Changes in symptom patterns and health-related quality of life of cancer patients before and after chemotherapy

OBJECTIVE: Symptom patterns are an important diagnostic concept in terms of Traditional Chinese Medicine. Although symptom patterns and healthrelated quality of life(HRQOL) are common diagnostic measures for cancer patients, the association between them has not been studied. This study aimed to describe the changes in the pattern of symptoms of Yang-deficiency, Yin-deficiency, blood stasis, and HRQOL before and after chemotherapy,and to examine the association between the patterns and the cancer patients' HRQOL.METHODS: A panel study was undertaken with 123 cancer patients who were about to begin their first course of chemotherapy at four teaching hospitals in Taiwan. A structured questionnaire was used before and after chemotherapy. HRQOL was assessed using the Medical Outcomes Survey Short-Form 36. The Traditional Chinese Medical Constitutional Scale was used to measure Yang-deficiency, Yin-deficiency, and blood stasis patterns,with higher scores indicating a larger deficiency.RESULTS: The patients had significantly worse scores for Yang-deficient pattern, Yin-deficiency pattern, blood stasis pattern, and the physical components of HRQOL after chemotherapy compared with before chemotherapy. The HRQOL scores correlated significantly with Yang-deficiency, Yin-deficiency, and the blood stasis pattern scores. A generalized estimating equation model showed that the HRQOL scores were significantly worse after chemotherapy compared with before chemotherapy for the physical component, but not for the mental component. Blood stasis pattern was significantly associated with a decreased HRQOL in both the physical and mental components. A hemoglobin level < 12 g/d L was associated with a worse physical component of HRQOL.CONCLUSION: The Yang-deficiency, Yin-deficiency,and blood stasis patterns were all associated with lower HRQOLincancerpatientsafterchemotherapy.

Factors associated with seeking western or Chinese medical treatment for fertility among women with breast cancer in Taiwan

OBJECTIVE: To examine and describe the use of Western and Chinese Medicine for pregnancy preparation among women with breast cancer after cancer-related treatment in Taiwan.METHODS: Women of reproductive age(20-49years) women who were treated for breast cancer from January 2011 through June 2015 in a Taiwan Residents city participated in the study. Of 306 eligible study participants, interviews were completed in197(64%). Participants were asked about sociodemographic variables, disease and treatment characteristics, their desire for fertility, and their use of Western or Chinese Medicine.RESULTS: The proportions of women who planned to use Western or Chinese Medicine to help achieve pregnancy were 17.3% and 14.7%, respectively. The result of binary logistic regression showed that current employment and lack of children were factors predictive of the use of Western Medicine. Younger age and the use of Chinese Medicine before treatment were predictors of using Chinese Medicine. While the desire for fertility preservation was related to the use of Western Medicine,the desire for pregnancy was related to the use of Chinese Medicine.CONCLUSION: Various characteristics guided the women's decisions to use Western or Chinese Medicine. Health care providers should learn patients' preferences for fertility preservation and provide appropriate advice, referring them to safe providers of their desired method of fertility treatment.