Recognition of cancer chemotherapy adverse effect by patients: a cross-sectional study from Palestine

It has been suggested that patient awareness of chemotherapy-induced side effects is not uniform and may vary according to communication quality between healthcare providers and patients, educational initiatives, and the type of cancer and chemotherapy regimen. This study aimed to assess real-world chemotherapy-induced adverse effects as reported by cancer patients in the West Bank of Palestine and to identify key predictors of these side effects.

This cross-sectional study was conducted between January and December 2023 in various hospitals in the West Bank of Palestine. A validated questionnaire, previously developed and reviewed for face validity by a panel of experts, was administered to 266 consenting cancer patients receiving chemotherapy, and their electronic medical records were also reviewed. Descriptive statistics, chi-square/Fisher's exact tests, and multiple regression analyses were used to explore associations between sociodemographic/clinical variables and chemotherapy-induced adverse effects.

The median age of the 266 cancer patients was 48 [25-60] years. Overall, 91.7% of patients reported weakness, 88.0% reported hair loss, and 87.2% experienced vertigo, among other side effects. Multiple regression analyses revealed that a longer duration of chemotherapy sessions was a consistent predictor of increased adverse effects-specifically, it predicted higher frequencies of fever (Beta = 0.29, p < 0.001), vertigo (Beta = 0.29, p < 0.001), and weakness (Beta = 0.14, p = 0.031). Additionally, older age was associated with lower frequencies of fever (Beta = -0.28, p < 0.001) and skin toxicity (Beta = -0.30, p < 0.001), while female sex was linked to increased reports of weakness (Beta = 0.20, p = 0.003), hair loss (Beta = 0.25, p = 0.001), and edema (Beta = -0.22, p = 0.001).

The findings underscore a substantial burden of chemotherapy-induced side effects among cancer patients treated in Palestinian hospitals, with treatment-related parameters-particularly the duration of chemotherapy sessions-significantly influencing the frequency of adverse effects. These results highlight the need for tailored counseling and personalized interventions that consider patient demographics and treatment characteristics to optimize care and improve quality of life.