Depression is seen in many cancer patients. It is common in the general population and in adults and children with cancer and frequently coexists with anxiety and pain. The pilot study evaluated the level of the global quality of life (QoL) and the incidence and the relevance of the depression among metastatic breast cancer patients in a programme of palliative cancer care. The study is prospective and cross-sectional. Dates were obtained during year 2008 among 41 patients. The mean age of all 41 subjects was 58 years old (aged 41-80 years old). The Czech version of Zung self-rating depression scale was performed for the evaluation of the depression. The Czech version of generic European Quality of Life Questionnaire EQ-5D was performed for the evaluation of the level of global QoL. The statistical evaluation presents that mean ZSDS (Zung self-rating depression score) certifies the presence of the signs of the moderate depression among metastatic breast cancer patients (ZSDS range was 60-69). The incidence of the depression was 61% (25 of all 41 subjects). The relevance of the depression is characterized: the severe depression was proved in five of all 25 subjects, the moderate depression in 10 of all 25 subjects, and the mild depression in 10 of all 25 subjects. The global QoL among metastatic breast cancer patients is on very low level. The mean EQ-5D score (dimension of QoL) was 55%. The mean EQ-5D VAS (subjective health status) was 59.2%. The results showed that subsist association between metastatic breast cancer, depression, and the low level of the global QoL.Keywords Depression Á Quality of life Á Metastatic breast cancer Á Palliative cancer care To the Editor, As an oncologist, I welcome this excellent study by authors Alacacioglu et al.[1] evaluating quality of life, anxiety, and depression among Turkish breast cancer patients and their husbands. The study [1] presents that 29% of the patients and 5.4% of the husbands (Beck depression scores C17 points) were determined depressive. It was determined that the EORTC-QLQ C30 physical and social function scales of the patients were significantly lower than their husbands. The difference of the global quality of life (QoL) scores and other function scales (role, cognitive, emotional function scales) between patients and their husbands were not significant. It was found that the depression of the breast cancer patients was significantly higher than their husbands. But there was no significant difference between the EORTC-QLQ C30 global quality of life scores and STAI scores of the breast cancer patients and their husbands.We would like to support the results of this study among Turkish breast cancer patients with the results of our pilot study evaluating the level of the global QoL, the incidence and the relevance of the depression among Czech metastatic breast cancer patients in a programme of palliative

Depression is seen in many cancer patients. It occurs in approximately 25% of palliative care patients. The quality of life term contains the information on an individual´s physical, psychological, social and spiritual condition.The study evaluated incidence and relevance of depression symptoms and level of health-related quality of life (HRQoL) among patients with metastatic breast cancer in programme of palliative cancer care.This study was local, prospective and cross-sectional. It was carried at Department of Clinical Oncology and Radiation Therapy of Charles University Hospital in Hradec Králové, Czech Republic. Dates were obtained during year 2008 among 41 patients with metastatic breast cancer in programme of palliative cancer care. The mean age for all 41 subjects was 58 years old (aged 41 -80 years old). The Czech version of Zung self-rating depression scale was perfomed for evaluation of depression symptoms. The Czech version of generic EuroQol Questionnaire EQ-5D was performed for evaluation of level of HRQoL.The statistical evaluation presents that mean ZSDS (Zung self-rating depression score) certifies the presence of signs of moderately depression symptoms among patients with metastatic breast cancer (ZSDS range was 60-69). The mean ZSDS in all subjects was 60,6. The mean ZSDS in group of healthy females was 38,9 (normal range of ZSDS). The incidence of depression was 61% (25 of all 41 subjects). The relevance of depression is characterized: severely depressed was proved in 5 of all 25 subjects, the moderately depressed in 10 subjects of all 25 subjects and mildly depressed in 10 of all 25 subjects. The statistical evaluation not presents statistically significant dependence of ZSDS on age, number of associated diseases and type of palliative cancer care. The HRQoL among patients with metastatic breast cancer is on very low level. The mean EQ-5D score (dimension of quality of life) was 55%. The mean EQ-5D VAS (subjective health condition) was 59,2%. The mean EQ-5D score in group of healthy females was 78,4% and the mean EQ-5D VAS was 85% (both QoL parameters show very good of QoL level). The statistical evaluation not presents statistically significant dependence of EQ-5D score and EQ-5D VAS on age, number of associated diseases and type of palliative cancer care.The results showed that subsist clear association between metastatic breast cancer in programme of palliative cancer care and depression. Also, the results showed that subsist low level of HRQoL of patients with metastatic breast cancer.Key words: metastatic breast cancer, programme of palliative cancer care, depression, health-related quality of life.

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Currently the outpatient palliative cancer care are coming more into the forefront. This type of care allows patients to stay as long as possible at home among their close relatives. Prerequisite for a well working outpatient palliative care is cooperation with general practitioners and home health care agencies.