Living with advanced breast cancer: development and application of a clinical checklist for patients on endocrine therapy

The management of advanced breast cancer frequently involves systemic treatment with hormone therapy, yet little attention has been paid to the impact of such treatment on patientsʹ well-being. Side-effects may be frequent and troublesome but are under-reported by patients and underestimated by medical staff. In an attempt to improve doctor-patient communication in this area, we have developed the C-PET, the Checklist for Patients on Endocrine Therapy: an interactional tool for use in clinical practice. A 13-item checklist of side-effects was constructed, translated and then piloted with 148 patients in seven institutes in France, Germany, Italy and the UK. The checklist contained a part for patients to complete and a part in which doctors or nurses could annotate their own responses to the patientsʹ reported symptoms. Feedback from professionals was positive and 86% of patients reported that the C-PET improved communication. Hot flushes, weight gain and low energy levels were reported by 50%, 44 % and 41% of women, respectively, and approximately 10% of patients wanted to discuss these symptoms with a professional. The impact of side-effects of hormonal therapy constitutes an important component of patientsʹ quality of life and warrants greater attention. The C-PET can help communication between patients and their professional carers about these concerns.