Quality of Life in Gynaecological Cancers and Tools for Its Improvement: An Indian Perspective

Abstract

Background: Gynecologic cancer and treatment related morbidities adversely affect the quality of life (QOL) and overall outcome. QOL assessment and focus on QOL improvement still lag behind in the priority list of cancer management in Indian women. Aim: To assess the quality of life in India gynecologic cancer patients and possible tools for its improvement. Methods: This review is based on PubMed literature search of all the studies related to QOL in gynecologic cancer patients in India. The studies were categorized into those assessing QOL and improving QOL. Results: Unlike the abundant literature on QOL of patients with breast and oral cancers, the studies on QOL of women with gynecologic cancers are scarce. Nonetheless, twenty-five articles could be retrieved that directed efforts to identify parameters and tools assessing QOL as well as to modify treatment strategies for better QOL. The principal of nerve sparing technique and easily reproducible steps of laparoscopy and robotic hysterectomy has been recently used in Indian patients. It helped in improving QOL of operable cervical cancer patients. Ayurveda holds an important place in Indian medicine and has effective remedies for many diseases. Studies on the use of Ayurvedic drugs during chemotherapy and radiotherapy have shown reduction in treatment related toxicities. Conclusion: Improvement in 'quality of life' should be considered as important as increment in overall survival while managing women with gynecologic cancers. Better QOL would boost the patient's and family's compliance to treatment and improve disease specific outcome. Simpler QOL assessment tools and refined multimodal therapy techniques suitable for Indian population need to be integrated in national cancer treatment guidelines.