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 menopause.

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.