Abstract:

Background: In recent times there had been increase in incidence of cancer in India as nearly two people were diagnosed every minute with cancer. This is mainly attributed to urbanization, industrialization, life style changes, population growth and increased life span. There is no current universally accepted definition for quality of life (QOL) as it takes into account many aspects of life which is very difficult to define and measure. Therefore, there is wide range of concepts and opinions about "quality of life" and, over time, these concepts had been turning to the patient's perception about the disease and treatment and its effects, in an objective and subjective way. Evaluation of quality of life was attempted in two ways, objective assessments done by the interviewer and subjective assessments completed by the patients themselves. Nowadays, QOL could be defined by the WHO as an individual’s perception of their own position (experience) in life, in the context of the culture and value systems in their life and in relation to their goals, expectations, standards, and concerns. The proposed study was considered valuable since it emphasized on quality of life as one of the possible outcomes that stressed on the factor that patients with cancer often experienced a loss of control and feelings of helplessness, anxiety and depression during chemotherapy or radiotherapy treatment.

Objectives: This study was conducted to assess the Patient’s perspective of QOL with respect to different domains of Quality of Life in Cancer patients during inpatient Chemotherapy Treatment or outpatient Radiotherapy Treatment sessions. The primary objective was to analyze subjective impacting factors of QOL in homogenous surviving cancer patients receiving chemotherapy or radiotherapy sessions. Because patients were the best source of information for QOL data as the patients are the ones who are experiencing the effects of the illness and treatment, therefore they might provide a unique perspective on how QOL could be better assessed and defined with respect to treatment regimens.

Methods: It was a cross-sectional, descriptive, hospital based evaluation study. Total duration of the study was 5 months (December 2015- April 2016), conducted in Medical and Radiation Oncology department of DR. B.L. Kapur Memorial Hospital, New Delhi, India. A convenience sample of 60 patients with cancer was selected. They were further divided into Chemotherapy group (n= 30) and Radiotherapy group (n= 30). Therefore, 30 cancer patients were on chemotherapy and the other 30 cancer patients were on radiotherapy. Data was obtained through direct interview, using validated Psychological intervention tool in the form of Questionnaire: WHOQOL-Bref Questionnaire, Zung Self-Rating Anxiety scale and Zung Self-Rating Depression scale, which was further managed through a statistical program, using appropriate statistical tests.

Results: A total of 60 cancer patients were included in the study in which Chemotherapy group consisted of 30n cancer patients and Radiotherapy group consisted of 30n cancer patients. In the study, 6(20%) were males and 24(80%) were females in the chemotherapy group, and, 15(50%) were males and 15(50%) were females in the radiotherapy group. Majority of the patients 32(53.34%) were in the age range of 46-60 years. The study population had Breast cancer 33(55%), Head cancer 6(10%), and Neck cancer 21(35%). Anxiety affected the Physical domain

(p= 0.007), Environmental domain (p= 0.036) in the Chemotherapy group and Social domain

(p= 0.016) in the Radiotherapy group. On the other hand, Depression affected the Social domain (p= 0.043) in the Chemotherapy group, and Social domain (p = 0.012) in the Radiotherapy group. Values of p < 0.05 were considered to be statistically significant.

Conclusion: The cancer patients who completed this survey/research study were able to conceptualize their quality of life by clearly stating which areas of their life that was important to them and how satisfied they were with that area. It was observed that in the chemotherapy group, overall health was significantly correlated with the psychological domain (r= -0.395; p = 0.031), social domain (r= -0.429; p = 0.018), and environmental domain (r= -0.598; p < 0.001) of the WHOQOL-Bref questionnaire. On the other hand, the radiotherapy group showed no significant difference.

Keywords: Cancer, Chemotherapy, Radiotherapy, Quality of Life, WHOQOL-Bref Questionnaire, Zung Self-Rating Anxiety scale, Zung Self-Rating Depression scale, Physical domain, Psychological domain, Social domain, Environmental domain, Patient-reported outcomes, Open-ended questions, Overall Health satisfaction.

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