Quality of Life among Breast Cancer Patients in Yemen

Al-Naggar, Redhwan Ahmed;Nagi, Nadeem Mohammed Saeed;Ali, Munef Mohammed Saleh;Almuasli, Mahfoudh

  • Published : 20110900

Abstract

Objective: the objective of this study is to determine the quality of life among breast cancer patients in Yemen based on socio-demographic and clinical characteristics. Methodology: This study was designed as a cross-sectional study. The data collected from 106 female breast cancer patients who were chosen for recruitment from the outpatient in National Oncology Centre (NOC), Sana'a, Yemen from November 2008 to June 2011. Questionnaires were distributed to the patients during their visit to the outpatient clinics in the center. The instrument of this study consists of two parts: Socio-demographic and the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire. Regarding data analysis, means and SD of subscales were evaluated for descriptive purpose. Analysis of variance (ANOVA) was performed to compare the three groups regarding QOL subscales. Whereas, independent t-test was performed for comparing two groups regarding QOL subscales. Multiple linear regression using backward analysis was performed to obtain the final model for each domain. The final model was chosen depending on R2 and the p value of the model. A p value less than 0.05 is considered statistically significant. Results: A total number of 106 breast cancer patients were participated in this study. The majority of them were uneducated, unemployed with normal weight and had middle income (60.4%; 95.3%; 59.4%, 46.2%; respectively). As for clinical characteristics of the study participants; the majority of them had had no family history of breast cancer, have been diagnosed at least 2 years, were diagnosed at grade 3 and size of tumor greater than 2 cm (88.7%, 66.0%, 35.8%, 73.6%; respectively). The majority of them underwent mastectomy, radiotherapy, chemotherapy and tamoxifen therapy (85.8%, 63.2%, 94.3% and 62.3%; respectively). For univariate analysis, the present study has identified several factors includes family monthly income, BMI, educational status, years after diagnosis, histological grade radiotherapy and surgery that influence the QOL of breast cancer patients in Yemen. For multivariate analysis, years after diagnosis, family monthly income and radiotherapy were significantly associated with total QOL of the breast cancer patients (p=0.01, p=0.023, p=0.039; respectively). Conclusion: Family monthly income, BMI, educational status, years after diagnosis, histological grade radiotherapy and surgery were significantly influence the QOL of breast cancer patients in Yemen, in univariate analysis. For multivariate analysis, years after diagnosis, family monthly income and radiotherapy were significantly associated with total QOL of the breast cancer patients.

Keywords

References

  1. Abdul Hamid G, Tayeb M, Bawazir A (2001). Breast cancer in South-east Republic of Yemen. East Mediterr Health J, 7, 1012-6.
  2. Abdulla Saleh AA, Aziz Alsafi I (2008). Estimating prevalence of breast cancer in Yemen, using capture-recapture method. Malaysian J Med Sci, 15, OM-11
  3. Alferi, S., Carver, C., Antoni, M., Weiss, S. & Rone, E. (2001). An exploratory study of social support, distress, and life disruption among low-income Hispanic women under treatment for early stage breast cancer. Health Psychology, 20, 41-6. https://doi.org/10.1037/0278-6133.20.1.41
  4. Al-Lawati JA, Santhosh-Kumar CR, Mohammed AJ, Jaffer MA (1999). Cancer incidence in Oman, 1993e1997. East Mediterr Health J, 5, 1035e41.
  5. Al-Naggar R, ?? (2008). Quality of life among women with breast cancer from universiti kebangsaan Malaysia medical centre, Malaysia. J Community Health, 14, 2.
  6. Al-Thobhani AK, Raja AYA, Noman TA (2001). The pattern and distribution of malignant neoplasms among Yemeni patients. Saudi Med J, 22, 910-3.
  7. Al-Thobhani A, Raja'a Y, Noman T, Al-Romaimah M (2006). Profile of breast lesions among women with positive biopsy findings in Yemen. East Mediterr Health J, 12, 599-604.
  8. Bawazir AA, Abdul-Hamid G, Morales E (1998). Available data on cancer in the southeastern governorates of Yemen. East Mediterr Health J, 4, 107-13.
  9. Bofill M (2003). Prevention and treatment of breast cancer in Cuba. Med Review, 6, 2-3.
  10. Brady MJ, Cella DF, Mo F, et al (1997). Reliability and validity of the functional assessment of cancer therapy-breast quality of life instrument. J Clin Oncol, 15, 974-86. https://doi.org/10.1200/JCO.1997.15.3.974
  11. Casso D, Buist DS, Taplin S (2004). Quality of life of 5-10 years breast cancer survivors diagnosed between age 40 and 49. Hlth Quality Life Outcomes, 2, 2-25. https://doi.org/10.1186/1477-7525-2-2
  12. Cella DF, Bonomi AE, Lloyd SR, et al (1995). Reliability and validity of the functional assessment of cancer therapy-lung (FACT-L) quality of life instrument. Lung Cancer, 12, 199-220. https://doi.org/10.1016/0169-5002(95)00450-F
  13. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al (1993). The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol, 11, 570-9. https://doi.org/10.1200/JCO.1993.11.3.570
  14. Chang S, Alderfer JR, Asmar L, Buzdar AM (2007). Inflammatory breast cancer survival: the role of obesity and menopausal status at diagnosis. Breast Cancer Research and Treatmen, 64, 157-63.
  15. Cohen L, Hack TF, Moor CD, Katz J, Goss PE (2000). The effects of type of surgery and time on psychological adjustment in women after breast cancer treatment. Ann Surg Oncol, 7, 427-34. https://doi.org/10.1007/s10434-000-0427-9
  16. Conde DM, Pinto-Neto AM, Cabello C, et al (2005). Quality of life in Brazilian breast cancer survivors age 45-65 years: associated factors. Breast J, 11, 425-32 https://doi.org/10.1111/j.1075-122X.2005.00124.x
  17. Cui, Y., Shu, X.O., Gao, Y., Cai, H., Wen, W., Ruan, Z., Jin, F. & Zheng, W. (2004). The long-term impact of medical and socio-demographic factors on the quality of life of breast cancersurvivors among Chinese women. Breast Cancer Research and Treatment, 87, 135-47. https://doi.org/10.1023/B:BREA.0000041620.76871.97
  18. El Saghir N S, Khalil M K, Eid T, et al (2007). Trends in epidemiology and management of breast cancer in developing Arab countries: a literature and registry analysis. Int J Surgery, 5, 225-33. https://doi.org/10.1016/j.ijsu.2006.06.015
  19. Engel J, Kerr J, Schlesinger-Raab A, et al (2003). Predictors of quality of life of breast cancer patients. Acta Oncol, 42, 710-8. https://doi.org/10.1080/02841860310017658
  20. Esbensen BA, Osterlind K, Roer O, Hallberg IR (2004). Quality of life of elderly persons with newly diagnosed Cancer. Eur J Cancer Care, 13, 443-53. https://doi.org/10.1111/j.1365-2354.2004.00546.x
  21. Fairclough DL, Cella DF (1996). Functional assessment of cancer therapy (FACT-G): non-response to individual questions. Qual Life Res, 5, 321-9. https://doi.org/10.1007/BF00433916
  22. Ganz PA, Desmond KA, Leedham B, et al (2002). Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst, 94, 39-49. https://doi.org/10.1093/jnci/94.1.39
  23. Ghouth ASB, Bafageer SS (2006). The pattern and distribution of malignancies reported in Hadramout, Yemen-2006. Breast, 48, 45.
  24. Golant M, Altman T, Martin, C (2003). Managing cancer side effect to improve quality of life. Cancer Nursing, 26, 37-44. https://doi.org/10.1097/00002820-200302000-00005
  25. Harcourt KF, Hicks KL (2003). Is there a relationship between case volume and survival in breast cancer? Am J Surg, 185, 407-10.
  26. Holzner B, Kemmler G, Koop M, et al (2001). Quality of life in breast cancer patients-not enough attention for long term survivors? Psychosomatics, 42, 117-23. https://doi.org/10.1176/appi.psy.42.2.117
  27. Hooper TI, Smith TC, Gray GC, et al (2005). Saudi Arabia-United States collaboration in health research: a formula for success. Am J Infect Control, 33, 192e6.
  28. Isikhan V, Guner P, Komurcu S, Ozet A, Arpaci F, Ozturk B (2001). The relationship between disease features and quality of life in patients with cancer. Cancer Nurs, 24, 490-5. https://doi.org/10.1097/00002820-200112000-00012
  29. Janni W, Rjosk D, Dimpfl T, et al (2001). Quality of life influenced by primary surgical treatment for stage I-III breast cancer-long term follow-up of a matched-pair analysis. Ann Surg Oncol, 8, 542-8.
  30. Janz NK, Mujahid M, Lantz PM, et al (2005). Population-based study of the relationship of treatment and socio-demographics on quality of life for early stage breast cancer. Qual Life Res, 14, 1467-147. https://doi.org/10.1007/s11136-005-0288-6
  31. Kagawa-Singer M (1995). Socioeconomic and cultural influences on cancer care of women. Sem Oncol Nurs, 11, 109-19 https://doi.org/10.1016/S0749-2081(05)80018-X
  32. Lu W, Cui Y, Zheng Y, et al (2007). Impact of newly diagnosed breast cancer on quality of life among Chinese women. Breast Cancer Res Treat, 102, 201-10. https://doi.org/10.1007/s10549-006-9318-5
  33. McNeely ML, Cambell KL, Rowe BH, et al (2006). Effects of exercise on breast cancer patients and survivors: a systemic review and meta-analysis. Can Med Ass J, 175, 34-41. https://doi.org/10.1503/cmaj.051073
  34. Merkin SS, Stevenson L, Powe N (2002). Geographical socioeconomic status, race, and advanced-stage breast cancer in New York City. Am J Public Hlth, 92, 64-70. https://doi.org/10.2105/AJPH.92.1.64
  35. Moody L, McMillan S (2003). Dyspnea and quality of life indicators in Hispanic patients and their caregivers. Hlth Quality Life Outcomes, 1, 1-8. https://doi.org/10.1186/1477-7525-1-1
  36. Naomi N, Caleb V Montgomery S (1999). Barriers to early detection of breast cancer among Caribbean population. Am J Pub Hlth, 5, 152-6.
  37. Nissen MJ, Swenson KK, Ritz LJ, et al (2001). Quality of life after breast carcinoma surgery. Cancer, 91, 1238-46. https://doi.org/10.1002/1097-0142(20010401)91:7<1238::AID-CNCR1124>3.0.CO;2-X
  38. Pandey M, Thomas BC, Ramdas K, Ratheesan K (2006). Early effect of surgery on quality of life in women with operable breast cancer. Jpn J Clin Oncol, 36, 468-72. https://doi.org/10.1093/jjco/hyl065
  39. Parker SL (1996). Cancer statistics, 1996. CA Cancer J Clin, 46, 5-27. https://doi.org/10.3322/canjclin.46.1.5
  40. Petro W (2001). Factors associated with mammography utilization among Jordanian women. J of Transcultural Nursing, 12, 284-91. https://doi.org/10.1177/104365960101200403
  41. Peuckmann V, Ekholm O, Rasmussen NK, et al (2007). Health-related quality of life in long-term breast cancer survivors: Nationwide survey in Denmark. Breast Cancer Res Treat, 104, 39-46. https://doi.org/10.1007/s10549-006-9386-6
  42. Pinar R, Salepci T, Afsar F (2003). Assessment of quality of life in Turkish patients with cancer. Turkish J Cancer, 33, 96-101.
  43. Rabin EG, Heldt E, Hirakata VN, Fleck MP (2008). Quality of life predictors in breast cancer women. Eur J Oncol Nurs, 12, 53-7.
  44. Rustoen T, Moum T, Wiklund I, Hanestad B (1999). Quality of life in newly diagnosed cancer patients. J Adv Nurs, 29, 490-8. https://doi.org/10.1046/j.1365-2648.1999.00912.x
  45. Salim EI, Moore MA, Al-Lawati JA, et al (2009). Cancer epidemiology and control in the Arab world—past, present and future. Asian Pac J Cancer Prev, 10, 3-16.
  46. Saudi Arabia Cancer Registry (1997). Non-communicable diseasesd regional situation. Saudi Arabian Ministry of Health publications;1998. Alwan A. Noncommunicable diseases: a major challenge to public health in the Region. East Mediterr Health J, 3, 6-16.
  47. Uzun O, Aslan FE, Selimen D, Koc M (2004). Quality of life in women with breast cancer in Turkey. J Nursing Scholar, 36, 207-213. https://doi.org/10.1111/j.1547-5069.2004.04039.x
  48. Wapnir IL, Cody RP, Greco RS (1999). Subtle differences in quality of life after breast cancer surgery. Ann Surg Oncol, 6, 359-66. https://doi.org/10.1007/s10434-999-0359-y
  49. Whelan TJ, Julian J, Wright J, Jadad AR, Levine ML (2000). Dose locoregional radiation therapy improve survival in breast cancer? A meta- analysis. J Clin Oncol, 18, 1220-9. https://doi.org/10.1200/JCO.2000.18.6.1220
  50. Wu XC, Chen VW, Steele B, et al (2003). Commentary on cancer incidence in adolescents and young adults in the United States, 1992-1997. J Adolesc Health, 32, 403-4. https://doi.org/10.1016/S1054-139X(03)00129-0