Quality of life and relation to disease in patients with bone sarcoma

IntroductionOver the last few decades, the world has experienced rapid growth in scientific research regarding health-related quality of life (Kasimova & Giryaeva, 2009). Quality of life is a complex system construct that includes a series of interconnected aspects, including safety of physical functions and the extent of physical suffering; psychological status, which includes the feeling of independence and satisfaction of life at a given moment; possibility of professional activity; quality of social contacts and other aspects. Thus, all basic aspects of personal functioning -- physical, psychological (spiritual), social -- in the system (integrating and interacting) are presented in the quality of life concept (Wasserman et al., 2011; WhOQOL Group., 1996). Changes in these basic aspects of personal functioning clearly manifest themselves in oncological patients, and moreover, the nosologic form of the disease significantly influences differences in the indices. The quality of life survey allows for describing and measuring the multiple disturbances that occur in oncological patients during the process of oncological tumor growth (Novik & Ionova, 2002). There is no doubt that a malignant bone tumor dramatically changes patients' quality of life, as the development of the bone tumor is accompanied by pain and, on some occasions, by bone fractures in the place of pathological process localization. Furthermore, the tumor development affects the mobility of the affected limb, which leads to a sharp decline in the possible physical loads of the patient, including the possibility of long periods of being confined to bed. Bone sarcoma and giant cell tumor treatment, in most cases, require surgical resection of the affected part of the bone and substitution of the defect with endoprosthesis. Thus, the patient experiences a lifelong severe limitation in physical activity. Less frequently, the treatment requires limb amputation, which leads to permanent disability. The treatment for patients with malignant bone tumors compromises every day competence, body image, work and social opportunities. As a consequence, it is important to consider the psychological, functional and quality of life outcomes (Yong-Jian et al., 2012; Eiser et al., 2001). Thus, the significant impact of bone sarcoma on physical activity and social functioning of patients highlights the relevancy of patient quality of life. The study of quality of life in patients with osteosarcoma is especially important given the young age of the patients (up to 35 years) and the aggressiveness of this type of tumor, as it requires that the treatment include both preoperative and postoperative chemotherapy (Agaev, 2005). In addition to the difficulties experienced by survivors of any cancer, those treated for a bone tumor may experience additional threats to quality of life as a consequence of restricted mobility, pain and stigmatization (Eiser & Grimer, 1999). Relation to disease has the same importance in the treatment and rehabilitation of oncological patients; it is an important component of the internal image of the disease (Luriya, 1977). Relation to disease largely determines the compliance level of the patient, which is a significant factor in treatment efficacy and patient survival (Danilov, 2008; Tkhostov & Nelyubina, 2011; Ngoh, 2009). The aim of this study was to investigate the basic aspects of quality of life and the relation to disease in patients with malignant bone tumors.The goals of the study were to conduct a 1) comparative analysis of subjective valuation of general health and psychological and social functioning in patients with different nosological types of malignant bone tumors, 2) comparative analysis of the severity of specific symptoms and the quality of life in patients with malignant bone tumors, and 3) comparative analysis of relation to disease in patients with different nosological types of malignant bone tumors. …