Anxiety and Depression and Quality of Life in Young Breast Cancer Patients Receiving Radiotherapy Treatment and Their Caregivers
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 9
Abstract
The most commonly diagnosed cancer for women is breast cancer and the most common treatment for primary breast cancer is breast surgery and adjuvant systemic treatments1. This is to reduce the chance of local and distant disease recurrence, but it also has the chance of affecting quality of life (QOL). More than ninety percent of people diagnosed with breast cancer receive adjuvant radiation therapy (RT)2. Breast conserving surgery is performed in early stage breast cancers such as stage I and II, but in some conditions, modified radical mastectomy (MRM) is preferred in stage II patients. In the case of Stage III breast cancer, the surgical procedure is chosen according to the response to neoadjuvant chemotherapy. Radiation therapy (RT) is used as an adjuvant treatment after a breast-conserving surgery (BCS) to lower the chance of reoccurrence and to increase the odds of disease-free survival. Several side effects are prevalent during treatment, especially depression and anxiety, in addition to various physical side effects3. Cancer-related fatigue is experienced by 30-80% of patients and is also one of the most common side effects post-surgery. 4These symptoms require aggressive treatment along with adjuvant radiation therapy. RT and BCS have an overall psychosocial impact that has been reported. Early menopause and possible infertility can also occur in younger patients. Poor sexual function, altered body image, and difficulty with shoulder and arm movements may also occur and have an impact on long-term QOL5. The importance of depression and anxiety is as important as quality of life in breast cancer patients and their caregivers. This study, which we have conducted, shows the depression scale and the presence of near and distant future anxiety states of younger patients with breast cancer and their caregivers, by evaluating and correlating the three stages which are: before starting radiotherapy (RT0), the end of radiotherapy (RT1), with the onset of acute side effects, and three months after finishing radiotherapy (RT2) with the onset of chronic side effects. Likewise, we observed the changes in the quality of life of young breast cancer patients and their caregivers during this period. In this context, it is the first current study to evaluate the quality of life and depression and anxiety of young breast cancer patients and their caregivers. European Organisation for Research and Treatment of Cancer Quality of Life Questionnairer EORTC-QLQ C30 is an important scale for determining the physical and functional scale of the patients6. EORTC QLQ-C30 version 3.0, a 30-item questionnaire, was used to assess quality of life. Global health status, five functional scales (physical, role, cognitive, emotional, social), and nine symptom scales/items (fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties) are the parts of the EORTC QLQ-C30. Patients’ responses were measured according to the EORTC QLQ-C30 scoring manual and then linearly transformed to a scale of 0 to 100. A high score on the functional scale represents a high level of functioning but a high score on the symptom scale represents very severe symptoms or financial impact. It is really important to evaluate patients and caregivers depression. Beck depression and State-Trait Anxiety Inventory (STAI) scoring anxiety system scale is a safe measuring method. The Beck Depression Inventory (BDI) was used to measure the severity of depression. The scale has 21 items and a range of 0 to 63. A score of <10 means no symptoms or minimal symptoms, 10-18 means mild to moderate, 19-29 means moderate to severe, and 30-63 is severe7. The STAI was the third test, which provides a reliable measurement of anxiety. It was developed in the 1970s by Spielberger. It consists of two subscales: state anxiety and trait anxiety. The state anxiety subscale has twenty items and asks subjects how they feel ‘‘right now.’’ The trait anxiety subscale also has twenty items and asks subjects how they feel “in general”. Responses are measured from 1 to 4, from least severe to most severe. State anxiety and trait anxiety are each scored separately and they range from 20 to 80, with higher scores demonstrating a higher level of anxiety8.
Authors and Affiliations
Serkan AKBULUT
Keywords
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