Women having chemotherapy for breast or ovarian cancer rank the potential impact of treatment on their family or partner above most physical concerns.

A prospective study of over 100 women found the impact on family and partner was the number one concern before starting chemotherapy and the number two concern – behind difficulty sleeping – during and at the end of chemotherapy.

Traditional concerns about loss of hair and nausea ranked in the top five concerns before initiation of chemotherapy but dropped away during treatment.

The findings, presented at the ESMO 2017 Congress in Madrid, also included concerns about not coping with treatment and the impact of treatment on work and home duties.

Study author Dr Beyhan Ataseven, from Kliniken Essen Mitte in Germany, said perceptions of chemotherapy side effects have changed over time and continue to change during treatment.

“What we found is that, on the one hand, side effects like nausea and vomiting are no longer a major problem for patients – this can be explained by the fact that modern medication against these symptoms is very effective.”

“On the other hand, hair loss is still a persistent, unsolved issue that particularly affects patients at the start of their treatment. As time passes and patients get used to this, however, their concerns evolve and other side effects become more significant.”

She said the findings provided some guidance to clinicians about possible improvements in the management of cancer patients.

“For instance, sleeping tablets were not until now a part of the routine regimen. There is also a clear case for providing stronger psychological support to address patients’ social anxieties and family-related concerns,” she said.

Chair of the ESMO Faculty Group on Palliative and Supportive Care Dr Karin Jordan said similar studies also need to be done for other cancer types.

“The results show that there might be a gap between what doctors think is important or disturbing for patients, and what patients really think. Physical, psychological, social and spiritual support is needed at every stage of the disease,” she said.

ESMO will soon publish a position paper on the need to integrate supportive and palliative care for patients, from diagnosis and throughout the course of the disease.