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Breast Cancer Research and Treatment

, Volume 103, Issue 2, pp 185–195 | Cite as

Breast cancer patients on adjuvant chemotherapy report a wide range of problems not identified by health-care staff

  • Mogens Groenvold
  • Peter M. Fayers
  • Morten Aagard Petersen
  • Mirjam A. G. Sprangers
  • Neil K. Aaronson
  • Henning T. Mouridsen
CLINICAL TRIAL

Abstract

Background

Adjuvant chemotherapy for primary breast cancer is associated with significant side effects. The aims of this study were (1) to compare health-related quality of life (HRQL) in patients undergoing adjuvant chemotherapy to patients not on chemotherapy and (2) to compare these results against a survey investigating health-care professionals’ knowledge of HRQL.

Methods

Patients on adjuvant cyclophosphamide, methotrexate, fluoracil chemotherapy were compared to ‘low-risk’ patients not on chemotherapy (‘control group’). A questionnaire including the EORTC QLQ-C30, the Hospital Anxiety and Depression Scale (HADS), and the DBCG 89 Questionnaire was administered six times during a 2-year period. Forty-six experienced health-care professionals were asked which quality-of-life issues they thought were affected by adjuvant chemotherapy.

Results

After 2 years, 159 of 242 patients on chemotherapy and 148 of 199 patients in the control group were alive and recurrence-free and had completed all questionnaires. Worse HRQL during chemotherapy was seen, as had been previously suggested, for 23 of 30 variables. A number of the health-care professionals had not indicated patients to have these side effects. Several side effects persisted after the chemotherapy.

Conclusions

This study provides the most comprehensive description of HRQL in adjuvant therapy to date. The discrepancy between patients and doctors/nurses suggests that patients have been insufficiently informed about the impact of chemotherapy on quality of life. The results of this study provide a basis for information that can be given to patients, and indicate that the care offered to patients in chemotherapy should seek to prevent, identify, and alleviate a very broad range of problems.

Keywords

Breast neoplasms Adjuvant therapy Chemotherapy Outcomes Quality of life 

Notes

Acknowledgement

Supported by the Danish Cancer Society (91-505 and 94 15001).

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Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Mogens Groenvold
    • 1
    • 2
  • Peter M. Fayers
    • 3
    • 4
  • Morten Aagard Petersen
    • 1
  • Mirjam A. G. Sprangers
    • 5
  • Neil K. Aaronson
    • 6
  • Henning T. Mouridsen
    • 7
  1. 1.The Research Unit, Department of Palliative MedicineBispebjerg HospitalCopenhagenDenmark
  2. 2.Department of Health Services ResearchInstitute of Public Health, University of CopenhagenCopenhagenDenmark
  3. 3.Department of Public HealthUniversity of Aberdeen Medical SchoolAberdeenUK
  4. 4.Unit for Applied Clinical ResearchNorwegian University of Science and TechnologyTrondheimNorway
  5. 5.Department of Medical PsychologyAcademic Medical Center, University of AmsterdamAmsterdamThe Netherlands
  6. 6.Division of Psychosocial Research and EpidemiologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  7. 7.Department of Oncology ONK, The Finsen Centre, RigshospitaletUniversity of CopenhagenCopenhagenDenmark

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