Educating patients can help limit side effects of chemotherapy and radiation

A new study finds patients about to undergo chemotherapy or radiation expect a high number of side effects, and that age, gender, educational background, and the type of cancer all influence how many side effects a patient expects.

The authors of the study, published July 12, 2004 in the online edition of CANCER, a peer-reviewed journal of the American Cancer Society, say it may help identify patients who may benefit from early side effect management and pretreatment information preparation.

Side effects from chemotherapy or radiation therapy can contribute to diminished quality of life for patients at best and to treatment failures at worst. More and more literature has found that patients who expect a side effect, such as nausea, are more likely to develop the symptom. While much time and effort is expended characterizing the side effects of cancer therapies, little is known about what side effects patients expect to experience and what type of patient is most likely to anticipate them.

Mr. Maarten Hofman from the James P. Wilmot Cancer Center at the University of Rochester was part of a team of investigators to characterize the side effect expectations of 938 cancer patients prior to treatment.

Patients anticipated an average 8.7 symptoms. Even after accounting for patients with existing similar symptoms, the most common expected side effects were fatigue, nausea, hair loss, skin problems, weight loss, pain, and sleep problems.

In identifying characteristics of those who anticipated more side effects, age, gender, educational background and the type of cancer influenced expectations. Patients under age 60 expected more side effects than patients over 60, and women expected more symptoms than men. Patients with a college education anticipated more side effects than those who had only a high school education. Furthermore, patients with hematologic cancers, such as leukemia, and lung cancer expected the greatest number of side effects while those with prostate cancer expected the fewest.

One question left unanswered by the study is whether expectation plays a role in the development of some symptoms. While prior studies have shown patients who expect nausea are more likely to experience it, it remains unclear whether the same holds true for other symptoms, like fatigue.

Clearly, patients expect a "high number of side effects prior to cancer treatment with either chemotherapy or radiotherapy," conclude the authors, adding: "A potential clinical application of these results is to identify, before treatment begins, a group of people for whom extra attention in terms of side effect management and informational preparation may be quite beneficial," pointing to studies that show educating patients can help limit side effects.