With cancer incidence on the rise, more and more people are receiving chemotherapy. This is, however, not without its set of side effects. These side effects have a bearing on both the physical as well as the emotional health of the patient. There were some reasons due to which chemotherapy side effects were often ignored.
Cancer assumes a bigger disease condition, and so side effects of chemotherapy (or anything else for that matter) assumes a much smaller role. Discussions always revolve around how the situation of the cancer is, and chemotherapy assumes a less role.
- The patient thinks that it was the expected response to the chemotherapy.
- They also assume that there might be no cure for that side effect.
All these necessitated the need for a systematic assessment tool. This has multiple benefits as below.
- It gives a structured framework for the doctor and the patient so that no points are missed during the discussion.
- It gives a guideline for the patient to look for chemotherapy side effects.
- It improves confidence, as the patient known what to expect from the chemotherapy.
- Overall patient outcomes can be improved
The Chemotherapy Symptom Assessment Scale (C-SAS) contains a checklist that contains symptoms which arise only out of chemotherapy treatment.
- It was introduced in 2002 and includes not just physical problems but also psychological and sexual issues.
- Developed with extensive inputs from both the patient and the doctor community, it has 24 questions. There is also a section for reporting of spontaneous symptoms.
- The patient records his symptoms on a regular basis, and this becomes a basis for discussion with the doctor at his next visit. It captures incidence, severity, and also how bothersome it is to the patient.
- There is also a section for nurses to include their comments, so the response to treatment to these symptoms is recorded.
Objectives: The C-SAS tool aims to:
- Improve reporting of symptoms pertaining to chemotherapy
- Help the patient understand the response to chemotherapy
- Help the medical fraternity understand the drug behavior
- Provide a structured framework for the doctor and patient discussions
- Collect more side effects for a particular chemotherapy regimen
- Improve overall quality of care
Challenges: Though the C-SAS is quite useful, there are still challenges to it, as below.
- Encouraging patients to use it. In many cases, the patients feel uncertain if a symptom is due to chemotherapy or part of cancer.
- Ensuring that the staff use it, not just to collect the symptoms but review and treat the symptoms.
- Getting some insights out of it, to get a holistic view of patient health.
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