The psychosocial impacts of chemotherapy have become more significant for patients than physical side effects such as nausea and vomiting, according to the preliminary results of a study presented at the European Society for Medical Oncology (ESMO) 2017 Congress.
The new study shows that perceptions of chemotherapy side effects in breast and ovarian cancer patients change not only over time, but also throughout the course of treatment.
“With the most recent analysis dating back to 2002, we felt it was time to collect new data and update the interview format,” said study author Dr. Beyhan Ataseven from Kliniken Essen Mitte Evang, Huyssens-Stiftung in Essen, Germany.
“Living conditions have changed, and so have the accompanying therapies linked to chemotherapy. As doctors, we want to know what our patients care about,” she said.
Contrary to previous studies, the researchers focused exclusively on breast and ovarian cancer patients and added a longitudinal analysis by carrying out three separate interviews before, during, and at the end of their chemotherapy.
At each interview, 141 patients scheduled for or undergoing chemotherapy were presented with two groups of cards featuring physical and non-physical side effects. The patients selected their five most burdensome symptoms in each group and ranked them by importance. Out of these 10 main side effects, they were then asked to select the five most significant ones and to rank these as well.
“What we found is that, on the one hand, side effects like nausea and vomiting are no longer a major problem for patients,” said Ataseven. “This can be explained by the fact that modern medication against these symptoms is very effective.
“On the other hand, hair loss is still a persistent, unsolved issue that particularly affects patients at the start of their treatment. As time passes and patients get used to this, however, their concerns evolve and other side effects become more significant.”
Ataseven said the most difficult side effects these patients deal with are sleep disorders — which become increasingly important over time — and anxiety about the effects of their illness on their partner or family, which persists as a top issue.
“As doctors, these findings might lead us to consider possible improvements to the accompanying therapies we offer our patients,” she said. “For instance, sleeping tablets were not until now a part of the routine regimen. There is also a clear case for providing stronger psychological support to address patients’ social anxieties and family-related concerns.”