The impact of cytotoxic chemotherapy--perspectives from patients, specialists and nurses.

This study, carried out in three European countries, elicited the views and impact of three medical groups involved in patient care. Their views were compared with patients' perspectives of their condition. The main stage of the study was carried out by self-completion questionnaires by 300 patients across Italy, France and the U.K. The views of the medical profession were quantified via 150 hospital specialists, 75 cancer care nurses and 30 general practitioner interviews. Patients' symptoms most frequently seen by the medical profession were nausea, tiredness, loss of hair, vomiting, worrying and lack of appetite. On a scale of 1-4 (1 = not at all; 4 = very much) the frequency of these side effects were rated at 2.8 or over. Intensity of concern was highest for nausea and vomiting. These two symptoms was most frequently highlighted as one of the three highest concerns respectively for 74% and 54% of specialists, 64% and 60% of nurses and 50% of general practitioners. Patients on average reported a lower frequency of major symptoms. Most frequent were loss of hair, tiredness, lack of energy, nausea and decreased sexual interest. In terms of the impact of these problems, tiredness, nausea and loss of hair were the most frequently mentioned. Vomiting bothered them more than the frequency would suggest. 1 in 10 patients claim to have delayed their treatment because of previous experiences of side effects. The main impact on patient's quality of life related to the aspects of worrying and the effects on the family. In terms of communication, both the medical profession and the patients felt that patients were well informed about the disease and treatment. However, differences emerged between what patients claim to have been told about the disease and its treatment and what nurses and doctors claim to have said.