Symptoms experienced during the first 4 months of chemotherapy administration: a longitudinal cohort study in an Australian cancer treatment unit

PURPOSE: Individuals undergoing chemotherapy experience a range of symptoms that can significantly impact their quality of life and treatment outcomes; the prevalence and severity of which can change across their treatment journey. This study aimed to identify and describe the longitudinal symptom experience during the first four months of chemotherapy administration across a range of cancer diagnoses. METHODS: A prospective longitudinal cohort study was conducted at a cancer centre in Queensland, Australia. Monthly surveys assessed symptoms, distress, and quality of life across 4 months of chemotherapy. RESULTS: A total of 252 participants completed baseline surveys (mean age 61 ± 12.3 years; 65% female; 40% breast cancer). Participants reported a mean of 22.5 ± 9.0 symptoms at baseline, with a statistically significant reduction in symptoms throughout the study period 21.9 ± 9.2 symptoms (p = 0.002). Fatigue (93%), insomnia (80%), and pain (72%) were most common at baseline and remained highly prevalent throughout the time period. Severe fatigue (25%), pain (15%), and constipation (15%) reduced over time, while peripheral neuropathy and decreased sexual interest increased. CONCLUSION: This study has produced insights into the high number of symptoms experienced during the initial four months of chemotherapy. Given the impact of symptoms on treatment outcomes, there is a critical need for the development of appropriate assessment tools capable of capturing this broad range of patient symptom experiences. IMPLICATIONS FOR CANCER SURVIVORS: Understanding symptom patterns over time can support early identification of high-risk patients, guide personalised supportive care strategies and optimise treatment tolerance and quality of life during and beyond chemotherapy.