ABSTRACT
Background: Breast cancer survivors (BCS) still experience fatigue that may impair their quality of life even after completion of treatment. There is a need to understand the sociodemographic and treatment-related factors associated with this to develop relevant and effective interventions. Aim: To assess the relationship between cancer-related fatigue and sociodemographic and treatment-related factors in BCS. Materials and methods: This is a cross-sectional study involving 80 BCS attending the radiation oncology University College Hospital Ibadan. Their sociodemographic, disease and treatment characteristics were obtained. Fatigue Symptom Inventory was used to assess fatigue. A score of at least 3 on average fatigue severity item was taken as cut-off for clinically meaningful fatigue. Result: The mean age of patients was 51.5 years. The prevalence of fatigue was 22.5%. On univariate analysis, fatigue was significantly associated with younger age (p = 0.022), employment (p = 0.006), stage of the disease(p = 0.014), anthracycline-based chemotherapy (p = 0.026), last chemotherapy less than 1 year (p = 0.001). Using logistic regression analysis, stage (Odds ratio (OR) 5.115, 95% CI 1.029-25.438, p = 0.046), employment status (OR 52.224, 95% CI 3.611-755.899, p = 0.004) and year of last cycle chemotherapy (OR 6.375, 95% CI 1.108-36.680, p = 0.038) were associated with fatigue in BCS. Conclusion: About a quarter of BCS reported fatigue. Advance stage disease, employment status and receiving last course of chemotherapy less than a year are correlates of fatigue.
ABSTRACT
Background: Chemotherapy improves tumour control and survival, but it may be associated with side effects (SEs) which can impair treatment compliance and worsen outcomes. Assessment of patients in routine clinical practice, outside clinical trials, may provide the information on effects of chemotherapy on patients and its impacts on treatment compliance. Aim: To assess the SE and compliance to chemotherapy in breast cancer patients. Methodology: A prospective study involving 120 breast cancer patients receiving chemotherapy was carried out at the oncology clinics of the University College Hospital Ibadan. SEs reported were recorded and graded using Common Toxicity Criteria for Adverse Events version 5. Compliance was defined as a receipt of planned cycles of chemotherapy in the planned doses within the planned duration. The data collected were analysed using the Statistical Package for the Social Sciences software version 25. Results: The patients were all females with a mean age of 51.2 ± 11.8 years. Patients reported between 2 and 13 SE with a median of 8 SE. Forty-two (35.0%) missed at least one course of chemotherapy while 78 (65%) were compliant. The reasons for non-compliance were deranged blood test 17 (14.2%), chemotherapy SE symptoms related 11 (9.1%), financial constraints 10 (8.3%), disease progression 2 (1.7%) and transportation-related 2 (1.7%). Conclusion: Breast cancer patients encounter multiple SEs from chemotherapy which led to non-compliance with the treatment. Early identification and prompt treatment of these SEs will improve compliance with chemotherapy.
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Purpose: Recovering cancer survivors hope to return to their premorbid lifestyle after treatment and be free from the disease. They are, however, faced with some psychosocial issues, including fatigue, which could negatively impact their quality of life. With increasing cancer awareness and improvement in treatment, it is expected that the number of cancer survivors will increase in Nigeria. Little has, however, been done with regard to survivorship care in the country. It is important to explore fatigue in this group of patients with a view to find ways of reducing it to the barest minimum. Aim: To assess the level of fatigue in breast cancer survivors on follow-up visit at a radiation oncology clinic and compare it with age and sex-matched apparently healthy controls. Materials and Methods: Fatigue levels were obtained using the Fatigue Symptom Inventory (FSI). Kruskal-Wallis H test was used to compare the FSI scores in cases and controls. Chi-squared test was used for comparison of proportions. Level of significance was set at 5%. Results: Seventy cancer survivors (cases) and 70 apparently healthy age (±1)-matched controls were recruited. The prevalence of fatigue was higher among cases than controls (24.3% versus 10%; p = 0.025). Breast cancer survivors reported significantly worse fatigue on the day they were most fatigued (p = 0.017), least fatigued (0.047) and fatigued on average (p = 0.006) compared to controls. Fatigue also significantly interferes with the ability to concentrate (p = 0.040) and relate with people (p = 0.002) more in cases compared to controls. While fatigue was more common in the morning and afternoon in breast cancer survivors, fatigue either occurred more in the evening or followed no daily pattern in the controls. Conclusion: Breast cancer survivors reported worse fatigue, suggesting the need to include fatigue screening as part of post-treatment follow-up. There is also a need to investigate the factors responsible for this and explore ways of reducing or eliminating it.
ABSTRACT
Background: Chemotherapy is an important treatment modality widely employed for cancer management. The study investigated nephrotoxicity and electrolytes disorders induced by chemotherapy in the cancer patients undergoing chemotherapy in selected Nigerian Tertiary Health care. Methodology: The participants of the study comprised 130 cancer patients aged 18- 70 years, purposively recruited from three medical centers in south-west Nigeria. Participants' socio-demographics and chemotherapy administered were obtained using questionnaire. Three milliliters of blood sample was collected intravenously from the participants before and after the last course of chemotherapy and centrifuged at 3000rpm for 10 minutes to obtain serum. The levels of electrolytes, creatinine, and urea in the serum samples were determined spectrophotometrically by automated Roche Hitachi 912 Chemistry Auto-Analyzer. The estimated glomeruli filtration rate (eGFR) was calculated using creatinine based Ukidney online eGFR-calculator while nephrotoxicity was determined according to U.S National Cancer Institute Common Terminology Criteria for Adverse events version 4.0. Collected data were expressed as mean ±standard error of the mean using IBM- SPSS version 22.0software. T- test were employed to test for significance at P< 0.05. Results: Findings from the study revealed significant decrease in the pre-chemotherapy sodium, potassium, chloride ion levels and eGFR as compared to that of post chemotherapy. Also, a significant increase in the pre-chemotherapy creatinine and urea levels as compared to that of post chemotherapy was observed. Conclusion: Overall, the significant reduction in the electrolyte profiles and estimated eGFR alongside with the significant increase in the mean creatinine and urea profiles recorded after chemotherapy administration confirmed chemotherapy-induced electrolytes disorders and renal toxicity in the cancer participants.
ABSTRACT
Background: Chemotherapy is an important component of treatment for breast cancer as it improves tumour control, overall survival or disease-free survival but is associated with side effects that could affect patients' quality of life. Patients' understanding and expectation of these side effects can improve their coping abilities. Exploring these understanding and expectations before chemotherapy can reduce the burden of chemotherapy side effects and improve compliance to treatment by increasing their physical and psychological preparedness. The study aimed to assess how the knowledge of expected side effects of chemotherapy affected the level of coping with the side effects of chemotherapy. Methodology: This study was carried out at the Radiation Oncology and the Surgical Oncology clinics of the University College hospital Ibadan Nigeria. Patients with breast cancer were randomly selected to participate in the study. Before commencement of 1st-course chemotherapy data on sociodemographic variables, clinical characteristics and patients' knowledge about chemotherapy side effects was collected using a set of questionnaires. While presenting for the second course, patients were asked if they encountered side effects and how long it took them to recover from the side effects. The data collected was analysed using the Statistical Package for the Social Sciences (SPSS) software version 21. Result: A total of 110 women participated in the study. Most of the patients (85%) knew chemotherapy side effects (SE).Most of the respondents, (73.5%), received their information on the side effects of chemotherapy from doctors, followed by nurses (40.9%), internet (32.7%), peers (32.7%) and family members (12.7%). Currently employed and younger patients tended to have more knowledge concerning chemotherapy SE (p = 0.018). Patients who knew SE before treatment recovered faster than those who did not (p=0.01). Conclusion: Majority of the patients were aware of the side effects of chemotherapy. Having knowledge about side effects was associated with faster recovery. Pre-Chemotherapy counselling should be done routinely for patients starting on chemotherapy.
ABSTRACT
Inflammatory musculoskeletal conditions are a common group of diseases among the elderly, worldwide. They are characterized by articular degenerative changes accompanied with often debilitating pain. Treatments often involve life-long analgesic therapy or joint replacement in extreme cases. The aim of this current review is to look at the role of radiation treatment with the hope of further study into the effectiveness of radiation treatment in reducing pain, eliminate or reduce the need for life-long analgesic therapy and thereby avoiding the analgesics' side effects. Extensive literature search was done on PubMed and other available data base and the findings are presented and discussed. Literature showed that many countries in Europe, especially Germany use radiation routinely for the treatment of many degenerative disorders including osteoarthritis with good results and few side effects. A pilot study is therefore recommended with a view to establish the effectiveness or otherwise of this treatment method in patients.
