Health-related quality of life (HRQoL) of women with breast cancer undergoing treatment in a tertiary care centre in India

Breast cancer in India accounts for 178361 of all cancers (Globocan 2020 report). Treatment causes financial, social, and psychological stress, impacting patients’ quality of life (QoL). Multiple studies have reported QoL among survivors, however few studies focused on patients undergoing treatment in India. Hence, the present study aimed to measure the QoL and its influencing factors associated with breast cancer undergoing various treatments in the oncology department of a tertiary care hospital in India. A hospital-based cross-sectional study (Nov 2022 - Jan 2023) used a semi-structured questionnaire on participants’ sociodemographic and clinical characteristics. The validated Marathi and English EORTC QLQ-C30 and BR23 assessed QoL. Participants were selected using convenience sampling. A total of 285 patients agreed to participate with a mean age of 54.2 ± 12.2 years and the mean score of Global Health Status (GHS)/QoL was 54.4 ± 19.6. Patients who received radiation had more pain (p < 0.001), insomnia (p < 0.001), and diarrhoea (p = 0.005), whereas, those who received chemotherapy had higher scores in constipation (p < 0.001) and loss of appetite (p = 0.001). Co-morbidities were significantly associated with breast cancer-specific symptoms scales – upset by hair loss (p = 0.025), arm symptoms (p = 0.026), and breast symptoms (p = 0.013). Education, occupation, hours of sleep, financial issues, and type of surgery were linked to the patient’s QoL. Therefore, these patients require additional attention and support services, including effective pain management and interventions to enhance sleep quality, to further enhance their QoL. Longitudinal studies incorporating detailed clinical and psychosocial variables are needed to understand the determinants of QoL. Despite the significant financial, social, and psychological stress associated with breast cancer treatment, evidence on the quality of life (QoL) of patients currently undergoing treatment are context specific. While most studies emphasize breast cancer survivors, very few have explored QoL during the active treatment phase in Indian settings. Understanding QoL and its influencing factors during treatment is crucial for developing effective support services and interventions to improve patient outcomes. This study investigates the impact of different treatments (radiation, chemotherapy, and hormonal therapy) on various aspects of QoL, including pain, insomnia, diarrhoea, constipation, and appetite loss. It also examines how sociodemographic and clinical characteristics affect problems caused by breast cancer or its treatment. The findings reveal that patients undergoing radiation therapy report higher levels of pain, insomnia, and diarrhoea, while those receiving chemotherapy experience more constipation and appetite loss. Additionally, patients who sleep less than eight hours have worse functional scales and report more pain, nausea/vomiting, and dyspnoea compared to those who sleep eight hours or more. These results highlight the distinct impacts of different breast cancer treatments on various aspects of patients’ QoL. Moreover, co-morbidities exacerbate specific breast cancer symptoms. Hence, the study highlights that when doctors and researchers assess patients’ outcomes and well-being during cancer treatment, they should consider both medical and social aspects to better understand their needs and improve their care. The study also underscores the need for comprehensive care that addresses these different dimensions of QoL.