Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
Abstract
Abstracts
Brief Communication
Case Report
Case Series
Commentary
Conference Abstract
Conference Editorial
Conference Proceedings
Current Issue
Editorial
Editorial Commentary
Erratum
IAPCONKochi 2019 Conference Proceedings
Letter to Editor
Letter to the Editor
Letters to Editor
Narrative Review
Original Article
Personal Reflection
Perspective
Perspectives
Position Paper
Position Statement
Practitioner Section
Report
REPUBLICATION: Special Article (Guidelines)
Review Article
Short Communication
Special Editorial
Special Review
Systematic Review
View/Download PDF

Translate this page into:

Letters to Editor
24 (
1
); 117-118
doi:
10.4103/IJPC.IJPC_170_17

Beware! Reduced Functional Capacity and Quality of Life with Increased Fatigue Level among the Breast Cancer Survivors Undergoing Chemotherapy in India

Department of Cardiopulmonary Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute University, Chennai, Tamil Nadu, India
Department of Sports Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute University, Chennai, Tamil Nadu, India
Department of Neuro Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute University, Chennai, Tamil Nadu, India
Department of Ortho Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute University, Chennai, Tamil Nadu, India
Department of Pediatric and Neonatal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar University, Mullana, Ambala, Haryana, India
Address for correspondence: Dr. Selvaraj Sudhakar, Department of Sports Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute University, Chennai, Tamil Nadu, India. E-mail: drsudhakar.acs@gmail.com
Licence

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Disclaimer:
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher; therefore Scientific Scholar has no control over the quality or content of this article.

Sir,

Breast cancer impact affects physical, social, psychological, and many other aspects of life among the cancer survivors. For the past two decades, there has been increasing number of studies highlighting the importance of physical activity and prevention, reduction, and reoccurrence of cancer. There is a paucity of information available on the functional capacity and quality of life (QoL) among the breast cancer survivors (BCS). The objective of this study is to determine the postchemotherapy changes on functional capacity and QoL among BCS. The functional capacity was determined by 6-min walk test (6MWT).[1] QoL was measured by the European Organization for Research and Treatment of Cancer (EORTC) breast cancer-specific QoL questionnaire (QLQ-BR23) (EORTC QLQ-BR23).[2] The EORTC QLQ-BR23 questionnaire consists of 23 items under two sections, function and symptom. The answers for each question are in a Likert scale format. This questionnaire contains two scales, namely, the functional scale and the symptom scale. In addition to the above, the fatigue level was monitored by Schwartz Cancer Fatigue Scale (SCFS).[3]

The university research and ethics committee (ACS/2016/57) approved the study protocol. A total of 116 female BCS, aged between 38 and 56 years, were included for the quasi-experimental, one-group pretest-posttest study design. The study was done in accordance with ethical guidelines for biomedical research on human subjects, the Indian Council for Medical Research, 2006, and also in accordance with the guidelines of Helsinki Declaration, revised 2013.[4] The detailed purpose, procedure, risks, and benefits of the study were explained to them after obtaining signed consent form before data collection and assured confidentiality of the collected data. Anthropometrics were measured according to the recommendations of the International Standards for Anthropometric Assessment. The total sample was stratified according to the Union for International Cancer Control/American Joint Committee on Cancer/International Association for the Study of Lung Cancer tumor, node, and metastasis staging.[5] Before the commencement and end of 4th-week chemotherapy, 6MWT was measured according to the guidelines of American Thoracic Society,[6] QoL by EORTC QLQ-BR23, and fatigue level by SCFS.

Normality of collected data was established by Kolmogorov–Smirnov test. As the collected data follow normal distribution, descriptive statistics were expressed in mean ± standard deviation. Parametric tests (paired t-test) were used to analyze the significant difference between sessions. Among 116 females (46.7 ± 8.3 years old; 154.8 ± 6.6 cm; 82.2 ± 8.0 kg; 28.2 ± 3.6 kg/m2), 47.5% were in Stage III and 52.5% were in Stage IV. There were 12 dropouts out of 116 BCS. However, they were analyzed using intention-to-treat analysis. Baseline and 4-week changes in 6MWT, EORTC QLQ-BR23, and SCFS were elaborated in Table 1.

Table 1: Baseline and postchemotherapy changes in functional capacity, quality of life, and fatigue level among the breast cancer survivors

The change score of 6MWT, EORTC QLQ-BR23, and SCFS is 51.1 ± 13.4 m, 10.9 ± 1.8, and 8.8 ± 2.2, respectively. Minimal clinically important difference for 6MWT in patient with cancer is 43.1 m[1] and EORTC QLQ-BR23 is a 10-point change in score.[7] The minimal detectable change of SCFS is 5.7.[8] There is a clinically significant reduction in functional capacity and QoL with increased fatigue level among BCS. Thus, we can rightly say that the chemotherapy has a potential to reduce functional capacity and QoL and increases the fatigue level among BCS in 4 weeks.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

REFERENCES

  1. , , , , , . Validity of the six-minute walk test in cancer patients. Int J Sports Med. 2013;34:631-6.
    [Google Scholar]
  2. , , , , , , . The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: First results from a three-country field study. J Clin Oncol. 1996;14:2756-68.
    [Google Scholar]
  3. , . The schwartz cancer fatigue scale: Testing reliability and validity. Oncol Nurs Forum. 1998;25:711-7.
    [Google Scholar]
  4. Declaration of Helsinki World Medical Association declaration of Helsinki ethical principles for medical research involving human subjects. J Am Med Assoc. 2013;310:2191-4.
    [Google Scholar]
  5. , , , , , . The 7th lung cancer TNM classification and staging system: Review of the changes and implications. World J Radiol. 2012;4:128-34.
    [Google Scholar]
  6. , , , , , , . ATS statement: Guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111-7.
    [Google Scholar]
  7. , , , , , , . Time to deterioration in quality of life score as a modality of longitudinal analysis in patients with breast cancer. Oncologist. 2011;16:1458-68.
    [Google Scholar]
  8. , , , , . Minimal important differences for fatigue patient reported outcome measures-a systematic review. BMC Med Res Methodol. 2016;16:62.
    [Google Scholar]
Show Sections