SEXUAL AND GENERAL QUALITY OF LIFE ASSESSMENT IN PATIENTS UNDERGOING HORMONAL THERAPY FOR BREAST CANCER: DATA FROM A BRAZILIAN PUBLIC ONCOLOGY DEPARTMENT

Introduction: Approximately one third or more of breast cancer patients will be treated by hormonal therapy (HT). This therapy is not exempt from unwanted side-effects associated with hypoestrogenic state. During hormonal therapy patients can worst their physical symptoms and develop sexual dysfunctions. Objectives: To assess how HT can influence patient’s general and sexual quality of life, comparing those in use of tamoxifen (TMX), anastrozole (ANA), or both (ANA/TMX) in sequence. Methods: An analytical observational study was performed with 41 female adult patients pre (31,7%) and post-menopausal (68,3%), undergoing HT in our Department. Patients were divided accordingly to used therapy: ANA, TMX and ANA/TMX. They answered two quality of life assessment instruments: Functional Assessment of Cancer Therapy FACT-B, and Female Sexual Distress Scale Revised FSDS-R, and a third set of customized questions on patients perception of their treatment. Chi-square statistical test (Fisher’s test) was applied to verify results. Patients with psychological conditions or those with impaired questionnaires comprehension were excluded. This study was approved by local ethical committee. Results: Patients in use of ANA reported better physical status with fewer difficulties in family-care activities (p = 0,01), less swelling and pain in one or both arms (p = 0,01) and fewer bed-ridden hours due to disease than other groups, while ANA/TMX showed poorest results (p = 0,0003). Pain complaint (p = 0,04), social life (p = 0,01) and sexual satisfaction (p = 0,01) were worse in the ANA/TMX group and lowest in the TMX group (p = 0,04). Acceptance of the disease was larger in ANA/TMX group, possibly due to longer period of treatment (p = 0,04). Results from the remaining questions did not reach level of statistical significance. Conclusions: ANA was associated with better physical status, fewer bed-ridden hours and arm swelling. On the other hand, those in use of TMX presented fewer pain rates, better social and sexual lives – confirmed by FSDS-R. As expected, ANA/TMX group reported highest pain complaints, bed-ridden time and impact on both social and sexual quality of life. These data not only confirm that HT plays an important impact on patients personal, social, and sexual lives, but also points at important differences presented between these groups, paving way for the development of more focused and efficient support strategies for all patients using HT for breast cancer.