Breast Cancer Treatment: Weighing the Benefits and Drawbacks of Hormone Therapy and Its Impact on Menopause Symptoms
In the fight against breast cancer, endocrine therapy, also known as hormonal therapy, plays a crucial role. This medication, which blocks the effects of estrogen on tissue and reduces the chances of cancer recurrence, is a vital tool in cancer treatment [1]. However, a concerning trend has emerged: more than 30% of patients stop taking endocrine therapy early, and many don't take it as prescribed [2].
The reasons for this non-adherence are multifaceted. Side effects, such as hot flashes, vaginal dryness, bone loss, joint pain, and genitourinary syndrome of menopause (GSM), can significantly reduce a patient's quality of life [3]. These side effects often lead patients to discontinue or not complete their prescribed treatment schedules, despite the therapy's proven benefits in preventing recurrence and improving survival [3].
Anna Weiss, M.D., the Comprehensive Breast Care program leader at Wilmot Cancer Institute, has discussed these issues in national articles and podcasts. She emphasizes the need for better patient education and support to manage these adverse effects [4].
The integrative oncology center at Wilmot's Pluta Cancer Center in Henrietta provides care for managing symptoms related to endocrine therapy. Simple measures like using moisturizers, lubrication during intercourse, pelvic floor exercises, and avoiding irritants can help manage GSM symptoms [5].
Systemic factors also contribute to non-adherence. Disparities in care, especially among underserved populations, are a significant issue. Studies have noted that nonadherence is more common in these groups, highlighting the need for tailored interventions such as nurse-led medication reconciliation and pharmacist counseling [1].
Advanced practice providers (nurse practitioners, physician assistants) in the Breast Health Program at Wilmot Cancer Institute have taken additional time to learn about endocrine therapy and its management from medical oncologists. Common brand names for endocrine therapy include Tamoxifen, Faslodex, Arimidex, and Femara [6].
It's important to note that about 80% of all breast cancers are estrogen-sensitive and are hormone-receptor positive, meaning they respond well to this therapy [7]. Endocrine therapy can reduce the risk of a recurrence by 40% and up to 75% in certain subgroups of people [8].
Being physically active can help manage various side effects, including brain fog, pain, and fatigue [9]. If advanced practice providers cannot answer a question, they refer patients to specialists with whom they have formed strong relationships.
In conclusion, the most common reasons for non-adherence to endocrine therapy in breast cancer patients are primarily related to side effects leading to reduced quality of life and lack of adequate support to manage these adverse effects, as well as systemic factors like disparities in healthcare delivery [1][3]. It's crucial to address these issues to ensure that patients receive the full benefits of this life-saving treatment.
References:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6677158/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826331/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6787438/
- https://www.wilmot.urmc.rochester.edu/breast-cancer/breast-health-program
- https://www.wilmot.urmc.rochester.edu/integrative-oncology
- https://www.cancer.gov/types/breast/patient/breast-hormone-therapy-pdq
- https://www.cancer.gov/types/breast/patient/breast-hormone-therapy-pdq#section/_140
- https://www.cancer.gov/types/breast/patient/breast-hormone-therapy-pdq#section/_170
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6049432/
- In the realm of health and wellness, managing side effects like hot flashes, vaginal dryness, bone loss, joint pain, and genitourinary syndrome of menopause (GSM) during endocrine therapy can significantly improve the quality of life for breast cancer patients.
- The scientific community has observed that a lack of proper education and support for managing these side effects may contribute to non-adherence to endocrine therapy among breast cancer patients, which could potentially reduce the therapy's effectiveness in preventing recurrence and improving survival rates.
- Women's health, particularly during menopause, plays a crucial role in adherence to endocrine therapy for breast cancer treatment, as managing symptoms such as GSM can help patients complete their prescribed treatment schedules and reap the full benefits of this life-saving therapy.
