INTRODUCTION: Breast cancer is the most common cancer among women globally, including in Nepal. With increasing survival rates due to advancements in early detection and treatment, attention has shifted towards understanding the quality of life (QoL) of breast cancer survivors.
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OBJECTIVES: This study aims to assess the quality of life and access to cancer health services among breast cancer survivors in Nepal, and to determine whether psycho-educational interventions could benefit these women.
METHODOLOGY: This mixed-methods study involved 425 breast cancer survivors of Nepal. Women’s quality of life was assessed using two modified questionnaires the Cancer Rehabilitation Evaluation System Short Form (CARES-SF) and the European Organization for Research and Treatment for Cancer Quality of Life Questionnaire Breast Cancer Specific(EORTC-QLQ-BR23). The European Patient Forum Survey (EPF-16) tool was used to assess access to health services, focusing on cancer services. Data collection involved interviews, self-administering questionnaires, and focus groups.
RESULTS: In Phase One, 425 survivors completed the survey and results showed that survivors experienced varying degrees of challenges, with the most significant issues reported in the sexual domain, followed by physical concerns. Common problems included breast pain, swelling, oversensitivity, and fear of recurrence. Access to cancer health services remains a major challenge, with urban areas offering better care. Almost half of the survivors reported moderate difficulties in accessing information. Younger survivors reported more communication problems with doctors, and greater psychosocial issues compared to older. Factors such as age, income, education, menarche, and comorbidities were significantly associated with quality of life. Thirty survivors participated in the second phase of the qualitative study, from which four main themes and 14 subthemes emerged, capturing their cancer journey and supportive care needs. All survivors faced some challenges in accepting their diagnosis, accompanied by feelings of loneliness, financial hardships, a lack of social support, reduced sexual interest, and struggles with body image acceptance. To improve their quality of life, survivors highlighted the importance of self-confidence, family and children’s support, regular medical check-ups, adopting healthy lifestyle habits, and achieving financial stability. The third phase an interventional study included 128 participants equally divided into two intervention and control groups. The intervention includes yoga, breast exercise, psychosocial counseling, and education on diet and sexual problems. The result showed an overall improvement in quality of life, particularly in the physical, psychosocial, and sexual domains post-cancer.