DISCORDANCE BETWEEN PHYSICIANS ESTIMATIONS AND BREAST-CANCER PATIENTSSELF-ASSESSMENT OF SIDE-EFFECTS OF CHEMOTHERAPY - AN ISSUE FOR QUALITY OF CARE

Because side-effects of chemotherapy may be more diverse and patients' reactions more individualistic than tends to be acknowledged by clini cians, a survey was carried out among 50 breast cancer outpatients to document self-reported physical symptoms experienced during NCF (mitox antrone + cyclophosphamide + 5-fluorouracil) adjuvant chemotherapy and to compare them with the clinicians' estimation in medical records. T he questionnaire evaluated the prevalence, duration/ severity and dist ress level of 17 symptoms. Symptom prevalence, assessed in 231 cycles, was high even for symptoms that do not usually focus clinicians' atte ntion. Of these, hot flushes, stomach pain and muscular and articular pains lasted 1 week or more for nearly half of the cycles. Hot flushes , vomiting and stomach pain were the most distressing symptoms. The me an number of symptoms per cycle is significantly correlated with the g lobal quality-of-life score. Concordance between patients' self-assess ment and clinical reports, measured in 180 cycles, is moderately corre ct for vomiting and sore mouth and inadequate for the remaining sympto ms even for hair loss (notified in 27% of cycles by clinicians vs 80% by patients) and nausea (38% vs 73%). A better understanding by physic ians of cancer patients' problems is necessary to improve quality of c are.