This study was designed to evaluate the effectiveness of VCO on the QOL of patients with breast cancer throughout six cycles of chemotherapy. The results showed that the functional status and global QOL were improved in the intervention group, with significant mean score differences between groups. Additionally, symptoms of fatigue, dyspnea, sleep difficulties and loss of appetite were also decreased in the intervention group, measured at the sixth cycle of chemotherapy. For breast-specific scores, there was improvement in all other patients’ functioning scores likes body image, sexual function and future perspective. Breast symptoms and side effects of systemic therapy showed significant mean score differences between groups at the sixth cycle of chemotherapy.
The findings of this study showed that women had a satisfactory score on functioning and global quality of life after consumption of VCO. In fact, breast cancer and its treatment, especially chemotherapy, can disrupt the QOL of breast cancer patients[12, 13, 26]. In addition, a study done by Vardy & Lemieux et al., reported that quality of life was most affected after patients experienced side effects from breast cancer treatments. At the sixth chemotherapy cycle, mean score for global QOL for the intervention group was 72.03 (SD: 12.82) while the control group was only 60.34 (SD: 20.36). This finding is contrary to the study performed by Montazeri et al.,, whereby the global health score was reduced. Nevertheless, the results are similar to Costanzo et al.,, which showed improvement in physical functioning. It is believed that consumption of VCO helped in increasing the energy level as well as maintaining physical function among the breast cancer patients. The effects of VCO in terms of energy, fats and protein metabolism have been demonstrated in the study carried out by Soerjodibroto. The study highlighted that VCO had a positive effect on immune responses among HIV positive patients which showed improvements and maintained stable throughout the study. Lauric acid which is a disease- fighting substance that has many health benefits[30–32], is abundant in coconut oil. Fife also mentioned that coconut oil improves nutrient absorption, boosts energy, possesses potent antimicrobial properties, and improves energy metabolism in the brain. There have been emerging fundamental evidences to explain the positive clinical effects of VCO on human health.
For the symptom scores evaluated in this study, no significant differences between the two groups were detected. Thus, the improvement of the symptoms scores were presented such as fatigue, dyspnea, sleep difficulties and loss of appetite at the sixth chemotherapy cycle. Serious side effects of chemotherapy often are perceived by patients as distress factors that contribute to poor QOL[12, 26]. For example, the most commonly reported symptom that affects QOL was loss of appetite. During the pre-assessment, the intervention group had a higher mean score for this symptom (50.53, SD: 33.20) than the control group (33.35, SD: 30.88). However, after VCO supplementation, the mean score of the intervention group declined and no significant difference between the two groups was detected. Coconut oil is unique, known as medium-chain triglycerides that are usually used to improve patients’ nutritional status[32, 33]. In addition, maintaining a good appetite can promote wound healing and encourage a speedy recovery from illness.
The QOL scores of breast cancer patients as measured by the EORTC QLQ-BR23 in this study showed improvement in several measures of function such as body image, future perspective and sexual function in the intervention group. Compared to a study performed by Montazeri et al.,, instead use found that most of the function mean scores decreased especially sexual function as a result of premature menopause following adjuvant systemic therapy in breast cancer patients. Physical and emotional status have been shown to affect sexuality, including negative body image, feelings of sexual unattractiveness, loss of femininity, depression, and anxiety following breast cancer diagnosis. Ganz et al., found that sexual functioning was worse for women who received chemotherapy. A similar result has been noted in another study from University of Sto. Tomas unveiled the beneficial effects of VCO on health and sex life. 13% of the VCO takers (189 participants) experienced becoming sexually active in the whole duration of their participation in the VCO study.
The current study was limited by the small number of breast cancer patients in Kelantan, Malaysia. Therefore, a large, multi-state comparison with varying demographics should be conducted in Malaysia. Furthermore, additional VCO intervention studies should be performed to confirm the specific beneficial effects of VCO that were detected in this study.