-up, while in GC rate of diseased QoL increased from 53% to 62%. Regarding single dimensions, in GC+ rates of diseased QoL increased from 12 months to 6 years (except global QoL), reaching significance for arm symptoms (9% vs 29%) and body image (3% vs 16%) (p<.01, McNemar`s test). In GC no dimension changed significantly, but rates of diseased QoL for arm symptoms (26% vs 31%) and body image (9% vs 17%) were already rather high at 12 months. Conclusions: Breast cancer patients need tailored QoL therapy, exceeding the first postoperative year. Similar to traditional medical care, QoL needs to be considered continuously by anchoring it in follow-up care.

Download Full-text