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Patients receiving chemotherapy for curative intent will often tolerate side effects with the knowledge that the treatment may result in eradication of their cancer. Patients receiving therapy for palliative intent often have their therapy tailored to improve quality of life while minimizing major side effects. A valuable sign of clinical improvement is the general well-being of the patient. Although general well-being is a combination of subjective (possibly partly a placebo effect) and objective factors, it nonetheless serves as a sign of clinical improvement along with improved appetite and weight gain and increased “performance status” (eg, ambulatory versus bedridden). Evaluation of factors such as activity status enables the clinician to judge whether the net effect of chemotherapy is worthwhile palliation (see Chapter 5).

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