Patient experience of chemotherapy needs monitoring

Cancer Nursing Practice consultant editor, Carole Farrell, says older people can be reluctant to report problems

Carole Farrell

Chemotherapy is well known for its toxicity and impact on patients’ quality of life; patients often fear it more than other types of cancer treatment and the decision to go ahead with chemotherapy is not taken lightly.

Nurses are well placed to discuss the pros and cons of chemotherapy treatment with patients and their families to facilitate decision-making. Many patients report feeling overwhelmed by the information given before chemotherapy, so it is crucial to prioritise key messages and give information in chunks, tailored to each person’s needs.

Written information is so easy to give, but we have to check it is at the right level and delivered at the right time to meet patients’ needs.

Ensuring patient safety during chemotherapy is also challenging. Recent guidance published by the National Chemotherapy Board is a timely reminder of the key issues during systemic anti-cancer therapies (SACT), with important recommendations.

Evidence of patients’ experiences and clinical management during SACT reflect findings from my recent study of patients 65 and over during chemotherapy. Older people are often reluctant to report problems and will often minimise chemotherapy-related toxicities, so thorough communication is needed to uncover details of patients’ experiences and treatment side effects.

The National Chemotherapy Board recommends proactive monitoring during SACT, including telephone support. Chemotherapy nurses are well placed to do this, and emerging research evidence identifies potential benefits.

For many cancer nurse specialists this proactive approach will require a different way of working. My recent study of a telephone intervention during chemotherapy identified a lack of CNS engagement.

More work is needed to address such issues to improve patients’ experiences during SACT, given the recent guidance recommendations. 

Carole Farrell is consultant editor Cancer Nursing Practice

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