December 1, 2005

Chemo-related side effects gradually dissipate

NEW YORK (Reuters Health) - Women receiving chemotherapy
for breast cancer suffer a worse quality of life than healthy
women, as well as troublesome symptoms such as fatigue, but
these problems -- and their quality of life -- gradually
improve, a new study shows.

While doctors are getting better at managing the side
effects of chemotherapy like nausea and vomiting, concern
remains about problems that can persist and perhaps become
chronic, such as fatigue, menopausal symptoms and mental
difficulties, Dr. Helen G. Mar Fan of the Princess Margaret
Hospital in Toronto and colleagues write. Menopausal symptoms
such as hot flashes can occur because chemotherapy can bring on

Given that there is little information about the long-term
effects of chemo on quality of life and potentially chronic
symptoms like fatigue, Mar Fan and her team have been following
a group of about 100 women who underwent chemo after breast
cancer surgery and 100 healthy women matched by age. The
researchers previously reported that women experienced more
fatigue and symptoms of menopause such as hot flashes during
chemo treatment, and rated their quality of life lower, than
the healthy women.

The current study reports on repeat evaluation of the
patients one and two years after cancer treatment. The control
group of cancer-free women also were evaluated at one and two
years after participating in the first study.

Levels of fatigue gradually improved among the cancer
patients, but remained higher than for the healthy women, the
researchers found. Menopausal symptoms improved, but persisted,
and were again more common among the cancer survivors. At
baseline, 30 percent of the cancer patients were
post-menopausal compared to 32 percent of the healthy women.
Two years later, 84 percent of the cancer patients were
postmenopausal and 46 percent of the healthy patients were.

While 16 percent of cancer patients at the study's outset
had moderate to severe cognitive impairment, this percentage
had fallen to 4 percent by the end of the two-year follow-up
period. And at one and two years after treatment, patients'
quality of life scores were similar to those of women who had
never had cancer.

"Overall, the results show a reassuring long-term trend for
patients undergoing adjuvant chemotherapy for breast cancer,
although fatigue and symptoms related to menopause improve
slowly," the researchers conclude.

SOURCE: Journal of Clinical Oncology, November 1, 2005.