Many researchers studies have shown that stressful life events, from the death of a loved one to the loss of a job, are linked to an increase in certain health problems, particularly heart disease, diabetes, and hypertension. Many people assume that stress leads to cancer as well. Evidence for this, however, is not clear. However, the significance of mind-body interactions in medicine is now increasingly being recognised.(Copied from article.)
Evidence suggests that breast cancer is taking the form of a chronic illness. This will add on to the present burden of managing chronic diseases in the healthcare delivery system. The burden of breast cancer being a chronic illness, calls for greater efforts to address the many neglected, physical-psycho-social and occupational functioning consequences. Timely efforts are needed to identify and implement interventions that are aim at improving the quality of life of women with breast cancer. At present, research evidence is highlighting that chronic diseases may best be managed using a self-management approach, and best treated by a balance of traditional medical care and the day-to-day practice of self-management skills. This paper presents the perspective of breast cancer as a chronic illness and its implication for rehabilitation and medical education. It is imperative that health professionals be made aware of these survivorship issues through medical education. The goals are to reduce the many disability risks, encourage patient-health provider communication and enhance partnership in care, within a timely, holistic therapeutic program to improve the quality of life of women with breast cancer.
Introduction: The Malay Version of EORTC-QLQ C30 was validated among Malaysian women who had undergone breast cancer surgery. Materials and Methods: Test-retest evaluation (i.e. three weeks and ten weeks following surgery) was carried out to examine the validity and reliability of the scale. The Cronbach’s alpha value was used to determine the internal consistency, meanwhile, test-retest Intraclass Correlation Coeffi cients (ICC) indicates the reliability of the scale. Effect Size Index and Mean Differences interpret the sensitivity of the scale. Discriminant validity was evaluated by comparing two groups i.e. women who had mastectomy and women who had lumpectomy. Results: Internal consistencies are acceptable for Global Health Status (0.91), Functional domains (ranging from 0.50-0.89) and Symptomatology domains (ranging from 0.75-0.99). Intraclass Correlation Coeffi cient (ICC) ranged from 0.05 to 0.99 for Global Health Status and Functional domains, and ranged from 0.13 to 1.00 for Symptomatology domains. Sensitivity of the scale was observed in nearly all of the domains. Conclusion: The Malay Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ C30) is a suitable tool to measure the quality of life of women with breast cancer.
Despite being the major cause of cancer-related death in Malaysian women,local data on patterns of breast cancer relapse and their long term outcomes are still scarce. We conducted a retrospective study on all patients treated for non-metastatic invasive breast cancer in 1999-2000 at the University of Malaya Medical Centre (UMMC), who subsequently developed relapse. We sought to analyse the patterns of relapse, their associated clinicopathological features and the overall survival ratefollowing the relapses. Univariate and multivariate analyses were used to analyse demographics and clinicopathological factors. Survival was analysed using the Kaplan and Meier method and compared by the log rank test. A total of 268 patients with a mean age of 50, were identified for the study. At a median follow-up of 50 months, 73 patients (27.2%) had relapsed. Local, regional and distant relapse rates were 5.5%, 1.9% and 19.8% respectively, whereas, the 5-year survival rates were 61%, 40% and 21% respectively (p < 0.01). Most relapses occurred within the first five years of diagnosis. Patients with long disease-free interval had better survival. The most common distant relapse site was the lungs while bone was the distant relapse site with the best prognosis. Disease stage, nodal status and oestrogen receptor status were found to have correlation with the risk of relapse. We concluded that the survival of patients with relapsed breast cancer was associated with the site(s) of first relapse and the disease free interval and clinicopathological factors can be used to predict the risk of relapse.