**1. Introduction**

Cancer is a disease mainly caused by uncontrolled division of body cells in any part in the human body. Normally the cell growth remains under control by the body's immune system. It is the time, when these cells start dividing uncontrollably, forming lumps or growths, that Cancer is caused. Growths like this are called tumors. There are two types of tumors malignant and benign [1].

## **2. Burden of cancer**

Needless to mention that Non-communicable diseases (NCDs) are now well known leading cause of morbidity and mortality worldwide, accounting for approximately 36 million deaths annually around the world, with a rapidly rising prevalence due to population growth and fast changing socio demographic characteristics including aging of population. Moreover, chronically ill patients often suffer from multiple co- morbidities, which can be defined as the co-occurrence of several chronic conditions within one person & one patient [2].

Cancer is epidemiologically one of major non communicable disease and very rapidly becoming to be main health issue in the community around the world. Around the world, cancer is becoming one of the most common causes for morbidity and mortality. Data from GLOBOCAN year 2012 mentions that around 14.1 million new patients were diagnosed with cancer and approximately 8.2 million deaths occurred due to cancer and it is estimated to rise approximately 70% by the year of 2030 [3].

## **3. What is quality of life (QOL)?**

We all have a rolling question all the time that, what is meant by the phrase "quality of life." We know that being free is better than being imprisoned, being healthy is better than being sick, and being relaxed is better than being stressed. There are people who choose to live in the city because they give value access to cultural and social offerings. On the other hand some people choose to live in rural areas because they value the slower pace, lack of traffic, and access to nature. These features affect the inherent goodness of our lives, or our wellbeing, referred to in the medical and scientific arenas as quality of life.

In medicine, we are often interested in how disease or its treatment affects quality of life, which is generally considered health-related quality of life. Health-related quality of life, also abbreviated as HRQOL or HRQL, has evolved over the time into a broad, multidimensional concept that includes both physical and mental health, and also includes social factors.

Quality of life information can be used in different ways in medical practice. Decision of Cancer treatment making is one of the major areas in where quality of life considerations are applied in cancer. For example, a patient and his or her physician may be attempting to decide between two treatments that show virtually no differences in survival or other disease-related outcomes. Quality of life over the time has become deciding factor in selecting one treatment over another. Alternatively, patients may also be provided autonomy to choose two different types of cancer treatment based on the expected toxicity, convenience, or other factors that impact quality of life (**Table 1**).

## **4. Definition of quality of life**

If we talk about root of the QOL concept goes way back to the 1947 World Health Organization (WHO) definition of health as a "state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity [5].

It is not easy to define QOL in single sentence QOL is such a broad domain with lot of subjective perceptions. Many researchers have tried to give one definition of QOL and tried to make it more objective & measurable but neither of definition could explain QOL completely. Nevertheless QOL has been defined by various researchers/ organizations differently. Some of the definitions may be accessed by referring the available literature [6].

## **5. Various dimensions of quality of life**

Broadly dimensions of QOL may be explained as Physical, Mental, Social and Functional Health. These dimensions of QOL have certain components so that every


#### **Table 1.**

*Uses for quality of life information/measures in medical practice.*


#### **Table 2.**

*Dimension of QOL and their respective components.*

dimension may be attained more objectively. **Table 2** mentions each dimension of QOL along with their respective components. Every cancer patient should be subjected to attain all these dimensions in all possible manners [6].

## **6. Quality of life among cancer patients**

Cancer patients tend to experience a variety of signs & symptoms. Inadequate & Improper medical management of these symptoms does hamper the performance of the day today functioning of a cancer patient including disturbed quality of life. Effective management of these symptoms will surely help in relieving the suffering from dreaded cancer and improve the quality of life (QOL) either.

These Symptoms led to major impact on QOL among the patients with breast cancers as well. This high symptom load has always been associated with the more levels of emotional suffering, poor physical & societal functioning and deteriorated QOL. Hence, effective clinical management of these symptoms can improve the QOL in cancer patients [7].

A study from India showed that cancer patients were in the below average category of QOL and the QOL of the cancer patients was influenced by reported symptoms. Very low-level QOL was observed in general, physical, psychological well-being of cancer patients. They were also suffered with below average economic well-being, pain, sleep problems and fatigue.The psychological health was affected by feeling very much depressed and they were not feeling comfortable in attending the social functions [7].
