Abstract
Introduction: Liver Cancer is aggressive cancer and patients are mostly screened and diagnosed when they become symptomatic at advanced. Disease severity, depression, fatigue, joint pain, and poor appetite have been reported as strong determinants of quality of life (QoL) among liver cancer patients.
 Aims: The objective of the study was to assess the quality of life and depression among liver cancer patients in Pakistan.
 Study Design: A descriptive cross-sectional study design was used.
 Place and Duration of Study: The study was conducted in healthcare facilities of Islamabad and Rawalpindi, Pakistan between June 2020-December 2020.
 Methodology: Two pre-validated questionnaires i.e. EORTC QLQ-C30 and HADS were self-administered to a sample of 100 liver cancer patients selected using a convenience sampling technique for measuring QoL and depression, respectively. After data collection, data was cleaned, coded, and entered in SPSS.
 Results: The results highlighted that the lowest scores observed in the domain of symptom scale were: Nausea and Vomiting (23.72, ± 28.238), Dyspnea (25.27, ± 26.90), Constipation (26.03, ± 34.75) followed by Diarrhea (22.63, ± 28.42), whereas highest scores in the symptom scale were observed in the domain of fatigue (37.69, ± 20.06), pain (40.37, ± 18.44), insomnia (41.65, ± 32.37) and financial difficulties (60.33, ± 33.830). On the other hand, highest score on the functional scale was observed for physical functioning (64, ± 21.76) and the lowest score was observed in social functioning (53.19, ± 20.66).
 Conclusion: The present study concluded that liver cancer had a negative impact on risk factors/past medical history, co-morbidities, and poor socio-economic of life across all domains along with moderate depression in liver cancer patients. Illiteracy, advanced liver cancer stage, risk factors/past medical history, co-morbidities and poor socio-economic status negatively affected functional and symptom scale. Appropriate health educational and psychological interventional programs targeting patients should be initiated to improve awareness and reduce depression among liver cancer patients.
Highlights
Liver Cancer is aggressive cancer and patients are mostly screened and diagnosed when they become symptomatic at advanced
Depression, fatigue, joint pain, and poor appetite have been reported as strong determinants of health-related quality of life among liver cancer patients [5]
Similar findings were reported from a study conducted in Taiwan which showed that liver cancer patients had reduced quality of life (QoL) in physical domains [14]
Summary
Liver Cancer is aggressive cancer and patients are mostly screened and diagnosed when they become symptomatic at advanced. Depression, fatigue, joint pain, and poor appetite have been reported as strong determinants of quality of life (QoL) among liver cancer patients. Aims: The objective of the study was to assess the quality of life and depression among liver cancer patients in Pakistan. Some HCV-affected individuals remain asymptomatic for long periods of time and may never develop progressive liver disease. Few of these patients develop hepatic de-compensation and/or hepatocellular carcinoma [4]. Depression, fatigue, joint pain, and poor appetite have been reported as strong determinants of health-related quality of life among liver cancer patients [5]. Predicting factors for depression were found to be low-level education, pain, old age and poor performance status [9]
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