Determination of Quality of Life in Patient with Metastatic Breast, Lung and Colorectal Cancer Before, During and After Anti-Cancer Treatment

Abstract

Objective In cancer, the body cells start dividing and spread into other nearby tissue. Breast cancer, lung cancer and colorectal cancer are the common cancer worldwide and nationwide. Quality of life is a standard of health, comfort and happiness experienced by an individual. Metastatic cancer is a life threatening disorder which is difficult to treat. Disease and/or treatment may affect psychology and emotions of the patients. Route of administration, stage, prior treatment, also affects quality of life of a patient. Thus the proposed study was an effort to elicit the actual quality of life by PRO (patient reported outcome) by patient himself. Methodology The proposed study was non-randomised, retrospective, prospective, single centric, observational study. Patients who were suffering from metastatic breast cancer, metastatic lung cancer and metastatic colorectal cancer were enrolled in the study. The questionnaire, EORTC QLQ-C30, BR23 (Breast cancer), LC13 (lung cancer) and CR29 (colorectal cancer) were filled up by patients at different time intervals i.e. before, during and after the anticancer treatment. We also compared quality of life between different routes of administration as well as between different treatment protocols. Basic characteristics such as Age, BSA, CBC, SGPT, RBS, CEA, alkaline phosphatase, serum creatinine were also analysed at different time interval. Statistical analysis was performed using two way ANOVA and Z-test. Results During the study, we screened 110 patients at Hemato-Oncology Clinic, Vedanta Institute of Medical Science, Ahmedabad from these, 17 patients who refused to give written consent were not included in the study. Total 93 patients’ were enrolled in the study and the data were analysed. Out of these 93 patients, 42 patients were suffering from metastatic breast cancer, 43 patients were suffering from metastatic lung cancer and 8 patients were suffering from metastatic colorectal cancer. In metastatic breast cancer overall functional score was better in after the anticancer treatment group, while oral treatment group showed better functioning when compared with IV treatment group. Other treatment group showed better functioning, but taxane group showed low scoring for function scale. For symptom score, during the treatment group showedlesser symptomology as compared to other two groups except for upset by hair loss and systemic therapy side effect. In oral treatment group the symptomology were higher as compared to IV group. While in different treatment protocol comparison, the other treatment group showed improvement in symptom score. However, the global quality of life was almost same in all the groups. Total 43 patients were enrolled in metastatic lung cancer, from which 33 were male and 9 were female. The function score was almost same at different time interval. While in oral group the functioning was bit higher as compared to IV group. The symptoms were decreasing throughout the study except for peripheral neuropathy, alopecia, fatigue, appetite loss, nausea vomiting, diarrhoea and pain in other parts of the body. Financial difficulties were increasing throughout the study. In oral group except for fatigue and pain in other parts of the body, the symptom score were decreasing. The global quality of life remained good in all the three group. Total 8 patients enrolled in metastatic colorectal cancer, from which 6 were male and 2 were female. The overall functioning score was good in during the therapy group. Before the anticancer treatment the symptomology was high which got decreased in during the treatment group. Global quality of life was same in all the three group. Conclusion Overall, the quality of life was better in during the therapy group of all the three cancer. The scores for symptom and functional scales were changing throughout the study. We also found that the functional scale was better in oral group for all the cancers. However, the symptom scale was high in metastatic breast cancer and was decreasing in metastatic lung cancer.