Quality of Life During Chemotherapy for Breast Cancer in a West African Population in Dakar, Senegal: A Prospective Study

Abstract

PURPOSE The prevalence of breast cancer is increasing in low- to middle-income countries such as Senegal. Our prospective study assessed the quality of life (QoL) of patients with breast cancer undergoing chemotherapy in Senegal. PATIENTS AND METHODS Our study included women with breast cancer undergoing chemotherapy as initial treatment at the Center Aristide Le Dantec University Hospital in Dakar. Clinical, sociodemographic, and QoL data were collected and analyzed at three different times: baseline, 3 months, and 6 months after the start of systemic therapy. Health-related QoL was assessed using a Functional Assessment of Cancer Therapies-Breast (FACT-B) questionnaire after translation into the Wolof language. Linear mixed-effects models were performed to assess the changes in QoL scores. RESULTS Between July 2017 and February 2018, 120 patients were included in the study. Their median age was 45 years. Most patients (n = 105; 92%) had locally advanced disease (T3 to T4 stage) and lymph node involvement (n = 103; 88%), and half had metastatic disease. The FACT-B total scores significantly improved over time (β = 1.58; 95% CI, 0.50 to 2.67; P < .01). Nausea and vomiting were significantly associated with a decrease in FACT-B total scores (β = −16.89, 95% CI, −29.58 to −4.24, P = .012; and β = −13.44, 95% CI, −25.15 to −1.72, P = .028, respectively). CONCLUSION Our study confirmed the feasibility of standardized QoL assessment in Senegalese patients with breast cancer. Our results indicated a potential improvement of QoL over the course of chemotherapy. Optimizing nausea and vomiting prevention may improve QoL.

Validating an Instrument for Direct Patient Reporting of Distress and Chemotherapy-Related Toxicity among South African Cancer Patients

“…While not the primary interest of this study, it is notable that >60% of participants reported at least one grade 3 or higher chemotherapy-related symptom, and >75% of participants reported DT scores ≥4. Chemotherapy adverse event (AE) rates in sub-Saharan African populations are rarely published, but our findings are consistent with the >70% rate of grade 3-5 events at one hospital in Ethiopia and much higher than the ~30% grade 3-4 event rate among breast cancer patients treated in Senegal [35,36]. Self-reported grade 3-4 AEs rates are comparable in high-income countries as well, with two studies from United States and one from Australia reporting rates at 63%, 51% and 62%, respectively [7,37,38].…”

Nutritional Intervention Contributes to the Improvement of Symptoms Related to Quality of Life in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Randomized Clinical Trial

“…When these toxicities occur over a prolonged time and in a greater degree of severity, they may cause the interruption of the treatment [ 9 ]. Moreover, there is a worsening of the quality of life [ 10 , 11 , 12 ] which seems to be associated with a less favorable clinical prognosis and increased risk of recurrence [ 8 ].…”

Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review

“…The majority of the included studies were retrospective studies ( n = 77, 55.8%) of mostly registries and patient files ( 6 , 10 , 24 – 98 ) followed by cross-sectional studies ( n = 51, 36.9%) ( 99 – 149 ), systematic reviews ( n = 5, 3.6%) ( 2 , 150 – 153 ) and reviews ( n = 2, 2.1%) ( 154 , 155 ). There were two prospective studies ( 156 , 157 ) and one modeling study ( 158 ) ( Figure 2 ).…”

“…We also found studies conducted in Ghana ( n = 6) ( 50 , 71 , 111 , 123 , 134 , 155 ), Kenya ( n = 5) ( 70 , 96 , 115 , 132 , 139 ), Zambia ( n = 4) ( 44 , 77 , 102 , 126 ), and Eritrea ( n = 3) ( 60 – 62 ). There were seven countries with two studies each [Botswana ( 43 , 47 ), the Central African Republic ( 31 , 32 ), Mozambique ( 57 , 58 ), Rwanda ( 130 , 136 ), Senegal ( 147 , 156 ), Sudan ( 84 , 114 ) and Zimbabwe ( 38 , 39 )]. The countries with a single study were Cote d'Ivoire ( 128 ), Democratic Republic of Congo ( 99 ), Mali ( 85 ), Swaziland ( 76 ), Tanzania ( 49 ), and The Gambia ( 30 ).…”

“…DALYs were reported by four incidence studies ( 46 , 69 , 117 , 119 ). One study reported quality of life ( 156 ) and another reported economic burden ( 142 ).…”