Physicians often missed key side effects of radiation therapy in patients with breast cancer who participated in a new study being presented at the 2020 San Antonio Breast Cancer Symposium. Common side effects missed by physicians included pain, itchy skin, swelling, and fatigue.
Dr. Reshma Jagsi, PhD. Image courtesy of University of Michigan Rogel Cancer Center.The findings come from researching the experiences of nearly 10,000 patients who visited dozens of practices in Michigan. The patients had all received radiation therapy following lumpectomy and noted their side effects on standard symptom reporting tools, according to presenter Dr. Reshma Jagsi, PhD, deputy chair of radiation oncology at Michigan Medicine in Ann Arbor.
When Jasgi and colleagues compared the symptoms reported by the patients on standard practice forms to the symptoms noted by physicians in the Common Toxicity Criteria for Adverse Events tool, they found physicians often said patients had no issues, even when the patients themselves said they had substantial concerns.
Under-recognition of radiation therapy side effects occurred in more than half (51%) of patients with swelling and more than one-third (37%) of patients with itchy skin. Physicians also often missed patients with pain (31%) and fatigue (19%).
Physicians were particularly likely to miss side effects in younger patients and Black patients, which could be contributing to larger health disparities. Jagsi suggested that using alternative methods to detect symptoms in these patients might improve outcomes.
The study included 9,941 patients visiting 29 practices throughout Michigan. It was part of the Michigan Radiation Oncology Quality Consortium, a quality initiative funded by Blue Cross Blue Shield of Michigan and the Blue Care Network.
