Health-related quality of life in treatment-naive, older patients with cancer from India: A prospective observational study

Abstract

ABSTRACT Background: Health-related quality of life (HRQoL) is a major concern for older patients with cancer. The goal of cancer care in most older patients is maintaining the quality of the remaining years of life rather than prolonging survival. Objectives: We aimed to evaluate the quality-of-life (QoL) domains in treatment-naïve older patients with cancer. Materials and Methods: This cross-sectional observational study was done in the Outpatient Department of Geriatric Medicine of the All India Institute of Medical Science, New Delhi, India from July 2015 to June 2017. Treatment-naïve patients aged 60 years and above with a histological diagnosis of malignancy were enrolled. The QoL questions were asked in Hindi/English (as per the patient’s comfort) using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ- C30). The scores on the different domains of the QoL were noted; scoring was as per the EORTC QLQ-C30 scoring manual. Continuous scores were converted into dichotomous variables by using a cut-off of 50, i.e. scores less than 50 were graded as “low scores” while scores of 50 and above were graded as “high scores.” Results: Out of the total of 419 questionnaires obtained, 360 were analyzed. Fatigue was reported in 248 (68.9%) patients, loss of appetite in 239 (66.4%), and pain in 180 (50%). Poor functioning (score <50) was seen in 238 (66%) patients in the global QoL domain (overall health and quality of life in the preceding one week), in 248 (68.9%) in the role functioning domain, in 200 (55.5%) in the physical functioning domain, and in 268 (74.3%) in the emotional functioning domain. Financial constraints were reported by 239 (66.4%) patients. Conclusion: In older patients with cancer, fatigue, loss of appetite, and pain were the predominant symptoms affecting QoL. Poorer scores were reported in the global health status domain, financial difficulties, and the domains of physical, role, and emotional functioning. These results can help in planning early interventions, targeted at improving the QoL in these patients.