Effect of diagnosis and treatment of inoperable cervical cancer on quality of life among women receiving radiotherapy at Kenyatta National Hospital.

Abstract

BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]