Breast Cancer Chemotherapy (NCT00087178) Header Time point This form is being filled out Quality of life I have a lack of energy. I have nausea. Because of my physical condition, I have trouble meeting the needs of my family. I have pain. I am bothered by side effects of treatment. I feel ill. I am forced to spend time in bed. I feel close to my friends. I get emotional support from my family. I get support from my friends. My family has accepted my illness. I am satisfied with family communication about my illness. I feel close to my partner. (or the person who is my main support) If you prefer not to answer it, please check this box and go to the next section. (Regardless of your current level of sexual activity, please answer the following question.)
No I am satisfied with my sex life. I feel sad. I am satisfied with how I am coping with my illness. I am losing hope in the fight against my illness. I feel nervous. I worry about dying. I worry that my condition will get worse. I am able to work. (include work at home) My work is fulfilling. (include work at home) I am able to enjoy life. I have accepted my illness. I am sleeping well. I am enjoying the things I usually do. I am content with the quality of my life right now. I have been short of breath. I am self-conscious about the way I dress. One or both of my arms are swollen or tender. I feel sexually attractive. I am bothered by hair loss. I worry that other members of my family might someday get the same illness I have. I worry about the effect of stress on my illness. I am bothered by a change in weight. I am able to feel like a woman. headaches indigestion nausea heartburn vomiting passing a lot of gas (flatulence) mouth sores diarrhea skin problems (including rash, dry skin, itching, irritation or redness) numbness or tingling in hands or feet fever or shivering (shaking, chills) difficulty with bladder control constipation hot flashes genital itching or irritation mood swings vaginal discharge vaginal bleeding or spotting vaginal dryness pain with intercourse cramps general aches and pains joint pains swelling of hands muscle stiffness weight gain weight loss unhappy with appearance of my body forgetfulness night sweats cold sweats difficulty concentrating Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf Lifting or carrying groceries Climbing several flights of stairs Bending, kneeling, or stooping Walking more than a mile Walking several hundred yards Walking one hundred yards Bathing or dressing yourself Did you feel full of life? Did you have a lot of energy? Did you feel worn out? Did you feel tired? Please score your overall quality of life as of today on an 11-point scale where 0 indicates being in the worst possible health and 10 indicates being in perfect health.