Quality of Life in Women with Gynecologic Cancer in Turkey

Goker, A;Guvenal, T;Yanikkerem, E;Turhan, A;Koyuncu, FM

  • Published : 20111100

Abstract

Aim: The management of gynecological cancer patients mainly aims at prolonging survival but modern therapy focuses on good survival combined with a good quality of life (QoL). The aim of this study was to evaluate QoL and identify its associated factors in Turkish women with gynecologic cancer. Method: The study included 119 women diagnosed with endometrial, cervical, ovarian or vulvar cancer and treated at the Gynecologic Oncology Department of Celal Bayar University Faculty of Medicine. The data were collected between January and June 2011. QoL was measured with EORTC QLQ-C30 version 3.0. Relationships between clinical and socio-demographic characteristics and QoL scores were analyzed using the Mann-Whitney U, Kruskal Wallis and t-tests. Results: Global health status, physical and role function scores were found higher in women under the age of 60 years. Role function scores were found lower, and emotional and social scores were found to be higher in single women than in married women. Physical scores were found higher in women who had graduated from secondary school or above. Women with ovarian cancer had the highest while women with cervical cancer had the lowest global health score ($65.3{\pm}24.7$ and $43.0{\pm}24.1$, respectively). Women with endometrial cancer were found to have better role function, and social well being than those with vulvar, cervical or ovarian cancer. Global, physical, role function, cognitive and social scores were found higher in women who had been treated with surgery. Conclusion: Gynecological cancer and treatment processes cause significant problems that have negative effects on physical, emotional, social and role function aspects of QoL. Health care providers play a key role in the identification and treatment of the complications of cancer therapy. Minimizing the effect of the symptoms of gynecologic cancer may positively impact on patient QoL.

Keywords

References

  1. Aaronson NK, Ahmedzai S, Bergman B, et al (1993).The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. J National Cancer Institute, 85, 365-76. https://doi.org/10.1093/jnci/85.5.365
  2. American Cancer Society Cancer Facts and Figures. Annuel report. California division and public health ins 2007. http://www.cancer.org/docroot/stt/stt_0.asp.
  3. American Cancer Society. Cancer facts and figures, 2009. Atlanta, Georgia, USA: American Cancer Society; 2009.
  4. Arriba LN, Fader AN, Frasure HE, von Gruenigen VE (2010). A review of issues surrounding quality of life among women with ovarian cancer. Gynecol Oncol. doi: 10.1016/j.yayno.2010.05.014
  5. Bjordal K, de Graeff A, Fayers PM, et al (2000). A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (The EORTC QLQ-H&N35). Eur J Cancer, 36, 213-9.
  6. Boyle P, Levin B (2008). IARC Publications. World cancer report. http:// www.iarc.fr/en/publications/pdfs-online/wcr/2008/index.php.
  7. Bradley S, Rose S, Lutgendorf S, Costanzo E, Anderson B (2006). Quality of life and mental health in cervical and endometrial cancer survivors. Gynecol Oncol, 100, 479-86. https://doi.org/10.1016/j.ygyno.2005.08.023
  8. Brucker PS, Yost K, Cashy J, Webster K, Cella D (2005) General population and cancer patient norms for the Functional Assessment of Cancer Therapy-General (FACT-G). Eval Health Prof, 28, 192-211 https://doi.org/10.1177/0163278705275341
  9. Capelli G, De Vincenzo RI, Addamo A, et al (2002). Which dimensions of health-related quality of life are altered in patients attending the different gynecologic oncology health care settings? Cancer, 95, 2500-7. https://doi.org/10.1002/cncr.10993
  10. Cella DF, Tulsky DS, Gray G, et al (1993).The functional assessment of cancer therapy (FACT) scale : development and validation of the general measure. J Clin Oncol, 11, 570-9. https://doi.org/10.1200/JCO.1993.11.3.570
  11. Cella DF, Onav EJ, Kornblith AB, et al (1991). Socioeconomic status and cancer survival. J Clin Oncol, 9, 1500-9. https://doi.org/10.1200/JCO.1991.9.8.1500
  12. Cheson BD, McCabe MS, Phillips PH (1995). Clinical trials, Referral resource. Clinical trials assessing quality of life. Oncology, 95, 1171-8.
  13. Dow KH , Melancan CH (1997). Quality of life in women with ovarian cancer. Western J Nurs Res, 19, 334-50. https://doi.org/10.1177/019394599701900305
  14. Eisemann M, Lalos A (1999). Psychosocial determinants of wellbeing in gynecologic cancer patients. Cancer Nurs, 22, 303-6. https://doi.org/10.1097/00002820-199908000-00007
  15. Ell K, Xie B, Wells A, et al (2008). Economic stress among low-income women with cancer: effects on quality of life. Cancer, 112, 616-25. https://doi.org/10.1002/cncr.23203
  16. EORTC QLQ-C30 scoring manual (internet adresi bulunup yazılacak)
  17. Fayers P, Aaronson N, Bjordal K, Sullivan M (1995). On behalf of the EORTC quality of life study group. EORTC QLQ-C30 scoring manual. http://groups.eortc.be/qol/questionnaires_qlqc30.htm.
  18. Ferrell BR, Dow KH, Grant M (1995). Measurement of the quality of life in cancer survivors. Qual Life Res, 4, 523-31. https://doi.org/10.1007/BF00634747
  19. Hoskins NS, Perez CA, Young RC (1997). Principles and practice of gynecologic oncology; second ed. Lippincott- Raven Publishers, Philadelphia.
  20. Matulonis UA, Kornblith A, Lee H et al (2008). Long term adjustment of early stage ovarian cancer survivors. Int J Gynecol Cancer, 18, 1183-93. https://doi.org/10.1111/j.1525-1438.2007.01167.x
  21. Fossa SD, Hess SL, Dahl AA, Hjermstad MJ, Veenstra M (2007) Stability of health-related quality of life in the Norwegian general population and impact of chronic morbidity in individuals with and without a cancer diagnosis. Acta Oncol, 46, 452-61 https://doi.org/10.1080/02841860601182641
  22. Greimel E, Thiel I, Peintinger F, Cegnar I, Pongratz E (2002). Prospective assessment of quality of life of female cancer patients. Gynecol Oncol, 85, 140-17. https://doi.org/10.1006/gyno.2002.6586
  23. Greimel ER, Winter R, Kapp KS, Haas J (2009). Quality of life and sexual functioning after cervical cancer treatment: a long-term follow-up study. Psychooncology, 18, 476-82. https://doi.org/10.1002/pon.1426
  24. Goncalves V (2010). Long-term quality of life in gynecological cancer survivors. Curr Opin Obstet Gynecol, 22, 30-5. https://doi.org/10.1097/GCO.0b013e328332e626
  25. Gustavsson- Lillius M, Julkunen J, Hietanen P (2007).Quality of life in cancer patients: the role optimism, hopelessness, and partner support. Qual Life Res, 16, 75-87. https://doi.org/10.1007/s11136-006-9101-4
  26. Jordhy MS, Fayers P, Loge SH, et al (2001). Quality of life in advanced cancer patients: the impact of sociodemographic and medical characteristics. Br J Cancer, 85, 1478-85. https://doi.org/10.1054/bjoc.2001.2116
  27. Matulonis UA, Kornblith A, Lee H et al (2008). Long term adjustment of early stage ovarian cancer survivors. Int J Gynecol Cancer, 18, 1183-93. https://doi.org/10.1111/j.1525-1438.2007.01167.x
  28. Miller BE, Pittman B, Strong C (2003). Gynecologic cancer patients' psychosocial needs and their views on the physician's role in meeting those needs. Int J Gynecol Cancer, 13, 111-9. https://doi.org/10.1046/j.1525-1438.2003.13001.x
  29. Miller BE, Pittman B, Case D, McQuellon RP (2002). Quality of life after treatment for gynaecologic malignancies: a pilot study in an outpatient clinic. Gynecol Oncol, 87, 178-84. https://doi.org/10.1006/gyno.2002.6812
  30. Lerman R, Jarski R, Rea H, Gellish R, Vicini F (2011). Improving symptoms and quality of life female cancer survivors: a randomized controlled study. Ann Surg Oncol.doi: 10.1245/510434-011-2051-2.
  31. Lundh HC, Seiger A, Furst CJ (2006) Quality of life in terminal care-with special reference to age, gender and marital status. Support Care Cancer, 14, 320-8. https://doi.org/10.1007/s00520-005-0886-4
  32. Pınar G, Algier L, Colak M, Ayhan A (2008). Quality of life in patients with gynecologic cancer. Int J Hematol Oncol, 3, 141-9.
  33. Reis N, Beji NK, Coskun A (2010). Quality of life and sexual functioning in gynecological cancer patients: Result from quantitative and qualitative data. Eur J Oncol Nurs, 14, 137-46. https://doi.org/10.1016/j.ejon.2009.09.004
  34. Steginga SK, Dunn J (1997). Women's experiences following treatment for gynecologic cancer. Oncol Nurs Forum, 24, 1403-8.
  35. Ozaras G, Ozyurda F (2010). Quality of life and Influencing factors in patients with gynecologic cancer diagnosis at Gazi University, Turkey. Asian Pac J Cancer Prev, 11, 1403-8.
  36. Tahmasebi M, Yanandi F, Eftekhar Z, Montazeri A, Namazi H (2007). Quality of life in gynecologic cancer patients. Asian Pac J Cancer Prev, 8, 591-2.
  37. Tan M, Karabulutlu E (2005). Social support and hopelessness in Turkish patients with cancer. Cancer Nurs, 28, 236-40. https://doi.org/10.1097/00002820-200505000-00013
  38. Tannock I (2011). Determinants of quality of life in patients with advanced cancer. Support Care Cancer, 19, 621-9. https://doi.org/10.1007/s00520-010-0866-1
  39. von Gruenigen VE, Huang HQ, Gil KM et al (2009). Assessment of factors that contribute to decreased quality of life in Gynecologic Oncology Group ovarian cancer trials. Cancer, 115, 4857-64. https://doi.org/10.1002/cncr.24520
  40. Wenzel LB, Donnelly JP, Fowler JM, et al (2002). Resilience, reflection, and residual stress in ovarian cancer survivorship: a gynecologic oncology group study. Psychooncology, 11, 142-53. https://doi.org/10.1002/pon.567
  41. Wilailak S, Lertkhachonsuk A, Lohacharoenvanich N, et al (2011). Quality of life in gynecologic cancer survivors compared to healthy check-up women. J Gynecol Oncol, 22, 103-9. https://doi.org/10.3802/jgo.2011.22.2.103
  42. Zimmermann C, Burman D, Swami N, et al (2003). Quality of life and psychosocial adjustment in gynecologic cancer survivors. Health Qual Life Outcomes, 1, 33 https://doi.org/10.1186/1477-7525-1-33