Cancer patients' expectations of experiencing treatment‐related side effects

Abstract

BACKGROUND Adequate management of treatment‐related side effects is important for patients and challenging for clinicians. Side effects generated by various treatments have been characterized reasonably well. However, to the authors' knowledge, less is known regarding what patients expect to experience regarding these side effects and how patient characteristics are related to these expectations. METHODS Patients with cancer (n = 1015 patients) from 17 Community Clinical Oncology Program (CCOP) institutions affiliated with the University of Rochester Cancer Center CCOP Research Base were surveyed regarding their expectations of experiencing side effects associated with cancer treatment, with 938 patients providing evaluable data. Patients responded to the item, “Indicate your expectations of having this side effect” for 12 common side effects. Patients rated their expectations using a 5‐point Likert scale, from 1 (“I definitely will not have this”) to 5 (“I definitely will have this”). RESULTS The median number of symptoms expected (characterized by any value other than one) was nine. The six most expected symptoms were fatigue, nausea, sleep disturbance, weight loss, hair loss, and skin problems. Patients age > 60 years expected to have fewer symptoms than younger patients; female patients expected more side effects than male patients; and patients who had some college education expected more side effects than patients who were high school graduates or had not completed high school. CONCLUSIONS Patients with cancer clearly exhibit expectations regarding treatment‐related side effects; and age, gender, and education level appear to influence these expectations. Further careful characterization of patient expectations and how expectations relate to experience may lead to earlier and more effective management of side effects. Cancer 2004. © 2004 American Cancer Society.

Predictors of expectancies for post-surgical pain and fatigue in breast cancer surgical patients

“…This relationship is congruent with previous research which found older surgery patients to expect less intense post-surgical pain than younger patients (Gagliese, Jackson, Ritvo, Wowk, & Katz, 2000). In addition, our finding is consistent with a recent study of cancer patients about to begin treatment, in which patients over age 60 expected to experience fewer side effects during treatment than younger patients (Hofman et al, 2004). The positive correlation between education and expectancies for post-surgical fatigue is also consistent with the literature, which has found that patients with at least a high school degree expected greater fatigue than less educated patients (Hofman et al, 2004).…”

“…Expectancies for treatment-related pain and fatigue are common among cancer patients (Hofman et al, 2004), and contribute to the subsequent experience of these taxing symptoms (Montgomery & Bovbjerg, 2004;Montgomery et al, 2002). Results of the present study indicated that: heightened distress on the day of surgery (prior to surgery) as well as heightened trait anxiety predicted higher expectancies for post-surgical pain and fatigue; having had the same surgical procedure in the past predicted lower expectancies for post-surgical fatigue; and higher levels of acute pre-surgical fatigue predicted higher expectancies for post-surgical fatigue.…”

“…For example, women scheduled to undergo breast cancer surgery have specific pre-surgical expectancies about how much post-surgical pain and fatigue they will experience (Montgomery & Bovbjerg, 2004;Montgomery, Weltz, Seltz, & Bovbjerg, 2002). A recent study found that such treatment-related expectancies are common among cancer patients (Hofman et al, 2004). According to Response Expectancy Theory (Kirsch, 1990), response expectancies are sufficient to cause nonvolitional outcomes.…”

“…A fourth source of response expectancies was suggested by the work of Hofman et al (2004), which indicates that among cancer patients, levels of pain and fatigue prior to treatment were related to expectancies for pain and fatigue during treatment. Therefore, it was hypothesized that pre-surgical levels of pain and fatigue in our sample would predict expectancies for post-surgical pain and fatigue.…”

Chemotherapy treatment: Colorectal cancer patients’ perception

“…In this context, different authors refer to the importance of analyzing the emotional sphere of cancer patients, since it has been documented that one-third to one-half of adults with cancer suffer from significant experience of stress. [5,6] In studies about the emotional sphere of cancer patients, the National Comprehensive Cancer Network (NCCN) does not use the term stress in this context because it considers an unpleasant multifactorial emotional experience and psychological (cognitive and behavioral), social and/or spiritual nature that can interfere in the capacity to deal effectively with the disease, its physical symptoms and its treatment. [7] In the current research, the choice of the patient in chemotherapy as the focus of analysis was due to considering this treatment interference in the daily routine of the patients and its greater impact in the physical and emotional sphere and in the experience of the symptoms.…”