Impact of radiotherapy on psychological, financial, and sexual aspects in postmastectomy carcinoma breast patients: A prospective study and management

Abstract

Objective:The aim of this study was to assess the impact of radiotherapy (RT) on psychological, financial, and sexual aspects in postmastectomy carcinoma breast patients affecting their quality of life (QOL) before, during, and after RT with a strong emphasis on their management and rehabilitation aspects.Methods:A cross-sectional study carried out in a specialized institution, comprising sixty women. Two standardized questionnaires European Organization for Research and Treatment of Cancer (EORTC) 30-item Quality of Life Questionnaire and Quality of Life Questionnaire breast cancer-23 (QLQ-BR23) for health-related quality, translated and validated for the Hindi language were used. The scores’ manual of the EORTC was used to calculate the domain scores of the questionnaires.Results:According to the first questionnaire, the emotional function was most affected even at onset of RT treatment and it was worst at the completion of RT treatment with a mean score of 63.75. The global QOL score was also worst at the end of radiation treatment with a mean score of 32.36, while the score 3 months after completion of treatment was 68.16. The symptoms with the highest scores were insomnia with a worst scoring at completion of treatment (29.99), fatigue (26.57), and pain (23.05). According to the QLQ-BR23, the mean score for side effects such as sexual functioning was minimum 0.55 at the completion of RT, which improved to 11.66 on the first follow-up after 3 months. Mean future perspective score which was 57.22 before the start of RT which was reduced to 50.55 at completion, which means that many women experience side effects of RT and impaired sexual satisfaction.Conclusions:Women with breast cancer showed changes in the following domains: financial, emotional, sexual satisfaction, and future prospects. The most frequently mentioned symptoms were fatigue, insomnia, and pain.

Autotaxin and Breast Cancer: Towards Overcoming Treatment Barriers and Sequelae

“…RT to the whole breast after lumpectomy results in Grade 1 fibrosis in~27% of patients at 3 years and Grade 2 fibrosis in~1% [136]. Fibrosis increases over decades [137,138] and it requires both cosmetic correction in severe cases and psychological care [139]. RT-fibrosis also contributes to lymphedema, which results in impaired function and decreased quality of life [140].…”

A Grateful Disposition Promotes the Well-Being of Women with Breast Cancer Through Adaptive Coping

“…These can include adverse side effects of chemotherapy, such as hair loss, nausea, early-onset menopause, ulcers, sexual dysfunction, and memory lapses, 9 as well as side effects of radiation therapy, such as insomnia, fatigue, and pain. 10 Undergoing a mastectomy tends to decrease women’s self-esteem and body image, thus adding to their distress, 11 , 12 although the possibility of reconstruction or conservation surgery may lower body image disturbance. 13 The progressive deterioration of a woman’s well-being thus begins a vicious circle that is difficult to break, as high levels of psychological distress further affect the physical state of patients, increasing the perceived levels of pain and fatigue.…”

Oncology Section EDGE Task Force on Cancer: A Systematic Review of Patient-Reported Measures for Sexual Dysfunction

“…31,38,40 A cutoff score of less than or equal to 21 is indicative of ED. While there are no reported MCID or MCDs, reference values for scoring include severe ED (5-7), moderate ED (8)(9)(10)(11), mild to moderate ED (12)(13)(14)(15)(16), mild ED (17)(18)(19)(20)(21), and no ED (22)(23)(24)(25). 38 Sexual Interest and Desire Inventory for Females (SIDI-F) EDGE Rating: 3 (Recommended)-The SIDI-F is a 13-item, clinician administered scale validated in women diagnosed with hypoactive sexual desire disorder (HSDD) designed to measure the severity of sexual dysfunction with its total score ranging from 0-51, with scores less than or equal to 33 indicating the presence of HSDD.…”

“…11 For women undergoing radiation therapy for breast cancer, sexual satisfaction is also a problem during treatment. 12 Sexual dysfunction and pain are associated with higher levels of depression and anxiety, and lower levels of sexual enjoyment and satisfaction. 13 The impact of sexual dysfunction can be debilitating and is likely multifactorial in etiology.…”