Abstract
During the last 20 years, numerous studies have highlighted the need to consider Quality of Life (QoL) issues in the treatment of brain cancer. However, gaps in scientific knowledge are still present as we have poor data surrounding the whole experience in patients and regarding their needs.The present study was aimed at evaluating QoL in brain cancer patients and correlated aspects. In particular, we aimed to assess QoL, mood state, and emotional issues in order to describe the patients’ experience to find out the critical aspects involved.MethodsWe obtained data from 85 patients during chemotherapy treatment at the National Neurological Institute ‘C. Besta’ of Milan, Italy. We used standardised questionnaires to assess different aspects of patients’ QoL. In particular, the functional assessment of cancer therapy-brain (FACT-Br) and the Hamilton scale were used. We also performed a semi-structured ad hoc interview in order to collect narrative data about patients’ experience.ResultsOur data depict a difficult adjustment process to the illness, even though positive elements emerged. Indeed, patients reported a satisfying self-perceived QoL, although specific concerns are still present. Further, even if many patients report depressive symptoms, only a minority have a severe condition.ConclusionBrain cancer may heavily affect patients’ QoL and well being. However, some element of the context may improve the adjustment to the disease. In particular, we found that most patients found psychosocial resources to cope with cancer and that spiritual well being also seems to play a key role. These issues deserve further studies in order to obtain significant clinical recommendations.
Highlights
Brain cancers contribute to about 2% of the cancer mortality in men and 1.4% of the mortality in women, and within the age group 15–34 years, they are the third most common cause of death because of cancer
Brain cancer patients have been the focus of a number of studies for some years, though only a few years ago Quality of Life (QoL) in brain cancer patients was a neglected issue [2] (Efficace and Bottomley, 2003)
We argue that a care pathway, in which is present a competent and wide monitoring of QoL of patients, including experiential aspects should help to maintain a patient-centred approach, supporting the patient’s adjustment process, as well as a good therapeutic alliance [13, 14] (Sprangers & Aaronson, 1992; Goerling, U & Stickel, 2014)
Summary
Brain cancers contribute to about 2% of the cancer mortality in men and 1.4% of the mortality in women, and within the age group 15–34 years, they are the third most common cause of death because of cancer. – Grade III and IV are called ‘high grade glioma’ (aggressive malignant). The most common types of brain tumours are glioblastoma multiforme (39% of all brain tumours), a high-grade (grade IV) astrocytic tumour that is almost always debilitating and rapidly fatal (6% survive two years) and anaplastic astrocytoma (grade III). Though high grade glioma remain fatal most of the time, new therapeutic options have arisen in the last ten years, increasing the life expectancy of patients and requiring adequate scientific considerations of QoL issues. Several medical institutions have implemented studies to assess QoL in cancer patients. Brain cancer patients have been the focus of a number of studies for some years, though only a few years ago QoL in brain cancer patients was a neglected issue [2] (Efficace and Bottomley, 2003). The situation is positively evolving, but a systematic evaluation of QoL and the correlating psychological aspects is still needed
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