Quality of life of Zambian breast cancer women receiving care at the cancer diseases hospital Lusaka

Abstract

Background: Breast cancer is the most frequently diagnosed malignancy among women in the world with an estimation of 1.67 million new diagnoses worldwide in 2012 estimated at 25% of all cancers. In Zambia, breast cancer is the second most common cancer affecting women and accounts for 9% of all histologically proven cancers among patients admitted at the country’s only Cancer Diseases Hospital Most of the patients receive multiple treatment modalities; Surgery, Chemotherapy, Radiation Therapy and Hormonal Therapy, each with its own long-term side effects with a potential to affect  the women’s functionality, self-image and sexuality consequently the general quality of life of these women.

Methods: A descriptive cross-sectional study design was used to investigate the Quality of Life (QoL) and factors influencing QoL among women with breast cancer receiving care at Zambia’s only Cancer Diseases Hospital. A total of 130 breast cancer patients on treatment who were willing to participate in the study were selected using simple random sampling. Data was collected using the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire (EORTCQLQ–C30) and its breast cancer supplementary measure (QLQ-BR23). The tool assessed QoL across the physical, role, cognitive, emotional, and social functioning and sexual function domains.

Results: Overall, just about half (52.5%) of the 130 respondents had high Quality of Life. QoL which was measured by the EORTCQLQ–C30 under the five domains (Physical, role, emotional, cognitive and sexual functioning) was high in four out of the five which scored above the global mean score of 68. Only the emotional functioning domain scored (65) below the mean. Conversely, the symptom scale scored high on all the eight sub items of fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation and diarrhea which signified high symptom experience among respondents. Similarly using the breast cancer supplementary measure (QLQ-BR23), two out of the four functional subscales (body image and sexual functioning) score high than average while sexual enjoyment and future perspectives score low. On the symptom scale, three out of the four scales scored higher than averages, signifying high symptom experience. Demographic characteristics which had significant association with QoL were age (p < .023), level of education (p < .023) and financial status (p < .000). Other factors that had significant association with QoL were type of treatment being received (p < .023), the severity of condition (p < .000), access to health care services (p < .000) and social support (p < .000).

Conclusions: A diagnosis of breast cancer and its subsequent treatment affects several facets of a woman’s life ranging from physical, emotional, social and financial aspects consequently affecting the entire QoL. However the QoL varies and is influenced by a number of factors including age at diagnosis of cancer, level of education, financial status, type of treatment received, severity of the condition, access to health care facilities and social support. Therefore any intervention aimed at improving the QoL should be multidimensional.