Impact of active coping, religion and acceptance on quality of life of patients with breast cancer in the department of radiotherapy, UCH, Ibadan.

BACKGROUND: A breast cancer diagnosis as well as the treatment that follows has considerable consequences on women's physical functioning, psychological health and overall well-being, resulting in significant interference with patients' quality of life (QoL). PURPOSE: The study seeks to assess the impact of active coping, religion and acceptance on the QoL of patients with breast cancer. PARTICIPANTS: This study, which is descriptive in nature, assessed the QoL and coping mechanism of 110 patients with breast cancer receiving treatment at the radiotherapy clinic in the University College Hospital (UCH). The patients had an age range of 25-75, an average age of 46.82 and an SD of 10.55. Male patients were 4 (3.60%), while 106 (96.40%) were female. Currently married participants were 84 (76.40%), while 26 (23.60%) were not. METHODS: Data was collected using the Functional Assessment of Cancer Therapy-Breast (FACT-B) V.4 QoL questionnaire and Carver's Brief Cope questionnaire. RESULTS: Analysis of data showed that significant differences were found between participants who used active coping, religious coping and acceptance more than those who did not in the overall QoL (p<0.05) as well as in some of the QoL dimensions. CONCLUSIONS: Significant differences exist in the QoL of patients with breast cancer based on the coping style they adopt. Patients with breast cancer should be helped to adopt coping styles that would enhance their QoL.

Cranial computed tomographic findings in Nigerian women with metastatic breast cancer.

INTRODUCTION: Brain metastases (BM) occur in up to one-fifth of patients with metastatic breast cancer (MBC). Imaging plays a key role in diagnosis. The pattern and distribution of these changes are also crucial to their management. These patterns have not been fully studied in Nigerian women. MATERIALS AND METHODS: Retrospective analysis of the findings on the cranial Computed Tomography (CT) scans performed in 59 breast cancer patients with suspected BM treated at the University Teaching Hospital in Ibadan, between 2005 and 2010. The imaging features were evaluated in relation to their clinical characteristics. RESULTS: In the 59 patients studied (mean age 50.9 years ± 11.75 SD), headache (40.7%) and hemiparesis/hemiplegia (16.9%) were the commonest clinical presentation. Lytic skull lesions were seen in 15 patients (25.4%), most commonly in the parietal bones. Thirty-nine patients (66.1%), had parenchymal brain lesions, and only 8 (20.5%) of these were single lesions. Most of the lesions were isodense (19/39; 51.4%) the parietal lobe was the most common site with 50.8% (30/59) occurrence and the leptomeninges the least with 13.6% (8/59). Orbital or sellar region involvement occurred in only two patients. The size of the lesions, was <2 cm in 17 (28.8%), 2-5 cm in 14 (23.7%) and >5 cm in 5 patients. Sixteen (27.1%) patients were free of any lesion either in the skull or brain. Patient presenting with multiple brain lesions were more likely to have skull lesions though this was not statistically significant (P = 0.584). CONCLUSION: The brain continues to be a sanctuary site for breast cancer metastases and CT imaging remains an invaluable tool in the clinical evaluation and therapeutic management of Nigerian women with BM from MBC. It also appears that the demographic and imaging findings in these patients are similar to other racial groups.

Oral morphine effectiveness in Nigerian patients with advanced cancer.

Oral morphine elixir in the immediate release form became available in Nigeria in the year 2006 after decades of use in the treatment of cancer pain in many other countries. In order to determine the effectiveness of oral morphine in Nigerian patients, 182 patients presenting with severe cancer pain at the Radiotherapy Clinic, University College Hospital (UCH), Ibadan, Nigeria, were recruited in a prospective descriptive observational study. Information on patient's demography, diagnosis, baseline intensity and character of pain, morphine dosages, and effects were collected using a semistructured questionnaire administered at recruitment and biweekly in the follow-up period. Mean (+ SD) age of the patients was 47 (+ 14.6) years and the most common types of cancer diagnosed in the study participants included cancer of the breast and uterine cervix. The pretreatment pain intensity score mean (+ SD) was 8.09 (+ 1.51). Of the 166 patients whose data were analyzed, 84.3% (95% confidence interval [CI] 77.8-89.5%) achieved a 3-point reduction in pain intensity using the 11-point Numerical Rating Scale at the end of the first week of treatment. Twenty-six patients (15.7%) required adjuvant therapy. The reduction in pain intensity was maintained throughout the 3 months follow-up period, with the mean 24-hour morphine consumption of 55.54 mg in the first month and 61.54 mg in the third month. Oral morphine significantly reduced cancer pain in Nigerian patients (P < .01). Increasing dose as required was found to enhance the effectiveness of oral morphine.