Quality Of Life In Cervical Cancer Patients Research Articles

Quality of life of carcinoma cervix patients attending tertiary care hospital: A cross-sectional study

Abstract Background: In 2012, cervical cancer became the leading cause of cancer-related deaths among women in India, with an estimated 123,000 new cases and 67,477 reported fatalities. Besides its considerable impact on mortality rates, cervical cancer also results in long-term disability, leading to a loss of productive years. Despite the development of various diagnostic and treatment approaches for cervical cancer, survivors still face significant morbidity, which significantly impacts their quality of life (QOL). The primary objective of this study is to assess the QOL of cervical cancer patients to identify and address issues within the current healthcare system. Objective: To investigate the QOL of cervical cancer patients as per the stage of their disease and the type of therapy they receive. Materials and Methods: A cross-sectional study was conducted between January 2023 and August 2023. During this period, patients who visited the Department of Obstetrics and Gynecology and agreed to take part in the study were included in interviews. The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire for cervical cancer (EORTC QLQ CX24) was employed to assess the QOL of cervical cancer patients. Results: The participants had an average age of 52.4 years, with a standard deviation of 10.5. Most were diagnosed at advanced disease stages (III and IV), while only approximately one-fourth were at stage I. The predominant treatment modality administered was radiotherapy, followed by surgery and chemotherapy. When examining the QOL, it was observed that individuals at stages I and II of the disease tended to experience more significant concerns related to body image and sexual worries. Additionally, patients in stages I and II and those receiving chemotherapy reported higher scores in terms of sexual activity and sexual enjoyment, indicating a better QOL in these aspects. Conclusion: As the disease stage progressed, there was a decline in QOL. In the early stages of the disease, QOL related to body image and sexual worries was notably lower. In contrast, QOL about sexual activity and sexual enjoyment was comparatively better for these patients. Patients who received chemotherapy or a combination of treatment modalities reported poorer QOL.

Early integration of palliative care in cervical cancer: Experiences from a pilot study.

Palliative care (PC) has been classically synonymous with end-of-life care offered to patients with advanced incurable cancers with an aim to improve their quality-of-life (QoL). However, there is growing evidence to suggest that early integration of PC (EIPC) along with cancer-directed management improves patient-reported outcomes. In this study, we aim to evaluate the impact of EIPC on QoL of cervical cancer patients treated with curative intent. Patients with locally advanced cervical cancer (stage IB2 to IIIB) having eastern cooperative oncology group (ECOG) performance score 0-2 were randomized into EIPC arm and standard of care arm of concurrent chemoradiation by a computer-generated table of random numbers. QoL was assessed by functional assessment of cancer therapy - general (FACT-G) questionnaire twice in both arms. The first assessment was done prior to starting treatment and second assessment at three months after treatment completion. The mean scores on physical, mental, emotional, social, and functional well-being subscales of FACT-G scale were calculated in both arms, and Wilcoxon test was used to evaluate differences in QoL scores within and in between the arms. This trial was registered with Clinical Trials Registry of India (CTRI) vide CTRI/2017/05/008704. Fifty patients were enrolled in each arm. However, only 42 and 45 patients in EPIC and standard oncological care arm were evaluated in the final analysis. Comparing QoL scores between the two time points in each arm, the mean pre-treatment scores in EIPC arm was significantly higher than post-treatment scores in the domains of physical and emotional well-being, whereas social and functional well-being scores improved significantly after treatment as compared with that as baseline. However, when compared between two arms, the difference of mean scores pre- and post-treatment were almost similar for physical and functional well-being but statistically significant differences were found only in social and emotional well-being scales. Our study is a feasibility study done in an attempt to test the validity of EIPC in cervical cancers. The results are inspiring to conduct robust studies in the future to explore this new domain of integration of palliative services in curable cancers.

Improving Treatment Outcome for Cervical Cancer Using 2-Point Assessment of Quality of Life Among Nigerian Women: A Protocol for a Multi-Center Study.

Cervical cancer is the fourth most common cancer among women globally, with quality of life (QOL) being a major concern for patients with cervical cancer, especially in low- and middle-income countries (LMICs). This is largely due to the advanced nature of the disease at presentation. Although there are a higher number of studies focusing on the QOL of high-income countries, the QOL of cervical cancer patients in LMICs is not available. The aim of this study is to evaluate QOL among women with cervical cancer in Nigeria using a 2-point assessment. A multi-center prospective cohort study will be conducted in 6 tertiary health facilities randomly selected from the 6 geopolitical zones of Nigeria and consisting of a 2-point assessment of the QOL of participants at the time of diagnosis of cervical cancer and after treatment. Women who were recently diagnosed with histologically confirmed cervical cancer (treatment naïve) will be included. QOL will be assessed using Quality of Life Questionnaire domains (EORTC QLQ30) as developed by the European Organization for Research and Treatment of Cancer (EORTC). In addition to the QOL assessment, relevant and clinicopathological variables will be obtained using a self-structured data extraction sheet designed for this study. All data will be anonymized and will be analyzed using SPSS version 25. Levels of QOL will be calculated using EORTC QLQ30. Ethical approval was obtained from National Health Research Ethics Committee (NHREC/01/01/2007-08/11/2021). In view of the paucity of data on QOL in LMICs like Nigeria, where most women with cervical cancer present with advanced disease, this research was designed to help in formulating evidence-based interventions to improve the QOL and treatment outcomes provided to women with cervical cancer in Nigeria and other LMICs. The study is expected to fill these knowledge gaps.

Symptom Clusters and Quality of Life in Cervical Cancer Patients Receiving Concurrent Chemoradiotherapy: The Mediating Role of Illness Perceptions.

ObjectivesAlthough studies shows that symptom clusters and illness perceptions are negatively associated with quality of life (QoL), it is unclear how these variables of cervical cancer patients who receive concurrent chemoradiotherapy (CCRT) relate to each other. This study aimed to identify the symptom clusters in cervical cancer patients who receive CCRT and evaluate the mediating effect of illness perceptions on the relationship between symptom clusters and QoL.MethodsA cross-sectional survey was conducted on 286 cervical cancer patients receiving CCRT from October 2019 to October 2020. M.D. Anderson Symptom Inventory, Brief Illness Perception Questionnaire, and Functional Assessment Cancer Therapy-Cervix were applied to investigate the symptom clusters, illness perceptions and QoL of the participants, respectively. Exploratory factor analysis was conducted to identify symptom clusters. The relationships among symptom clusters, illness perceptions, and QoL were analyzed with the structural equation modeling.ResultsA total of four symptom clusters were identified, including psychological status symptom cluster, therapy side-effect symptom cluster, sickness symptom cluster, and gastrointestinal symptom cluster (χ2 = 1,552.282, Df = 78, P < 0.001). Symptom clusters, illness perceptions, and QoL were significantly correlated. Symptom clusters had significant direct (β = −0.38, P < 0.001) and indirect effects (β = −0.21, P < 0.001) on QoL.ConclusionIllness perceptions played a significant mediating role between symptom clusters and QoL in cervical cancer patients receiving CCRT. Strategies like prompting effective symptom management for the purposes of alleviating illness perceptions may contribute to improving their QoL.

Quality of life among cervical cancer patients undergoing radiotherapy.

IntroductionThere has been an increasing rate of the incidence and mortality of cervical cancer in Ghana. Cancer and the treatment's side effects have adverse effects on the patients and this affects patient's well-being and lifestyle during and after radiotherapy. The study sought to assess the impact of demographic and clinical characteristics on Quality of Life (QoL) among cervical cancer patients undergoing radiotherapy in Ghana.MethodsA cross sectional quantitative study design was carried out on 120 cervical cancer patients who were conveniently sampled from the study site. The data was collected between the months of December, 2017 and February, 2018. QoL was measured using the FACT-G questionnaire. The mean scores of QoL were determined, whiles the chi-square test was used to determine the impact of socio-demographic and clinical characteristics on the QoL of the patients.ResultsThe mean age of the patients was 56.8 years. Majority of the patients reported stable QoL. The social well-being of the older patients was more affected than other patients. The unmarried, widows and patients who underwent surgery with radiotherapy were emotionally affected. Majority (56%) of the participants had stable QoL whiles 22% each had poor and good QoL. Significant association was found among 35-39 age group with physical well-being and overall QoL (p=0.017 and 0.029) respectively.ConclusionThere is a need to embrace a QoL assessment instrument in the study site so as to help the oncology team in the identification and addressing of specific indicators that affect the QoL of cervical cancer patients.

Effect of treatment on the quality of life of cervical cancer patients: a prospective study from a tertiary care centre of West Bengal

Background: Cervical cancer is one of many health care ironies. Better survival rates demand better quality of life (QoL). The aim of present study was to determine the change in QoL of cervical cancer patients due to treatment.Methods: An observational prospective study was conducted from July 2017 to June 2018 among 80 new cervical cancer patients without any prior history of treatment for cervical cancer, attending radiotherapy department of a tertiary care centre of West Bengal using a semi-structured schedule and European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ). Information was collected on socio-demographic and clinical aspects and QoL domains. Those with history of surgery for cervical cancer, advanced stage of disease were excluded. EORTC QLQ was administered at baseline and one month after completion of treatment. Data was analysed by percentage, means±standard deviation, range and Wilcoxon signed rank test etc. using SPSS-16.Results: Only 60 patients could be analysed as 10 patients died and 10 lost to follow-up. After treatment there was a significant improvement in global health, physical, emotional and cognitive functioning as well as decrease in symptoms like fatigue, pain, insomnia, appetite loss and constipation along with worsening of financial difficulties. There was significant improvement in body image, decrease in problems of symptom experience, peripheral neuropathy and menopausal symptoms after treatment.Conclusions: The cervical cancer patients show an overall improvement in their QoL in most of the domains after one month of treatment except worsening of financial difficulties.

Assessment of Quality of Life of Cervical Cancer Patients Using ECOG-Performance Status Scale

Background: Cervical cancer is becoming one of the emerging health burdens for womenhood and India accounts for one-third of the cervical cancer deaths globally. More than 80% of women with cervical cancer are diagnosed at an advanced stage. In this study, we aimed to assess the Quality of Life (QOL) of patients with cervical cancer after treatment and to examine the factors affecting their QOL.&#x0D; Materials and Methods: This is a retrospective observational study, included 218 cervical cancer patients. The study was conducted in a tertiary care hospital in Warangal of Telangana State. The impact of socioeconomic factors and clinical factors on the QOL of the patients were studied using Eastern Cooperative Oncology Group-Performance status (ECOG-PS) scale. The protocol was approved by KIEC-KMC, Warangal. The statistical analysis was performed by using Fischer's Exact test, a value of p&lt;.05 was considered as significant.&#x0D; Results: Out of 218 patients 189 were alive and 29 were deceased. Patient of age group 21-40 years, patients from urban areas, from upper socioeconomic status (SES), patients with literacy, without any social habits had good QOL, where as patients in labour forces had poor QOL and are statistically significant. Patients with early stage at diagnosis and patients underwent surgical treatment along with chemoradiation therapy had good QOL yet, these results are statistically insignificant.&#x0D; Conclusion: The lack of access to preventive and definitive care by the health care sectors, poor socioeconomic status, educational status of the women and awareness regarding the disease and its treatment patterns resulted in poor follow up, low adherence to the treatment, which accentuated the cervical cancer burden. Hence, enhancing the above listed factors could be beneficial in improving QOL of cervical cancer patients.

Factors affecting quality of life of cervical cancer patients: A multivariate analysis.

The aim of good management for cancer survivors should not be limited to only clinical care, but rather it should also include best quality of life (QOL). The objective of this study was to find out various factors affecting QOL in cervical cancer patients so that by modifying these factors, the best QOL can be provided to them. This was a prospective cohort study conducted in the Department of Obstetrics and Gynaecology and Department of Radiotherapy, King George's Medical University (KGMU), Lucknow, from May 2015 to July 2016. The cases were selected from patients visiting the outpatient department or who were admitted to the Department of Obstetrics and Gynaecology and Department of Radiotherapy, KGMU. The data information was collected in the form of face-to-face interview using European Organization for Research and Treatment of Cancer general cancer QOL Score 30 (EORTC QLQ C-30) and EORTC QOL questionnaire cervical cancer module (QLQ CX-24) questionnaire. QOL was assessed in 85 patients. Health-related QOL was separately studied in terms of overall general QOL and cancer cervix-specific QOL, and various factors affecting QOL were studied by multivariate analysis. Education, tobacco use, degree of differentiation of tumor, and size of tumor were the independent factors found to have statistically significant effect on QOL of cervical cancer survivors.

Effects of Intrinsic and Extrinsic Factors on the Level of Hope and Psychological Health Status of Patients with Cervical Cancer During Radiotherapy.

BackgroundThis study aimed to explore the factors affecting the level of hope and psychological health status of patients with cervical cancer (CC) during radiotherapy.Material/MethodsA total of 480 CC patients were recruited. Psychological distress scale, Herth hope index, functional assessment cancer therapy-cervix, and Jolowiec coping scale were used to conduct surveys on psychological distress, level of hope, quality of life (QOL), and coping style to analyze the factors affecting the level of hope and psychological health status of CC patients.ResultsThe morbidity of significant psychological distress in 480 CC patients during radiotherapy was 68%, and the main factors causing psychological distress were emotional problems and physical problems. During radiotherapy, most patients had middle and high levels of hope, and the psychological distress index of patients was negatively correlated with the level of hope. The QOL of CC patients during radiotherapy were at middle and high levels, and the QOL was positively correlated with confrontment, optimism, appeasement, and self-reliance, but it was negatively correlated with predestination and emotional expression.ConclusionsFor CC patients during radiotherapy, the morbidity of psychological distress was high, but they were at middle and high levels of hope.

A longitudinal study to assess quality of life in cervical cancer patients before and after cancer-directed treatment

Background: Cervical cancer is world’s one of the most deadly but easily preventable cancers of women. Diagnosis and treatment is emotionally traumatic and results in psychosexual sequelae-affecting quality of life (QoL). The present study was conceptualized as Department of Community Medicine, Government Medical College, Jammu is already reporting these cancers to Indian Council of Medical Research (ICMR) and it was thought that a QoL study would help us in getting fair idea about their QoL as well. Objectives: To assess and compare QoL of cervical cancer patients before and after completion of cancer-directed treatment (CDT). Materials and Methods: The present longitudinal study was conducted in Government Medical College which is a tertiary care hospital in Jammu. All newly diagnosed cases of cervical cancer over a period of 6 months were included in the study. European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaire (QLQ) C-30 (general) and EORTC CX-24 (specific) questionnaires were used to assess QoL. The data was analyzed using computer software Microsoft Excel and SPSS version 17. A scoring algorithm recommended by EORTC was used. Pre- and post-mean scores were compared by the use of paired t-test. Pre- and post-Cronbach’s alpha reliability coefficient was also calculated. Results: Stage III was the most common stage diagnosed followed by Stage II. Regarding QLQ C-30, the mean scores across all domains showed statistically significant worsening of QoL from baseline. The worsening was more severe in emotional and social functioning. Regarding, Global health status and EORTC QLQ CX-24 questionnaire all items also showed worsening of QoL from their baseline values. Conclusion: QoL of cervical cancer patients showed worsening after CDT in all domains due to acute and subacute adverse effects of radiotherapy and chemotherapy in the course of treatment.

Quality of life by stage of cervical cancer among Malaysian patients.

Stage of cervical cancer may adversely affect the quality of life (QOL) among patients. The objective of this study was to predict the QOL among cervical cancer patients by the stage of their cancer. A cross-sectional study from September 2012 until January 2013 was conducted among cervical cancer patients who completed treatment. All patients completed a interviewer-guided questionnaire comprising four sections: (A) socio- demographic data, (B) medical history, (C) QOL measured by general health status questionnaire (QLQ-30) and (D) cervical cancer specific module CX-24 (EORTC) was used to measured patient's functional, symptom scale and their global health status. Results showed that global health status, emotional functioning and pain score were higher in stage III cervical cancer patients while role functioning was higher in stage I cervical cancer patients. Patients with stage IV cancer have a lower mean score in global health status (adjusted b-22.0, 95 CI% -35.6, -8.49) and emotional functioning (adjusted b -22.5, 95 CI% -38.1, -6.69) while stage III had lower mean score in role functioning (adjusted b -14.3, 95 CI% -25.4, -3.21) but higher mean score in pain (adjusted b 22.1, 95 CI% 8.56, 35.7). In conclusion, stage III and IV cervical cancers mainly affect the QOL of cervical cancer patients. Focus should be given to these subgroups to help in improving the QOL.

Quality of life in women with cervical precursor lesions and cancer: a prospective, 6-month, hospital-based study in China

The overall survival of patients with cervical cancer has improved due to detection at an early stage and availability of comprehensive treatments in China. As patients' lives prolonged, it is important to understand their health-related quality of life (QoL) during and after treatment. We used the EQ-5D questionnaire to assess QoL of 194 patients with cervical lesions at Sichuan University West China Second Hospital between May 2010 and January 2011. Patients were surveyed before primary treatment and at 1, 3, and 6 months after primary treatment. Results showed a consistent decline in EQ-5D scores in the spectrum of cervical lesions at each time point after treatment (all P < 0.05). For patients with precursor lesions, there was an increasing trend along the timeline of treatment (P < 0.01). For patients with early-stage cervical cancer, EQ-5D scores declined in the first month (P = 0.01) and gradually increased to higher levels at 6 months post-treatment than those before treatment (P < 0.01). EQ-5D scores followed a similar trend in patients with advanced cervical cancer (P = 0.04), though they did not statistically rebound after 6 months (0.84 ± 0.19 vs. 0.86 ± 0.11, P = 0.62). Regarding advanced cervical cancer, EQ-5D scores for women above 40 years of age appeared to recover more rapidly and reached higher levels than those for women below 40 years (P = 0.03). Caution and extra care are recommended in the early period of cervical cancer treatment given the slight deterioration in the QoL, and in particular, for younger cervical cancer patients. Our study implies that health care providers may need to improve the health-related QoL of cervical cancer patients.

Investigation on quality of life status of cervical cancer after opration in follow-up period

Objective To know the quality of life (QOL) state of cervical cancer patients in follow-up period and to analyze the related factors of influencing QOL.Methods A total of 97 female serviced cancer survivors in follow-up finished chemotherapy and radiotherapy were investigated by filling out questionnaire of Chinese version EORTC QLQ-C30 and the EORTC QLQ-BR23.And SPSS was used for data analysis.Results The overall QOL score of all 97 serviced cancer patients was 71.31.The lowest score of functioning in QLQ-C30 was emotional functioning,and the highest score was financial difficulties.In the QLQRR23,the lowest score of functioning was sexual functioning and the highest score was systemic therapy side effects.Conclusions Postoperative cervical cancer patients in follow-up period have a relatively good QOL.Functions of all aspects of patients had improved and all kinds of symptoms of them had abated.Medical staffs should pay attention to sexual function of these cervical cancer survivors.It can improve QOL of cervical cancer patients in follow-up period. Key words: Cervical cancer; Follow-up period; Quality of life; Influencing factor