When I came across this recent article by HealthDay News, a project of the U.S. Department of Health and Human Services Office on Women’s Health, I understood all too well the responses that many women have to taking tamoxifen or aromatase inhibitors.
Hot flashes and other unpleasant side effects are a major reason one-quarter of breast cancer patients do not start or do not complete their recommended hormone-blocking therapy, a new study finds. Five years of daily pills — either tamoxifen or aromatase inhibitors — is recommended for many women whose breast cancer expresses the hormones estrogen or progesterone. The drugs have been shown to reduce the risk of cancer returning and to extend survival.
Despite such benefits, this study of more than 700 breast cancer patients in Detroit and Los Angeles who were eligible for hormone therapy found that about 11 percent never started treatment and 15 percent stopped it early.Unpleasant, menopause-type side effects, such as vaginal dryness, hot flashes or joint pain, were the most common reasons women either stopped or never started the therapy.
“We need to develop better ways of supporting women through this therapy,” lead study author Christopher Friese, an assistant professor at the University of Michigan School of Nursing, said in a university news release.
Those most likely to complete their hormone therapy were patients who were most worried about their cancer returning and those who already took medication regularly, according to the study, which was published online March 31 in the journal Breast Cancer Research and Treatment.
Patients least likely to begin hormone therapy included those who received less information about hormone therapy, which suggests that doctors need to properly educate patients before treatment begins, the researchers said.
Women who saw a breast cancer surgeon instead of a medical oncologist as their primary follow-up also were less likely to begin hormone therapy.
“It was particularly interesting that greater fear of recurrence was associated in our patient sample with greater adherence to endocrine therapy,” study senior study author Dr. Jennifer Griggs, a professor of internal medicine at the University of Michigan Medical School.
“We don’t want our patients living under a cloud of fear, so we need to develop creative ways to both reassure and motivate them,” said Griggs, a medical oncologist. “This means providing better education about the importance of staying on these medications and partnering with primary care and cancer doctors to help women manage symptoms.”
More information
The U.S. National Cancer Institute has more about breast cancer treatme
