e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

On the Receiving End: Have patient perceptions of the side-effects of cancer chemotherapy changed since the 20thcentury? (#341)

Janette L Vardy 1 2 3 , Andre Liew 3 , Anne Warby 4 , Alexander Elder 3 , Itay Keshet 4 , Rhonda Devine 4 , Calina Ouliaris 3 , Corrinne Renton 4 , Martin HN Tattersall 5 , Haryana Dhillon 4
  1. University of Sydney, Concord, NSW, Australia
  2. Concord Cancer Centre, Concord, NSW, Australia
  3. Sydney Medical School, Concord Clinical School, University of Sydney, Sydney, NSW, Australia
  4. CeMPED, University of Sydney, Sydney, NSW, Australia
  5. The University of Sydney, Sydney, NSW, Australia

Background

Studies in 1983 and 1993 identified and ranked symptoms experienced by cancer patients receiving chemotherapy. We repeated the studies to obtain updated information on patient perceptions of chemotherapy-associated symptoms.

 

Methods

A cross-sectional interview and patient-reported outcome questionnaires were administered to out-patients receiving chemotherapy.  Patients selected from 124 cards to identify and rank physical and psychosocial symptoms they had experienced and attributed to chemotherapy (primary endpoint). The patient’s medical oncologist and primary chemotherapy nurse were invited to rank the five symptoms they believed the patient would rank as their most severe.

We analysed the association of symptoms and their severity with patient demographics, chemotherapy regimen and patient-reported outcomes. Results were compared to the earlier studies.

 

Results

Overall, 302 patients completed the interview from 2008 to 2016: median age 58 years (range 17-85); 56% female; main tumour types colorectal 81 (27%), breast 67 (22%), lung 49 (16%); 45% treated with curative intent. Most common symptoms (reported by >50%) were: alopecia, general weakness, effects on family/partner, loss of taste, nausea, fatigue, difficulty sleeping, effects on work/home duties, and having to put life on hold. The most severe symptoms (ranked by >15% in top five) were: concern about effects on family/partner, nausea, fear of the future, fatigue, not knowing what will happen, putting my life on hold, and general weakness.  Severity of several non-physical symptoms, including having to put life on hold and cost of treatment, were associated with lower quality-of-life (FACT-G) and higher depression/anxiety symptoms (GHQ-12). Perceptions of doctors and nurses of patients’ symptom severity closely matched patients’ rankings.

 

Conclusions

Compared to earlier studies there was an increase in psychosocial concerns such as effects on family and future, and a decrease in physical symptoms, particularly vomiting, but nausea, fatigue and general weakness remained bothersome.