title: Breast cancer patients on adjuvant chemotherapy report a wide range of problems not identified by health-care staff.
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.
authors.affiliation: The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark. mg02@bbh.hosp.dk
authors.forename: Mogens
authors.initials: M
authors.lastname: Groenvold
authors.forename: Peter M
authors.initials: PM
authors.lastname: Fayers
authors.forename: Morten Aagard
authors.initials: MA
authors.lastname: Petersen
authors.forename: Mirjam A G
authors.initials: MA
authors.lastname: Sprangers
authors.forename: Neil K
authors.initials: NK
authors.lastname: Aaronson
authors.forename: Henning T
authors.initials: HT
authors.lastname: Mouridsen
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology; D017024:Chemotherapy, Adjuvant; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life