Cancer Patients’ Perspectives and Experiences of Chemotherapy-Induced Myelosuppression and Its Impact on Daily Life

Robert S Epstein,1 Upal K Basu Roy,2 Matti Aapro,3 Tehseen Salimi,4 Donald Moran,4 JoAnn Krenitsky,1 Megan L Leone-Perkins,5 Cynthia Girman,6 Courtney Schlusser,7 Jeffrey Crawford8 1Epstein Health, LLC., Woodcliff Lake, NJ, USA; 2LUNGevity Foundation, Bethesda, MD, USA; 3Clinique De Genolier, Genolier, Switzerland; 4G1 Therapeutics Ltd., Research Triangle Park, NC, USA; 5HealthiVibe, a Division of Corrona, LLC., Arlington, VA, USA; 6Chapel Hill Consulting, LLC., Chapel Hill, NC, USA; 7UNC Gillings School of Global Public Health, Chapel Hill, NC, USA; 8Duke University Medical Center, Durham, NC, USACorrespondence: Robert S EpsteinEpstein Health, LLC., Woodcliff Lake, NJ, 07677, USATel +1 201-285-5800Email repstein@epsteinhealth.comPurpose: To evaluate which side effects of chemotherapy are considered most burdensome by patients with cancer, identify which health care professionals pay most attention to symptoms associated with chemotherapy-induced myelosuppression (CIM) from the patient perspective, and capture the “patient voice” describing how CIM impacts their daily lives.Participants and Methods: Online survey of participants with breast, lung, or colorectal cancer who had received chemotherapy within the past 12 months and experienced ≥ 1 episode of CIM in the past year. Participants were asked to answer close-ended questions and provide qualitative responses to: “In your own words, please describe how side effects from myelosuppression have impacted your life.”Results: Among 301 survey participants, fatigue was the most frequently reported side effect of chemotherapy; 55% of participants rated fatigue as highly bothersome (9 or 10 on a 1– 10 scale of “bothersomeness”). Participants rated symptoms associated with CIM, including fatigue, weakened immune system (infections), bleeding and/or bruising, and shortness of breath, as being as bothersome as other side effects of chemotherapy, including alopecia, neuropathy, and nausea/vomiting. Overall, 24– 43% of participants thought that CIM and its symptoms had a negative impact on their daily lives, including their ability to complete tasks at home and work, and to socialize. Qualitative responses supported these findings; participants highlighted that CIM-related symptoms, particularly fatigue and fear of infections, affected their ability to be physically active, complete work, or continue meaningful relationships with friends and family.Conclusion: Participants described a real-world impact of CIM that often isolates them from family and friends, and means that they are unable to work or perform tasks of daily living. Using measures that help patients to recognize and communicate the signs and symptoms of CIM might increase the likelihood of maintaining daily lives as close to normal as possible, during and after chemotherapy treatment.Keywords: cancer, chemotherapy, myelosuppression, real world, quality of life, patient burden