Urinary Incontinence among Women with Adjuvant Endocrine Therapy after Breast Cancer
Date Issued
2015
Date
2015
Author(s)
Chao, Yu-Fen
Abstract
Background: Hormone therapy is a postoperative adjuvant treatment of breast cancer, side effects may occur due to estrogen deprivation. Various studies have documented the prevalence and severity of menopausal symptoms, such as: vaginal dryness, discharge and dyspareunia, in breast cancer patients with adjuvant endocrine therapy. However, urinary incontinence as a part of menopausal symptoms has received little attention. Purpose: This study aims to investigate the prevalence and severity of urinary incontinence symptoms and its impact on quality of life (QoL) in breast cancer patients with adjuvant endocrine therapy and non- users; and to compare the differences between the groups. Methods: A cross-sectional survey study was conducted using a structured validated questionnaires, including the Urinary Distress Inventory-6 (UDI-6), Incontinence Impact Questionaire-7 (IIQ-7) and King''s Health Questionnaire (KHQ) to investigate the prevalence, severity of urinary incontinence (UI) and QoL in breast cancer patients with adjuvant endocrine therapy and age-matched non- users. Descriptive statistics was computed for subject demographics. Independent t- tests or Mann-Whitney U test were performed to compare the basic data of two groups. Frequencies were compared between groups by chi-square test. Results: A total of 140 breast cancer women were surveyed, 70 breast cancer patients taking tamoxifen and 67 controls. Tamoxifen-treated group had significantly more incontinent women than control group (42.9% vs 20.9%，p < 0.05); of these, stress UI was the most common symptom (63%). In addition, the domain of UDI-6 concerning irritative symptoms (e.g., frequency and urgency) was significantly poorer in tamoxifen- treated patients than in control group (p < 0.05). In the KHQ, the sleep/energy and gravity domains was significantly affected in tamoxifen-treated incontinent women than control group (p < 0.05). Discussion and Conclusion: This was a preliminary study using a validated questionnaire to assess the prevalence of incontinence and the impact on HRQOL in tamoxifen users. Tamoxifen was found to increase urinary incontinence compared with non-users of tamoxifen; and incontinence symptoms tend to be mild in severity. In addition, incontinence can have a negative impact on daily life. It is therefore possible that estrogen deficiency induced by tamoxifen plays an etiological role in the development of UI. Frequent monitoring of the presence and severity of incontinence symptoms and treatment of these bladder problems is required to optimize patient quality of life and to assure adherence to endocrine therapy.
Subjects
breast cancer
hormone therapy
urinary incontinence
quality of life
SDGs
Type
thesis
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