Association between Treatment-Related Symptoms and Quality of Life among a Sample of Patients with Breast Cancer
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Session presented on Friday, July 24, 2015: Purpose: Patients with breast cancer receiving disease related treatments might trigger early onset of menopause and lead to early exposure of menopause related symptoms. Healthcare professionals need to pay attention to symptoms experienced by patients with breast cancer and provide adequate management because unrelieved symptoms can lead to serious consequences. The objectives of this study were to (a) investigate treatment-related symptoms among patients with breast cancer, and (b) explore association between treatment-related symptoms and health-related quality of life (HRQL) among patients with breast cancer. Methods: This study was a cross-sectional, descriptive study. In total, 200 Taiwanese women with breast cancer were recruited. A structured questionnaire was used to collect information about participants' individual characteristics, treatment-related symptoms, and HRQL. Symptom assessment scales commonly used among cancer patients seldom include the content of menopause related symptoms. We used the Breast Cancer Prevention Trial (BCPT) Symptom Scale developed by Stanton et al. (2005) to measure symptoms because it includes symptoms related to the menopause. The BCPT symptom scale comprises 25 symptoms that are relevant to breast cancer treatments. Higher total BCPT symptom scores indicate that individuals experience severer symptoms. The Short Form 36 (SF-36) Taiwanese version was used to measure HRQL. It consists of 36 items: one item representing self-perceived changes in health and 35 items representing eight HRQL domains (physical functioning, social functioning, role limitations caused by physical health problems, role limitations caused by emotional problems, bodily pain, mental health, vitality, general health). The physical component summary (PCS)/mental component summary (MCS) scores were also calculated to respectively represent individuals' overall HRQL related to physical and mental health. Descriptive statistics was used to demonstrate participants' individual characteristics, BCPT symptom scores, and HRQL. Association between treatment-related symptoms and HRQL was examined by Pearson correlation. Results: Mean age of the participants was 52.3 +/- 8.9 years. The majority of participants were diagnosed with breast cancer between 1 to 5 years (n = 140, 70.0%), and had received surgery (n = 196, 98.0%), endocrine therapy (n = 165, 82.5%), and chemotherapy (n = 133, 66.5%). Mean value of the BCPT symptom score was 12.3 +/- 10. 1. The top five symptoms frequently experienced by participants were forgetfulness, joint pains, tiredness, unhappy with the appearance of body, and muscle stiffness. The mean HRQL score at 8 domains ranged from 65.1 to 83.0: physical functioning 83.0 +/- 17.6, social functioning 81.1 +/- 18.9, role l limitations caused by emotional problems 78.7 +/- 36.0, bodily pain 78.1 +/- 19.9, mental health 70.5 +/- 15.1, role limitations caused by physical health problems 67.4 +/- 39.9, general health 66.5 +/- 21.6, and vitality 65.1 +/- 18.1. Associations between treatment-related symptoms and HRQL (8 domains/PCS/MCS) were significant (r = -.18 - -.66, p < 0.01): participants who experienced severer symptoms (higher symptom scores) reported lower HRQL. Conclusion: Study results demonstrated that some symptoms related to the menopause were prevalent among patients with breast cancer, and treatment-related symptoms might have a negative influence on HRQL. Healthcare professionals should pay attention to the symptoms which could not be identified in common symptom assessment scales. Beneficial interventions such as counseling services or exercise therapy could be provided to improve treat-related symptoms for patients with breast cancer.