Symptom distress, quality of life and challenges of illness according to race and income in women with metastatic breast cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8609-8609 ◽  
Author(s):  
M. Rosenzweig ◽  
T. Wiehagen ◽  
A. M. Brufsky ◽  
R. M. Arnold
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
African American ◽  
Metastatic Breast Cancer ◽  
Quantitative Data ◽  
White Women ◽  
Metastatic Breast ◽  
Symptom Distress ◽  
Distress Scale

8609 Background: Response to a diagnosis of metastatic breast cancer (MBC) may vary according to race and income. The aims of this study were: 1) to identify quality of life, symptom distress and challenges of illness during MBC treatment and 2) to determine if these variables differ according to race and income. Methods: The study was a 2×2 prospective design conducted at an urban breast cancer center. Women with MBC were categorized into four groups based on race and income: white low (WL), white high (WH), African American high (AAH) and African American low (AAL). Instruments were 1) Symptom Distress Scale (SDS), (higher scores /worse distress) 2) Functional Assessment of Cancer Therapy (FACT), (higher scores/better QOL) and a 3) semi structured interview assessing patient perspectives of MBC. Interview analysis utilized grounded theory. Results: Preliminary results are for 51 women. Mean age was 58.2 years, with mean 24 months since MBC diagnosis. Quantitative data indicated worse quality of life in AA than white women. (P=0.06), with AALI women exhibiting worse symptom distress (P=0.03) as compared to white women. Qualitative data (n=48) corroborated quantitative data. The most prevalent themes among all sociodemographic groups were of hope (33/48 - 69%), faith (28/48 - 58%) and progressive loss (29/48, 60%). Each racial/economic delineation expressed unique themes: AALI talked about physical (7/7,100%)and social distress (6/7, 86%) as well as uncertainty regarding “whether treatment was worth it” (6/7 - 86%). WLI women verbalized an overall optimism, describing themselves as “lucky” (6/14 - 43%), with minimization of symptoms (10/14 - 71%). WHI women articulated a sense of betrayal at their progressive illness (9/20 - 45%) and fear of physical and economic dependence. Conclusion: Race and economic delineation brings unique symptom experience, quality of life and patient perspective to the metastatic breast cancer experience. These findings will advise tailored intervention. [Table: see text] No significant financial relationships to disclose.

Impact of symptoms and toxicity on quality of life: Exploratory analysis of gemcitabine plus docetaxel vs capecitabine plus docetaxel in metastatic breast cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 682-682 ◽  
Author(s):  
P. Fumoleau ◽  
G. Romieu ◽  
S. Chan ◽  
J. Huober ◽  
M. Tubiana-Hulin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Exploratory Analysis ◽  
Phase Iii ◽  
Serious Adverse Events ◽  
Distress Scale

682 Background: A recent phase III trial comparing gemcitabine-docetaxel (GD) with capecitabine-docetaxel (CD) for metastatic breast cancer (MBC) found comparable progression-free survival but patients (pts) on GD had less toxicity (Chan, ASCO 2005). To better understand how quality of life (QoL) is impacted by toxicity and symptoms, we conducted an exploratory analysis. Methods: The study had 305 pts who relapsed after anthracycline-based treatment either in (neo)adjuvant or first-line MBC. Pts were randomized to GD or CD for 21-day cycles until PD or unacceptable toxicity. QoL was assessed every cycle with Rotterdam Symptom Checklist (RSCL). Only pts with RSCL data were included in the QoL analysis. Comparison between arms of changes from baseline in RSCL dimensions at each cycle were analyzed using analysis of co-variance (ANCOVA). Because the physical symptom distress scale (PSDS) includes symptom- and toxicity-related items, distributions of responses to each item were explored. Results: 302 pts received treatment (GD 152; CD 150); median number of cycles was 6 for both arms. 267 pts (88%) had baseline RSCL data; compliance ranged from 79%-88% for the first 6 cycles. Baseline RSCL scores were comparable between arms. No statistical differences between arms were seen for any of the RSCL dimensions (p>.05 at all cycles). Both arms had worsening in the PSDS (median increases of 3–6.8 on 69-point scale). Numerical differences were seen in some PSDS items rated as “quite a bit” or “very much.” By cycle 3, more GD pts reported tiredness (58% v 47%), lack of energy (45% v 38%), back pain (19% v 9%), and by cycle 2, alopecia (76% v 66%). By cycle 1, more CD pts reported tingling hands/feet (15% v 7%) and burning/sore eyes (14% v 3%). Conclusions: Preliminary analysis indicated no QoL differences between GD and CD; however, further exploration shows that physical distress is explained by different symptoms and toxicities in each arm. Results, particularly at later cycles, should be cautiously interpreted because of pt attrition and different reasons for discontinuation (eg, more CD than GD pts discontinued due to serious adverse events [28% v 13%]). Further analysis incorporating clinical outcomes may better explain QoL outcomes [Table: see text]

How are quality of life and work productivity associated with living longer with HER2+ metastatic breast cancer?

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 215-215 ◽  
Author(s):  
Preeti S. Bajaj ◽  
Matthew Sussman ◽  
Jeffrey Yu ◽  
Carolina M. Reyes ◽  
Alisha Stein ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Metastatic Breast Cancer ◽  
Work Productivity ◽  
Metastatic Breast ◽  
Well Being ◽  
Symptom Distress ◽  
Activity Impairment ◽  
Eq Vas

215 Background: Advances in therapy have led to an increase in survival in women with HER2+ metastatic breast cancer (MBC). However, changes in health-related quality of life (HRQoL) and productivity related to longer survival have not been well studied. Methods: A one-time survey was administered to women recruited through select clinics and advocacy organizations. Inclusion criteria were female sex, age 18+, US residence, and having HER2+ MBC. HRQoL and impact on productivity were assessed using several validated instruments: EQ Visual Analogue Scale (EQ VAS), Functional Assessment of Cancer Therapy-Breast (FACT-B), Rotterdam Symptom Checklist (RSCL), Distress Thermometer (DT), PROMIS Applied Cognition-Abilities-8a, and Work Productivity & Activity Impairment Questionnaire-Specific Health Problem (WPAI-SHP). Regression analyses were conducted to compare differences in measures by years since diagnosis (< 6 vs. ≥ 6 years), adjusting for age. Results: A total of 404 women participated in the survey. Mean age was 54.2 years, 91.6% were white, and 27.5% reported it had been ≥ 6 years since their HER2+ MBC diagnosis. In unadjusted analyses, women living with MBC ≥ 6 years reported significantly greater HRQoL (FACT-B, p=0.01) and emotional well-being (FACT-B EWB, p<0.01), lower distress (DT, p = 0.02; RSCL Physical & Psychological Symptom Distress, p = 0.01 & p = 0.03), and lower impairment due to MBC (WPAI-SHP, p<0.05). No differences were seen in EQ VAS or PROMIS scores. In age-adjusted analyses, women living with MBC ≥ 6 years had significantly greater emotional well-being (FACT-B EWB, p<0.01), lower distress (DT, p<0.05; RSCL Physical Symptom Distress, p = 0.03), and lower activity impairment due to breast cancer (WPAI-SHP, p<0.01). There were no major differences in findings between women recruited online versus in clinics. Conclusions: Women living with HER2+ MBC for ≥ 6 years may experience improvements in HRQoL compared to women diagnosed more recently. This may suggest that women adjust to the disease over time; however, potential selection biases in the recruitment of survey respondents may limit generalizability of these findings. Further investigation of temporal changes in HRQoL is warranted.

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