Impact of anticancer therapy on the quality of life of Sudanese patients with breast cancer at Khartoum oncology hospital

Abstract

Background Chemotherapy-related toxicity affects the quality of life (QOL) of patients with cancer. Measuring the QOL in breast cancer (BC) patients has been the focus of clinical practices and research in recent decades. This study aimed to assess the impact of BC medications on QOL of Sudanese patients with BC. Methods A cross-sectional study was conducted in Khartoum Oncology Hospital, Sudan, from November 2020 to March 2021. All patients diagnosed with BC were included in the study. QOL was assessed using the European Organization for Research and Treatment of Cancer quality of life (EORTC QLQ-C-30) and breast cancer supplementary module (QLQ-BR23). ANOVA, independent t-test and logistic regression analysis were used to assess the association between variables. Results Two hundred patients were enrolled in the study, with a mean age of 50 ± 11.7 years. 52.5% of the patients were on a conventional therapy whereas 40.5% and 7% received hormonal and HER2-targeted therapies, respectively. In QLQ-C30 scale, the global health-QOL status score was (53.2 ± 1.9), with 54.0% of patients having poor global health-QOL status. In the functional scale, the cognitive functioning was the highest score (80.7 ± 1.8). In QLQ-C30 symptom scale, the most distressing issue was financial difficulties (63.7 ± 2.9). In QLQ-BR23 scale, body image scored the worse functioning (47.7 ± 2.7), with 54.5% of patients having poor QOL. In QLQ-BR23 symptoms scale, “being upset by hair loss” was the highest disturbing symptom (62.1 ± 3.3), with 68.6% of patients having poor QOL. Global health status (P = 0.000), social (P = 0.000), emotional (P = 0.002) and role functioning (P = 0.000) were significantly higher in patients taking HER2-targeted or hormonal therapy compared to conventional therapy. The level of symptomatology was significantly low in patients taking HER2-targeted therapy or hormonal therapy (P = 0.000) than those on conventional therapy. Hormonal (OR = 3.7, p = 0.01) and HER2-targeted therapies (OR = 10.2, p = 0.04 ) were positive predictors of QOL. Conclusion BC survivors in Sudan had a low QOL/global health status. Hormonal and HER2-targeted therapies were predictors of good QOL.

Symptoms, concerns, and experiences of women living with and beyond breast cancer in Africa: A mixed‐methods systematic review

“…In total, 48 studies were included, comprising quantitative 28–51 ( n = 24), qualitative 52–74 ( n = 23) and mixed methods 75 ( n = 1) studies. All included studies were published between 1998 and 2022 and represented data from countries ( n = 10) in Africa and covered the five regions of Africa (central, eastern, southern, western, and northern) with at least one study from each region.…”

“…During and after treatment, commonly experienced physical symptoms included fatigue, trouble sleeping, pain, burnout, sexual dysfunction, appetite loss, diarrhoea, constipation, nausea, and vomiting, alongside worry relating to body image and hair loss 32,37,38,40,42 . Studies reported that women generally had low quality‐of‐life scores across multiple domains during treatment cycles 37,38,41,44 and that younger women, in particular, were likely to experience reduced emotional well‐being 41 .…”

“…35,39 Many studies showed that most of the women had financial issues and were unable to pay for treatment, transport, and other costs associated with their cancer. 30,38,39,43,45,46 3.3.2 | Restoration: Readjusting life with cancer Participants strived for normalcy after cancer using active and passive coping strategies. 32,45,46,50 In one study, religious coping was the most commonly used active coping strategy.…”

“…28,[30][31][32][33][34][35][36]39 During and after treatment, commonly experienced physical symptoms included fatigue, trouble sleeping, pain, burnout, sexual dysfunction, appetite loss, diarrhoea, constipation, nausea, and vomiting, alongside worry relating to body image and hair loss. 32,37,38,40,42 Studies reported that women generally had low quality-of-life scores across multiple domains during treatment cycles 37,38,41,44 and that younger women, in particular, were likely to experience reduced emotional well-being. 41 For participants accessing healthcare, instances of health workers lacking empathy were reported, indicating adequate emotional support was not received, alongside a lack of information about their treatment (pre and post).…”

“…Zambia (n = 1) (qualitative studies (n = 1) 52 ); Kenya (n = 1) (quantitative studies (n = 1) 49 )) and North Africa (Sudan (n = 2) (quantitative studies (n = 2) 38,45 ); Morocco (n = 1) (quantitative studies (n = 1) 43 )). The mean age of participants reported across studies ranged from 39.9 to 58.5 years, with participant ages ranging from 21 to 99 years.…”