4. Health predictors of Gynaecological cancer patients

Gynecological cancers are many a times known as the ‘silent killer’, as it is generally not detected early enough and by the time the person knows she has the disease, it generally has her in her clutches. It accounts for about 5 million new cases annually and is also the most frequently diagnosed cancer in the majority (140 of 184) of countries that accounts for 25% of cancer cases and 15% of cancer deaths among women worldwide (American Cancer Society, 2015). Cervical cancer and breast cancer have a major impact on women's lives worldwide, particularly in developing countries where it is the leading cause of cancer deaths among women (Ferlay et al., 2013). In India, among all gynecologic cancers, ovarian and cervical cancers are the most common, endometrial cancer is having low incidence rate and vulvar cancer is in a declining trend (Maheshwari etal., 2015). There are an estimated 1, 00,000-1, 25,000 new breast cancer cases in India every year and it is estimated to double by 2025. All women are at risk for gynecological cancer, and the risk increases with age (Centers for Disease Control and Prevention [CDC], 2015). India has the highest (age standardized) incidence rate of cervical cancer as 22 (per 100,000 women per year) in South Asia (estimations for 2012). Cervical cancer is the commonest gynecological cancer with an incidence of 1.5 to 2 times higher in rural women and decreasing trend in urban women at the rate of 18 percent per decade. Breast cancer is increasing both in young (11% per decade) and old women (16% per decade) and Ovarian cancer incidence has remained stable in the past few decades (Maheshwari etal., 2015). As per the cancer registry data, there are 974 female cancer patients per million in Kerala among which Breast cancer (30 to 35%) is the commonest and having high occurrence rate (Plus I H., 2017) and cervical cancer as the second with a declining incidence rate over the past two decades (Padmavathy., Sebastian, 2016). Cancer had a major impact on the individual’s overall wellbeing. The major areas of concern of patients with Gynecological cancer include physical, psychological, financial, spiritual and social wellbeing. There are fundamentally five needs such as personal needs, social support needs, health care needs, worksite or community needs and the media or cultural needs. The personal needs incorporate the mental dispositions, physiological requirements, demographics, and health behaviors while the social support needs are the help from family, friends and coworkers. The health care needs incorporate diet services, exercise programs, complimentary therapies, nutritional supplements, pharmaceutical delivery and the social needs are those cultural needs are those funding sources and the support from mass media (Beesley etal., 2008). This Cross sectional non-interventional exploratory study was conducted in collaboration with the University of Melbourne, Australia in 2017. It was employed to identify the major issues and needs of patients with gynecological cancer being treated from three different hospitals, both government and private in Ernakulam. 130 women completed a 68-item self-report instrument to identify whether they were experiencing problems, how much distress those problems caused, and whether they wanted assistance.

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