In patients with advanced, incurable cancer, anticancer treatment may alleviate patients’ cancer-related symptoms and cancer-associated complications [1]. These beneficial effects may occur even in the absence of a tumor response [2]. In contrast, reduction of tumor size does not necessarily imply a benefit to patients [3]. Chemotherapy may cause physical and psychosocial side effects [4]. An important focus of treatment is therefore to have a beneficial impact on health-related quality of life (HRQL) [5]. HRQL was reported by health care professionals [6] and medical

oncologists [7] to be the most important outcome in assessing the effect of palliative chemotherapy. Inhibitors,research,lifescience,medical However, HRQL considerations rated by physicians after consultation were poorly associated with decisions regarding modification Inhibitors,research,lifescience,medical of palliative chemotherapy [8]. While both monitoring of tumor response and toxicity are defined by gold standards (i.e., RECIST, CTCAE v3.0), symptoms and syndromes, also conceptualized as patient-reported outcomes Inhibitors,research,lifescience,medical (PROs), are yet only partially incorporated in routine oncology care [9,10]. Symptoms, which are subjective perceptions of patients, cannot be measured by currently used toxicity scales [11]. Syndromes are mainly clinically described patterns, a combination of symptoms and clinical signs. Cachexia for instance is Inhibitors,research,lifescience,medical the combination of

the sign weight loss and the symptom anorexia [12]. It is often assumed that an oncologist can estimate the symptoms of the patient accurately using a regular history. However, oncologists’ perceptions may differ from patients’ reported physical and psychosocial experiences. In patients with advanced cancer, the assessment of relevant psychological domains, but also of pain, Inhibitors,research,lifescience,medical asthenia/fatigue,

or nutritional problems are often underestimated [13,14]. They may not be detected (lack of screening), not be quantified by the patient or by a professional (lack of measuring individuals’ symptom distress) [15,16] or their impact on patients’ everyday functioning is not taken into account (lack of estimation of the magnitude of the problem). Physicians’ concerns about time constraints arising from dealing whatever with unexpected or complex symptoms may contribute to underestimation of symptoms, [17]. In Switzerland, an average of 15minutes of consultation time is general find protocol practice [18]. For the monitoring of anticancer treatment, the palliative effect of chemotherapy on disease-related symptoms and syndromes [15] has been operationalized by defining a clinical benefit criterion. In pancreatic cancer, the endpoint of clinical benefit response (a composite assessment of pain, performance status and weight) was created to provide a way in which the impact of therapy on tumor-related symptoms could be assessed [19] and has become a well-accepted outcome parameter.

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