Worse Body Image Research Articles

The impact of age and clinical factors on quality of life in early breast cancer: An analysis of 2208 women recruited to the UK START Trial (Standardisation of Breast Radiotherapy Trial)

Quality of life (QOL) assessments of women entering a UK randomised trial of adjuvant radiotherapy (START) were investigated to estimate the independent effects on QOL of age, time since surgery, type of breast surgery, chemotherapy and endocrine therapy. QOL was evaluated using the EORTC general cancer QOL scale (EORTC QLQ-C30), breast cancer module (BR23), the Body Image Scale (BIS) and the Hospital Anxiety and Depression Scale (HADS). Independent effects of age and clinical factors were tested using multiple regression analysis. A total of 2208 (mean age 56.9 years, range 26-87) consented to the QOL study prior to radiotherapy; 17.1% had undergone mastectomy (Mx) and the remainder had undergone a wide local excision (WLE). 33.3% had received adjuvant chemotherapy (CT) and 56.7% were taking endocrine therapy (ET). Age had significant effects on QOL with older and younger subgroups predicting poorer QOL for different domains. CT affected most QOL domains and resulted in worse body image, sexual functioning, breast and arm symptoms (<0.001). Mx was associated with greater body image concerns (p<0.001), and WLE with more arm symptoms (p=0.01). There were no effects of ET on QOL. Women <50 years (proxy pre-menopausal) had worse QOL in respect of anxiety, body image and breast symptoms but age and clinical factors had no effect on depression. Overall, QOL and mental health were favourable for most women about to start RT, but younger age and receiving CT were significant risk factors for poorer QOL, and so patients in these subgroups warrant further monitoring. Surgery had a limited impact and ET had no effect on QOL.

Menopausal symptoms in women with breast cancer: prevalence and treatment preferences.

Menopausal symptoms are common and problematic for women receiving adjuvant treatment for breast cancer and management presents a challenge. This cross-sectional descriptive study aimed to investigate the experience of menopausal symptoms, current management and treatment preferences of 113 patients with breast cancer. These women (who were prescribed tamoxifen and were on average 3 years post-diagnosis) were recruited from a breast unit database. They completed the Hot Flush and Night Sweats Questionnaire (HFNSQ), the Women's Health Questionnaire (WHQ) and subscales of the EORTC-QLQ-C30 and the BR23, as well as questions about treatments. Forty-four of this sample were also interviewed. The prevalence of hot flushes and night sweats was 80 and 72%, respectively (average 30 per week). Having more problematic hot flushes and night sweats were associated with more anxiety and sleep problems (WHQ), and with poorer emotional and social functioning and worse body image (EORTC-QLQ-C30). The women had used a range of treatments for menopausal symptoms but there was often no evidence for the efficacy for many of these treatments. Strongest preferences were for non-medical treatments, particularly vitamins and herbal remedies and cognitive behavioural therapy (CBT). The evidence for the effectiveness of the former is weak, whereas CBT has been shown to reduce menopausal symptoms, but needs to be evaluated in a population of women who have been treated for breast cancer.

Quality of life after pelvic exenteration

Objectives. Pelvic exenteration, for gynecological and urological cancer, is an extensive and mutilating procedure. The 5-year survival rate is fairly good (40–60%), but little is known about the long-term quality of life. Methods. In this retrospective cohort study, the quality of life was assessed using the EORTC QLQ-C30 (version 3.0) and the EORTC QLQ-OV28 questionnaires. Results. Healthy females and those who underwent pelvic exenteration for a gynecological or urological malignancy reported comparable levels of emotional functioning and general quality of life. More physical, sexual, and social problems were, however, noted after exenteration. Younger patients and patients who underwent total pelvic exenteration had the most difficulty in adapting to daily life, disease, and treatment. They also had a worse body image, and the influence of the operation on their sex life was greater compared to other patient groups of this study. Conclusion. Despite the immense effect of pelvic exenteration on physical, sexual, and social functioning, women who underwent this procedure reported similar levels of emotional functioning and general quality of life compared to healthy women. Adaptation and the mechanism of response shift presumably play an important role.

Sexual functioning in ambulatory men with HIV/AIDS.

Sexual functioning is often neglected in the care of HIV-infected patients. Little information exists about the relationship between hormonal factors, psychological factors, medication, HIV disease stage and sexual functioning among persons with HIV disease. In this study, 50 HIV+ men completed the Derogatis Sexual Functioning Inventory (DSFI), and had serum hormonal assays drawn (testosterone, thyroid function test, leuteinizing hormone, prolactin and oestradiol). Although all the subjects reported some degree of sexual dysfunction, persons with symptomatic HIV/AIDS reported more negative mood, lower sexual satisfaction scores and worse body image than persons with asymptomatic HIV. Persons with asymptomatic HIV also tended to have normal testosterone levels compared with persons with symptomatic HIV/AIDS. No relationship was found between medications and low testosterone, although numbers were small. These results suggest that sexual dysfunction is prevalent among persons with HIV disease, is more common as patients become symptomatic and progress to AIDS and that both physiological (low testosterone) and psychological issues play a role.