1. ¹South West Wales Cancer Institute, Singleton Hospital, Swansea University, Swansea SA2 8QA, UK
2. ²Quantics Consulting Limited, Kippilaw Mains, Melrose TD6 9HF, UK
3. ³NHS Scotland, Information and Statistics Division, 1st Floor, Gyle Square, South Gyle, Edinburgh EH12 9EB, UK
4. ⁴Edinburgh University, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK
5. ⁵James Cook University Hospital, Middlesbrough TS4 3BW, UK
6. ⁶St Vincents University Hospital, Elm Park, Dublin 4, Republic of Ireland
7. ⁷Hammersmith Hospitals NHS Trust and Imperial College, Du Cane Road, London, W12 0HS, UK

Correspondence: Professor RCF Leonard, Cancer Services & Clinical Haematology, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK. E-mail: BLeonard@hhnt.nhs.uk

Received 20 April 2006; Revised 28 September 2006; Accepted 30 September 2006.

Abstract

Three hundred and ninety women participated in the quality of life (QL) study of ACCOG1, a high-dose vs conventional adjuvant chemotherapy breast cancer trial, for patients with a high risk of relapse. Patients completed the European Organisation for Research and Treatment of Cancer QLQ-C30, questions on menopausal symptoms and the Sexual Activity Questionnaire. Pretreatment, 6,12, 24, 36, 48 and 60-month assessments were conducted. For the high dose group the median decrease in global QL at 6 months was significantly greater than in the conventional group. At 12 months, however, the median change had returned to 0 for both groups. Social functioning was also significantly lower in the high-dose group at 6 months, again returning to prebaseline levels for both groups after 12 months. The most persistent changes appear to be in the effect of treatment in both arms on sexual outcomes, reflected in problems with discomfort and pleasure. Both high-dose and conventional chemotherapy showed persisting negative effects on sexual health. This has not been previously reported as a long-term complication of high-dose chemotherapy. However, it did not have long-term affects on sexual habit, which appeared to return to pretreatment frequency and similar to that of conventional chemotherapy by about 12 months from treatment.