Patient Preferences for Side Effects Associated With Cervical Cancer Treatment
Charlotte Sun, DrPH*,
Alaina J. Brown, MD*,
Anuja Jhingran, MD†,
Michael Frumovitz, MD, MPH*,
Lois Ramondetta, MD* and
Diane C. Bodurka, MD*
*Departments of Gynecologic Oncology and Reproductive Medicine and
†Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Address correspondence and reprint requests to Charlotte C. Sun, DrPH, Department of Gynecologic Oncology and Reproductive Medicine, CPB6.3244, Unit 1362, The University of Texas MD Anderson Cancer Center, 1155 Herman Pressler, Houston, TX 77030; E-mail: ccsun{at}mdanderson.org.
Objectives The aim of this study was to assess patient preferences regarding side effects associated with cervical cancer treatment.
Methods/Materials The visual analog scale (VAS) and modified standard gamble (SG) were used to elicit preferences of women with no evidence of disease after primary treatment of cervical cancer. Higher scores on VAS and SG indicated more favorable ratings for a given health state. Health states (HS) included vaginal shortening, diarrhea, dietary changes, menopause, moderate nausea/vomiting, rectal bleeding, sexual dysfunction, and urinary self-catheterization. Descriptive statistics, Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed-ranks tests and correlation coefficients were used for statistical analysis.
Results Seventy-eight patients participated in the study. Median age was 44.1 years (range, 24.9–67.8 years). Median time since treatment completion was 31.2 months (range, 1.0–113.3 months). The HSs rated as most favorable by VAS were also rated as most favorable by SG. Increasing age was associated with higher VAS scores for menopause and vaginal shortening (P = 0.04 and 0.036). African Americans had higher VAS scores for dietary changes (P = 0.05), sexual dysfunction (P = 0.028), and diarrhea (P = 0.05) when compared with Hispanic and non-Hispanic white patients. Women receiving radiation had more favorable VAS scores for menopause compared with women undergoing radical hysterectomy (P = 0.05). Women receiving chemotherapy rated urinary self-catheterization less favorably by VAS score compared with those not receiving chemotherapy (P = 0.045).
Conclusions Multiple demographic and clinical factors influence the severity of treatment-related adverse effects perceived by women surviving cervical cancer. A better understanding of factors influencing patient preferences regarding treatment side effects will allow providers to formulate care better tailored to the individual desires of each patient.
http://dx.doi.org/10.1097/IGC.0000000000000149
© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.