Perception of chemotherapy side effects - Cancer versus noncancer patients

PURPOSE: This study was conducted to identify and compare perceptions regar ding the disruption in quality of life caused by chemotherapy side effects in patients with cancer receiving chemotherapy and in noncancer, chemothera py-naive patients. DESCRIPTION OF STUDY: One hundred forty-six patients with cancer and 224 pa tients without cancer completed two instruments to assess the perceived mag nitude of 41 physical and psychosocial chemotherapy side effects. Instrumen t 1 used a 5-point Likert scale (1 = not at all; 2 = a little bit; 3 = some what; 4 = quite a bit; and 5 = very much) to summarize patient responses to the question. "How much did or would each of the following side effects of chemotherapy bother you?" Instrument 2 was a serial ranking questionnaire that asked patients to select the 10 most bothersome side effects and to nu merically rank the top five. An index of the relative magnitude of chemothe rapy side effects was calculated for each instrument. RESULTS: For patients with cancer, loss of hair (50%), chances in taste (46 %), constantly being tired (42%), affects work duties (39%), and changes in smell perception (35%) were most frequently perceived as bothering them "q uite a bit" or "very much." Nausea and vomiting were ranked 11th and 22nd, respectively. With instrument 2, the five side effects perceived as most tr oublesome were, in decreasing order: nausea, loss of hair, constantly tired , vomiting and changes in the way things taste. For noncancer patients, tho se factors potentially bothersome "quite a bit" or "very much" were financi al hardship (82%), hardship on family (78%), vomiting (73%), shortness of b reath (70%), and ability to perform work duties (69%). Via instrument 2, th e top five side effects in decreasing order were vomiting, hardship on fami ly, loss of hair, financial hardship, nausea, and having to move close to a treatment center. CLINICAL IMPLICATIONS: Noncancer chemotherapy-naive patients perceived most chemotherapy-associated side effects as having greater impact on the quali ty of life than did cancer patients who had received chemotherapy. These fi ndings can be used to direct patient education, education of the public and specific materials concerning cancer chemotherapy. The expertise of variou s members of the healthcare team can maximize the patient's comprehension o f the adverse effects of the treatment options. The physician's knowledge o f the overall treatment plan can assist in patient understanding, oncology pharmacists and nurses are in a unique position to educate patients and the ir families regarding potential chemotherapy side effects.