Symptoms and treatment burden associated with cancer treatment: results from a cross-sectional national survey in the U.S

Support Care Cancer. 2008 Jul;16(7):791-801. doi: 10.1007/s00520-007-0380-2. Epub 2008 Jan 17.


Goals: To examine the prevalence of chemotherapy-or radiotherapy-associated side effects and related treatment burden, and correlates of fatigue and missed work days among cancer patients.

Materials and methods: A cross-sectional survey was conducted using a dual sampling frame of 63,949 cancer patients (35,751 from an online panel and 28,198 from telephone listings) > or = 18 years receiving chemotherapy and/or radiotherapy at the time of the survey or during the previous 12 months. Data were collected on cancer type, time since diagnosis, treatment side effects, visits, caregiver burden, missed work days, and sociodemographic characteristics. Data are presented only for patients receiving cancer treatment at the time of the survey.

Main results: Of the 15,532 patients (24%) who responded to the screening questionnaire, 1,572 met the eligibility criteria and 1,569 completed the survey; 814 received chemotherapy and/or radiotherapy at the time of the survey. The most common side effects were fatigue (80%), pain (48%), and nausea/vomiting (48%). Patients spent 4.5 h, on average, per visit to treat side effects. Approximately 43% of the patients were employed; of these, 78% were actively working. Employed patients missed, on average, 18 work days annually for side effect treatment. Females, younger and unemployed patients, and those with higher levels of anxiety and depression experienced more fatigue; patients with a greater number of side effects endured more missed work days.

Conclusions: In addition to the symptomatic experience of side effects, patients reported a considerable time burden for treatment. It is important to consider supportive care strategies that may effectively reduce side effects and their associated treatment burden.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Cross-Sectional Studies
  • Fatigue / epidemiology*
  • Fatigue / etiology
  • Fatigue / therapy*
  • Female
  • Health Status Indicators
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Neoplasms / radiotherapy
  • Neoplasms / therapy*
  • Prevalence
  • Radiotherapy / adverse effects
  • Risk Factors
  • Surveys and Questionnaires
  • United States / epidemiology


  • Antineoplastic Agents