scholarly journals Elucidating mechanisms of quality‐of‐life disparities in Hispanic women with breast cancer: An examination of disease stage, coping, and affect

2020 ◽  
Author(s):  
Molly E. Ream ◽  
Mollie S. Pester ◽  
Zachary T. Goodman ◽  
Sierra A. Bainter ◽  
Michael H. Antoni
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Hispanic Women ◽  
Disease Stage

Urban voices: The quality-of-life experience among women of color with breast cancer

2007 ◽  
Vol 5 (2) ◽  
pp. 115-125 ◽  
Author(s):  
ANNE M. FATONE ◽  
ALYSON B. MOADEL ◽  
FREDERICK W. FOLEY ◽  
MEGAN FLEMING ◽  
LINA JANDORF.
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
African American ◽  
African American Women ◽  
Women Of Color ◽  
Breast Cancer Survivors ◽  
Hispanic Women ◽  
Treatment Plan ◽  
Financial Strain

Objectives:Research on the health-related quality of life (HRQL) among women of color (i.e., Hispanics and African Americans) with breast cancer suggests that they may be at elevated risk for a variety of physical and psychosocial sequelae. The context in which these women perceive, experience, and respond to these HRQL challenges can provide important information for planning a culturally appropriate palliative care treatment plan.Methods: In an effort to understand the quality of lifeexperienceafter breast cancer among women of color, this study describes the nature and impact of physical, emotional, and menopausal symptoms among African American (n= 8) and Hispanic (n= 12) breast cancer survivors based on qualitative data gathered through semistructured interviews. Themes were identified and categorized into six HRQL domains: physical (e.g., pain, nausea), psychological (e.g., sadness, irritability), cognitive (e.g., memory problems), sexual (e.g., decreased desire), social/functional (e.g., financial strain, social distress), and spiritual/existential (e.g., increased faith, spiritual coping), with high interrater reliability (kappa = .81).Results:For both groups, physical issues had a major impact on HRQL, with psychological issues being additionally salient for Hispanic women. Most (88%) African American women voiced positive changes in their faith after diagnosis whereas 50% of Hispanic women viewed faith as an important way of coping with breast cancer.Significance of results:This research broadens our understanding of the experience of breast cancer among ethnic minority women, and in turn, offers some key directions for guiding the development of culturally tailored HRQL interventions.

Patient perceptions about potential side effects and benefits from chemotherapy agents.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6595-6595 ◽  
Author(s):  
Iryna Kuchuk ◽  
Nathaniel Bouganim ◽  
Kathy Beusterien ◽  
Jessica Grinspan ◽  
Lisa Vandermeer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Side Effect ◽  
Standard Gamble ◽  
Sensory Neuropathy ◽  
Disease Stage ◽  
Motor Neuropathy ◽  
Grade Iii

6595 Background: Little is known about how breast cancer patients (pts) perceive the relative side effects and benefits of different chemotherapy (CT) agents. The objective of this study was to better understand these preferences in pts receiving CT at a Canadian cancer center. Methods: Pts completed a Web survey. Grade I/II (mild to moderate) and III/IV (moderate to severe) descriptions of 9 common CT side effects were assigned preferences by: conjoint and standard gamble (SG). Conjoint involved making trade-offs among different risks of side effects, yielding preferences (utilities) for each side effect. SG involved choosing to stay in a selected side effect state or taking a gamble between full health (probability p) or being dead (1-p). For each side effect, p was varied until the patient was indifferent of the side effect. Pts were also asked to rate how much of detriment in quality of life they would endure for benefits in survival. Results: 102 women participated, mean age 54 + 11, stage 1 (21%), 2 (24%), 3 (38%) and 4 (18%). Among the grade I/II side effects, a 5% reduction in risk of sensory neuropathy, nausea, and motor neuropathy had the highest impact on preferences. Among grade III/IV side effects, motor neuropathy, nausea/vomiting, and mucositis made the most difference. SG preferences for side effects were lowest (i.e. least preferred) for grade III/IV nausea (0.624) followed by diarrhea (0.633), hand-foot syndrome (0.681), and highest for grade I/II sensory neuropathy (0.757), mucositis (0.756), and myalgia (0.750). Agree/disagree items revealed patients are willing to endure quality of life detriments for improvement in survival; this willingness increased as disease stage increased (p=0.01). Conclusions: Relatively small changes in the risks of some CT side effects may have substantial impacts on pt treatment preferences. Nevertheless, pts will endure significant toxicity for a potential gain in survival. The standard gamble utilities from this population may also be used to quality-adjust life expectancy in cost-effectiveness evaluations of breast cancer chemotherapies.

Psychosocial well-being assessment in women with breast cancer.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 207-207
Author(s):  
Rosana Gnanajothy ◽  
Jennifer Aileen Correll ◽  
Lindsay Leuthen Peterson
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Behavioral Medicine ◽  
Disease Stage ◽  
Mcgill Pain Questionnaire ◽  
Psychosocial Wellbeing ◽  
Significant Difference ◽  
Significant Depression ◽  
Psychological Quality Of Life

207 Background: A breast cancer (BC) diagnosis can affect psychosocial wellbeing. The goal of the current study is to identify the severity of and specific risk factors for depression, anxiety, and quality of life impairment in a sample of BC patients. Early identification of at risk individuals can expedite appropriate referrals and interventions. Methods: Data from 53 female BC patients referred to a Behavioral Medicine service at a large academic medical center in 2013-2015 by medical providers who identified distress at routine clinic visits were analyzed. Patients completed the Center for Epidemiology Studies Depression Scale, State Trait Anxiety Inventory, McGill Pain Questionnaire, and the Short Form 12 Quality of Life Inventory as part of their initial assessment following referral. Demographic factors, disease and treatment related factors were analyzed for correlation with psychosocial wellbeing. Results: Mean age was 52. The majority of the population were Caucasian (79%), and 53% were married. All stages of disease were represented. Significant depression, anxiety and psychological quality of life impairment were seen in 53%, 50%, and 39% of patients respectively. There was a trend towards a significant difference in higher anxiety scores in patients who were not on chemotherapy (M=44.2, SD 5.4) compared to those on chemotherapy at the time of assessment (M=38.54, SD 9.3; t (51) = -1.94 p=0.077). A positive correlation was seen between depression and pain scores (r 0.294, p=0.038). Depression and psychological quality of life scores were negatively correlated (r -0.632 p<0.001), as were pain and physical quality of life scores (r -.343, p 0.024). There was no correlation between higher rates of depression or anxiety with type of surgical intervention or stage of disease. Conclusions: Significant depression, anxiety and quality of life impairment were seen in a large percentage of BC patients referred to Behavioral Medicine for perceived distress, regardless of type of surgery and disease stage. Higher rates of anxiety were seen in patients referred while not on chemotherapy compared to patients who were on chemotherapy at the time of referral. Early referral is the key to proper identification and treatment of high risk individuals.

Effect of Esthetic Outcome After Breast-Conserving Surgery on Psychosocial Functioning and Quality of Life

2008 ◽  
Vol 26 (20) ◽  
pp. 3331-3337 ◽  
Author(s):  
Jennifer F. Waljee ◽  
Emily S. Hu ◽  
Peter A. Ubel ◽  
Dylan M. Smith ◽  
Lisa A. Newman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Treatment ◽  
Psychosocial Functioning ◽  
Breast Conserving Surgery ◽  
Breast Cancer Treatment ◽  
Fear Of Recurrence ◽  
Disease Stage ◽  
Breast Asymmetry

Purpose Although breast-conserving surgery (BCS) is often assumed to result in minimal deformity, many patients report postoperative breast asymmetry. Understanding the effect of asymmetry on psychosocial functioning is essential for patients to make an informed choice for surgery. Patients and Methods All women who underwent BCS at the University of Michigan Medical Center (Ann Arbor, MI) during a 4-year period were surveyed using a mailed questionnaire (N = 714; response rate = 79.5%). Women were queried regarding five aspects of psychosocial functioning: quality of life (QOL), depression, fear of recurrence, stigmatization, and perceived change in health status. Postoperative breast asymmetry was assessed using items from the Breast Cancer Treatment and Outcomes Survey. Multiple regression was used to examine the relationship between breast asymmetry and each outcome, controlling for age, time from surgery in years, race, education level, disease stage, surgical treatment, and the occurrence of postoperative complications. Results Women with pronounced breast asymmetry were significantly more likely to feel stigmatized as a result of their breast cancer treatment (odds ratio [OR] = 4.58; 95% CI, 2.77 to 7.55) and less likely to report unchanged or improved health after treatment (OR = 0.43; 95% CI, 0.27 to 0.66). Minimal breast asymmetry was associated with higher QOL scores (86.3 v 82.4, P < .001). Finally, women with pronounced breast asymmetry were more likely to exhibit depressive symptoms (minimal asymmetry, 16.2%; moderate asymmetry, 18.0%; pronounced asymmetry, 33.7%, Wald test = 16.6; P = .002). Conclusion Pronounced breast asymmetry after BCS is significantly correlated with poor psychosocial functioning. Identifying patients at risk for postoperative asymmetry at the time of consultation may allow for improved referral for supportive counseling, prosthetics, and reconstruction.

The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study.

1996 ◽  
Vol 14 (10) ◽  
pp. 2756-2768 ◽  
Author(s):  
M A Sprangers ◽  
M Groenvold ◽  
J I Arraras ◽  
J Franklin ◽  
A te Velde ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Performance Status ◽  
The United States ◽  
Disease Stage ◽  
Scaling Analysis ◽  
Life Questionnaire ◽  
European Organization ◽  
Quality Of Life Questionnaire

PURPOSE To construct a breast cancer-specific quality-of-life questionnaire (QLQ) module to be used in conjunction with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and to test its reliability and validity cross-culturally. PATIENTS AND METHODS Module construction took place after the EORTC guidelines for module development. The module--the QLQ-BR23--consists of 23 items covering symptoms and side effects related to different treatment modalities, body image, sexuality, and future perspective. This module was tested in 170 Dutch, 168 Spanish, and 158 American cancer patients at two points in time. The timing for the Dutch and Spanish patients was before and during treatment with radiotherapy or chemotherapy. For the American patients, the questionnaire was administered at admission at the breast clinic and 3 months after the first assessment. RESULTS Multitrait scaling analysis confirmed the hypothesized structure of four of the five scales. Cronbach's alpha coefficients were, in general, lowest in Spain (range; .46 to .94) and highest in the United States (range; .70 to .91). On the basis of known-groups comparisons, selective scales distinguished clearly between patients differing in disease stage, previous surgery, performance status, and treatment modality, according to expectation. Additionally, selective scales detected change over time as a function of changes in performance status and treatment-induced change. CONCLUSION These results lend support to the clinical and cross-cultural validity of the QLQ-BR23 as a supplementary questionnaire for assessing specific quality-of-life issues relevant to patients with breast cancer.

scholarly journals Real-World Data on Health-Related Quality of Life Assessment in Patients With Breast Cancer Receiving Subcutaneous Trastuzumab

2018 ◽  
Vol 12 ◽  
pp. 117822341875803 ◽  
Author(s):  
John Syrios ◽  
Evelina Pappa ◽  
Nikolaos Volakakis ◽  
Anastasios Grivas ◽  
John Alafis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Advanced Disease ◽  
Negative Impact ◽  
Disease Stage ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Purpose: Trastuzumab, a humanized anti-human epidermal growth factor receptor 2 (anti-HER2) antibody delivered intravenously, has revolutionized the treatment of patients with breast cancer overexpressing HER2 protein. Recently, a newer subcutaneous formulation was shown to have comparable efficacy to the initial intravenous trastuzumab. In this study, we aimed to evaluate the impact of subcutaneous trastuzumab on the health-related quality of life (HRQoL) of patients diagnosed with early or metastatic HER2-overexpressing breast cancer. Methods: Patients were provided with the EORTC QLQ-C30 (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30) and the BR-23 questionnaires. The scoring of questionnaires and patient’s sociodemographic and clinicopathologic characteristics were recorded and analyzed by descriptive and correlation statistics employing t test and 2-way analysis of variance. Results: A total of 163 patients agreed to participate in the study. About 90 of 163 patients (55.21%) received subcutaneous trastuzumab and 21 patients intravenous trastuzumab (12.88%). A control group of 52 HER2+ patients received chemotherapy without trastuzumab (31.90%). Patients receiving subcutaneous trastuzumab were older and of more advanced disease stage compared with those receiving chemotherapy (58.5 vs 51 years, 39.8% vs 28.8% advanced disease). In univariate analysis, subcutaneous trastuzumab was associated with less nausea and vomiting ( P = .002) but worse cognitive function ( P = .013) and dyspnea ( P = .042). Patients who have received >8 cycles of subcutaneous trastuzumab reported less diarrhea ( P = .049) and systemic therapy side effects ( P = .015). Multivariate analysis showed that patients without comorbidity receiving subcutaneous trastuzumab had less treatment side effects, less upset by hair loss, and higher emotional functioning. Of note, mastectomy and subcutaneous trastuzumab were associated with improved role functioning ( P = .021). In metastatic disease, no negative impact of subcutaneous trastuzumab on HRQoL was found. Conclusions: The administration of subcutaneous trastuzumab improved certain symptoms and did not adversely affect most of the assessed functional scales. Particularly, in the metastatic setting, subcutaneous trastuzumab had no negative impact on HRQoL.

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