Quality of life in gynaecologic cancer subjects attending a tertiary care centre

Abstract

INTRODUCTIONGynaecological cancers include cervical cancer, endometrial cancer, gestational trophoblastic tumour, ovarian epithelial cancer, ovarian germ cell tumour, uterine sarcoma, vaginal cancer and vulvar cancer. 1 It is estimated that about 9 million new cancer cases are diagnosed every year and over 4.5 million people die from cancer each year in the world. Cervical cancer is one of the most prevalent cancers that afflict women and that lead to deaths worldwide. The estimated number of new cancers in India per year is about 7 lakhs and over 3.5 lakhs people die of cancer each year. Out of these 7 lakhs new cancers about 2.3 lakhs (33%) cancers are tobacco related.2 More than 4,70,000 new cases per year, of about 2,30,000 deaths every year are due to cervical cancer 3 . The data from HBCRs of India has shown that Cancer of Cervix (28%) and Breast (16%) in women are most common and cancer of Head and Neck region constitute about 30 % of all cancer in males and females. 1 ABSTRACT Background: As newer treatment modalities improve survival; quality of life issues takes on increasing importance for survivors. An adequate knowledge is required for psychosocial interventions and designing programs aimed at improving the quality of life of the cancer patients. The purpose of the study is to assess quality of life among gynaecological cancer subjects and its association with duration since diagnosis, type of cancer, mode of treatment and socio-demographic variables. Methods: This is an interview based cross sectional study involving 131 patients diagnosed to have gynaecological cancer who were evaluated using WHOQOL-BREF Questionnaire. The gynaecological and socio-demographic data was analysed for any significant difference in QOL scores using one-way ANOVA. Results: Social domain scored high with median score 50 ± 22.82. Environmental domain scored least with median score 28 ± 24.91. Based on domain scores it was found that only 2.3% subjects had better quality of life. Physical (55.7 ± 7.43) and psychological (57.95 ± 22.85) domain mean score was statistically significantly higher among subjects with cancer for more than 12 months. Subjects who had radiotherapy and chemotherapy scored least (44.52 ± 9.8) and subjects who had surgery and chemotherapy scored highest (59.43 ± 8.8) in physical domain. Conclusions: As cancer incidence is increasing and post treatment survival is improving among cancer patients, two factors are gaining importance. One is early detection and prevention of cancer and the other is improving quality of life of survivors. In clinical practice the QOL instruments may be used with other forms of assessment, giving valuable information that can indicate areas in which a person is most affected and help the practitioner in making the best choices in patient care.