Skip to main content
Erschienen in: Supportive Care in Cancer 12/2023

01.12.2023 | Research

The lived experience of patients with breast cancer on adjuvant endocrine therapy: side effects and coping strategies during the first year of medication initiation

verfasst von: Sameh Gomaa, AnaMaria Lopez, Rachel Slamon, Rita Smith, Emmanuel Lapitan, Ginah Nightingale, Suzanne M. Miller, Kuang-Yi Wen

Erschienen in: Supportive Care in Cancer | Ausgabe 12/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Adjuvant endocrine therapy (AET) is pivotal for hormone receptor-positive breast cancer patients, significantly enhancing survival rates. Yet, adherence to AET remains challenging due to side effects. This study delves into the lived experience of breast cancer survivors concerning AET-induced side effects and examines differences in symptom profiles between Tamoxifen and aromatase inhibitors (AIs).

Methods

We interviewed 35 breast cancer survivors on AET, conducting qualitative iterative analysis using grounded theory. A codebook was developed to aid data coding and interpretation. NVIVO software facilitated comprehensive transcript analysis.

Results

Survivors reported a spectrum of side effects like hot flashes, sexual issues, joint pain, stiffness, mood swings, and fertility concerns. Symptom profiles differed based on AET type. Tamoxifen users experienced more frequent sexual side effects and mood swings, while AIs were linked to joint pain, stiffness, and bone health worries. Those on AET for over 6 months expressed heightened concerns about side effects.

Conclusion

Tailored patient education, aligned with AET type, empowers survivors to manage side effects using self-regulatory strategies. Acknowledging distinct symptom profiles enables informed decisions, improving adherence and quality of life.

Implications

This study underscores tailored survivorship support, equipping patients with tools to manage side effects, enhancing adherence, and long-term outcomes. The findings inform the integration of comprehensive survivorship programs, emphasizing individualized strategies for managing side effects and promoting better adherence and improved quality of life.
Literatur
1.
Zurück zum Zitat Bashar MA, Begam N (2022) Breast cancer surpasses lung cancer as the most commonly diagnosed cancer worldwide. Indian J Cancer 59(3):438–439PubMed Bashar MA, Begam N (2022) Breast cancer surpasses lung cancer as the most commonly diagnosed cancer worldwide. Indian J Cancer 59(3):438–439PubMed
3.
Zurück zum Zitat Giaquinto AN et al (2022) Breast cancer statistics, 2022. CA: A Cancer J Clin 72(6):524–541 Giaquinto AN et al (2022) Breast cancer statistics, 2022. CA: A Cancer J Clin 72(6):524–541
4.
Zurück zum Zitat Berry DA et al (2005) Effect of Screening and Adjuvant Therapy on Mortality from Breast Cancer. N Engl J Med 353(17):1784–1792CrossRefPubMed Berry DA et al (2005) Effect of Screening and Adjuvant Therapy on Mortality from Breast Cancer. N Engl J Med 353(17):1784–1792CrossRefPubMed
5.
Zurück zum Zitat Howell A et al (2005) Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet 365(9453):60–62CrossRefPubMed Howell A et al (2005) Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet 365(9453):60–62CrossRefPubMed
6.
Zurück zum Zitat Davies C et al (2011) Early Breast Cancer Trialists′ Collaborative Group (EBCTCG) Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378(9793):771–84CrossRefPubMed Davies C et al (2011) Early Breast Cancer Trialists′ Collaborative Group (EBCTCG) Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378(9793):771–84CrossRefPubMed
7.
Zurück zum Zitat Early Breast Cancer Trialists' Collaborative G (1998) Tamoxifen for early breast cancer : an overview of the randomized trials. Lancet 351: p. 1451–1467 Early Breast Cancer Trialists' Collaborative G (1998) Tamoxifen for early breast cancer : an overview of the randomized trials. Lancet 351: p. 1451–1467
8.
Zurück zum Zitat Burstein HJ et al (2010) American society of clinical oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor–positive breast cancer. J Clin Oncol 28(23):3784–3796 Burstein HJ et al (2010) American society of clinical oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor–positive breast cancer. J Clin Oncol 28(23):3784–3796
9.
Zurück zum Zitat Murphy CC et al (2012) Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat 134(2):459–478CrossRefPubMedPubMedCentral Murphy CC et al (2012) Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat 134(2):459–478CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Partridge AH, Wang PS, Winer EP, Avorn J (2003) Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer. J Clin Oncol 21(4):602–606CrossRefPubMed Partridge AH, Wang PS, Winer EP, Avorn J (2003) Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer. J Clin Oncol 21(4):602–606CrossRefPubMed
11.
Zurück zum Zitat Partridge AH et al (2008) Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer. J Clin Oncol 26(4):556–562CrossRefPubMed Partridge AH et al (2008) Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer. J Clin Oncol 26(4):556–562CrossRefPubMed
12.
Zurück zum Zitat Grunfeld EA, Hunter MS, Sikka P, Mittal S (2005) Adherence beliefs among breast cancer patients taking tamoxifen. Patient Educ Couns 59(1):97–102CrossRefPubMed Grunfeld EA, Hunter MS, Sikka P, Mittal S (2005) Adherence beliefs among breast cancer patients taking tamoxifen. Patient Educ Couns 59(1):97–102CrossRefPubMed
13.
Zurück zum Zitat Demissie S, Silliman RA, Lash TL (2001) Adjuvant tamoxifen: predictors of use, side effects, and discontinuation in older women. J Clin Oncol 19(2):322–328CrossRefPubMed Demissie S, Silliman RA, Lash TL (2001) Adjuvant tamoxifen: predictors of use, side effects, and discontinuation in older women. J Clin Oncol 19(2):322–328CrossRefPubMed
14.
Zurück zum Zitat Lash TL et al (2006) Adherence to tamoxifen over the five-year course. Breast Cancer Res Treat 99(2):215–220CrossRefPubMed Lash TL et al (2006) Adherence to tamoxifen over the five-year course. Breast Cancer Res Treat 99(2):215–220CrossRefPubMed
15.
Zurück zum Zitat Kahn KL et al (2007) Patient centered experiences in breast cancer: predicting long-term adherence to tamoxifen use. Med Care 45(5):431–439CrossRefPubMed Kahn KL et al (2007) Patient centered experiences in breast cancer: predicting long-term adherence to tamoxifen use. Med Care 45(5):431–439CrossRefPubMed
16.
Zurück zum Zitat Güth U et al (2011) Drug switch because of treatment-related adverse side effects in endocrine adjuvant breast cancer therapy: how often and how often does it work? Breast Cancer Res Treat 129(3):799–807CrossRefPubMed Güth U et al (2011) Drug switch because of treatment-related adverse side effects in endocrine adjuvant breast cancer therapy: how often and how often does it work? Breast Cancer Res Treat 129(3):799–807CrossRefPubMed
17.
Zurück zum Zitat Cella D, Fallowfield LJ, Fallowfield LJ (2008) Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy. Breast Cancer Res Treat 107(2):167–180CrossRefPubMed Cella D, Fallowfield LJ, Fallowfield LJ (2008) Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy. Breast Cancer Res Treat 107(2):167–180CrossRefPubMed
18.
Zurück zum Zitat Pellegrini I et al (2010) Women’s perceptions and experience of adjuvant tamoxifen therapy account for their adherence: breast cancer patients’ point of view. Psychooncology 19(5):472–479CrossRefPubMed Pellegrini I et al (2010) Women’s perceptions and experience of adjuvant tamoxifen therapy account for their adherence: breast cancer patients’ point of view. Psychooncology 19(5):472–479CrossRefPubMed
19.
Zurück zum Zitat Henry NL et al (2012) Predictors of aromatase inhibitor discontinuation as a result of treatment-emergent symptoms in early-stage breast cancer. J Clin Oncol : Off J Am Soc Clin Oncol 30(9):936–942CrossRef Henry NL et al (2012) Predictors of aromatase inhibitor discontinuation as a result of treatment-emergent symptoms in early-stage breast cancer. J Clin Oncol : Off J Am Soc Clin Oncol 30(9):936–942CrossRef
20.
Zurück zum Zitat Kirk MC, Hudis CA (2008) Insight into Barriers Against Optimal Adherence to Oral Hormonal Therapy in Women with Breast Cancer. Clin Breast Cancer 8(2):155–161CrossRefPubMed Kirk MC, Hudis CA (2008) Insight into Barriers Against Optimal Adherence to Oral Hormonal Therapy in Women with Breast Cancer. Clin Breast Cancer 8(2):155–161CrossRefPubMed
21.
Zurück zum Zitat Wen K-Y, Smith R, Padmanabhan A, Goldstein L (2017) Patient experience of taking adjuvant endocrine therapy for breast cancer: a tough pill to swallow. Patient Experience J 4(3):104–114CrossRef Wen K-Y, Smith R, Padmanabhan A, Goldstein L (2017) Patient experience of taking adjuvant endocrine therapy for breast cancer: a tough pill to swallow. Patient Experience J 4(3):104–114CrossRef
22.
Zurück zum Zitat Stanton AL, Petrie KJ, Partridge AH (2014) Contributors to nonadherence and nonpersistence with endocrine therapy in breast cancer survivors recruited from an online research registry. Breast Cancer Res Treat 145(2):525–534CrossRefPubMed Stanton AL, Petrie KJ, Partridge AH (2014) Contributors to nonadherence and nonpersistence with endocrine therapy in breast cancer survivors recruited from an online research registry. Breast Cancer Res Treat 145(2):525–534CrossRefPubMed
23.
Zurück zum Zitat Neugut A et al (2012) Non-initiation of adjuvant hormonal therapy in women with hormone receptor-positive breast cancer: The Breast Cancer Quality of Care Study (BQUAL). Breast Cancer Res Treat 134(1):419–428CrossRefPubMedPubMedCentral Neugut A et al (2012) Non-initiation of adjuvant hormonal therapy in women with hormone receptor-positive breast cancer: The Breast Cancer Quality of Care Study (BQUAL). Breast Cancer Res Treat 134(1):419–428CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Rani NS, Abd Wahab MS, Zulkifly HH, SH (2021) Mohamad, Factors associated with disease progression among hormone receptor-positive breast cancer patients treated with endocrine therapy: A 5-year cross-sectional, retrospective follow-up study. J Appl Pharm Sci 11(1): p. 072–077 Rani NS, Abd Wahab MS, Zulkifly HH, SH (2021) Mohamad, Factors associated with disease progression among hormone receptor-positive breast cancer patients treated with endocrine therapy: A 5-year cross-sectional, retrospective follow-up study. J Appl Pharm Sci 11(1): p. 072–077
25.
Zurück zum Zitat Huiart L, Ferdynus C, Giorgi R (2013) A meta-regression analysis of the available data on adherence to adjuvant hormonal therapy in breast cancer: summarizing the data for clinicians. Breast Cancer Res Treat 138(1):325–328CrossRefPubMed Huiart L, Ferdynus C, Giorgi R (2013) A meta-regression analysis of the available data on adherence to adjuvant hormonal therapy in breast cancer: summarizing the data for clinicians. Breast Cancer Res Treat 138(1):325–328CrossRefPubMed
26.
Zurück zum Zitat Sood N et al (2022) Association of Endocrine Therapy Initiation Timeliness With Adherence and Continuation in Low-Income Women With Breast Cancer. JAMA Netw Open 5(8):e2225345–e2225345CrossRefPubMedPubMedCentral Sood N et al (2022) Association of Endocrine Therapy Initiation Timeliness With Adherence and Continuation in Low-Income Women With Breast Cancer. JAMA Netw Open 5(8):e2225345–e2225345CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Strauss A. Corbin JM, Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. 1998: SAGE Publications Strauss A. Corbin JM, Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. 1998: SAGE Publications
28.
Zurück zum Zitat Beckwée D, Leysen L, Meuwis K, Adriaenssens N (2017) Prevalence of aromatase inhibitor-induced arthralgia in breast cancer: a systematic review and meta-analysis. Support Care Cancer 25:1673–1686CrossRefPubMed Beckwée D, Leysen L, Meuwis K, Adriaenssens N (2017) Prevalence of aromatase inhibitor-induced arthralgia in breast cancer: a systematic review and meta-analysis. Support Care Cancer 25:1673–1686CrossRefPubMed
29.
Zurück zum Zitat Din OS, Dodwell D, Wakefield RJ, Coleman RE (2010) Aromatase inhibitor-induced arthralgia in early breast cancer: what do we know and how can we find out more? Breast Cancer Res Treat 120:525–538CrossRefPubMed Din OS, Dodwell D, Wakefield RJ, Coleman RE (2010) Aromatase inhibitor-induced arthralgia in early breast cancer: what do we know and how can we find out more? Breast Cancer Res Treat 120:525–538CrossRefPubMed
31.
Zurück zum Zitat Baumgart J et al (2013) Sexual dysfunction in women on adjuvant endocrine therapy after breast cancer. Menopause 20(2):162–168CrossRefPubMed Baumgart J et al (2013) Sexual dysfunction in women on adjuvant endocrine therapy after breast cancer. Menopause 20(2):162–168CrossRefPubMed
32.
Zurück zum Zitat Helland T et al (2019) Drug monitoring of tamoxifen metabolites predicts vaginal dryness and verifies a low discontinuation rate from the Norwegian Prescription Database. Breast Cancer Res Treat 177(1):185–195CrossRefPubMed Helland T et al (2019) Drug monitoring of tamoxifen metabolites predicts vaginal dryness and verifies a low discontinuation rate from the Norwegian Prescription Database. Breast Cancer Res Treat 177(1):185–195CrossRefPubMed
34.
Zurück zum Zitat Price R et al (2022) Oral and topical treatment of painful diabetic polyneuropathy: practice guideline update summary: report of the AAN Guideline Subcommittee. Neurology 98(1):31–43CrossRefPubMed Price R et al (2022) Oral and topical treatment of painful diabetic polyneuropathy: practice guideline update summary: report of the AAN Guideline Subcommittee. Neurology 98(1):31–43CrossRefPubMed
35.
Zurück zum Zitat Browall M, Mijwel S, Rundqvist H, Wengström Y (2018) Physical activity during and after adjuvant treatment for breast cancer: an integrative review of women’s experiences. Integr Cancer Ther 17(1):16–30CrossRefPubMed Browall M, Mijwel S, Rundqvist H, Wengström Y (2018) Physical activity during and after adjuvant treatment for breast cancer: an integrative review of women’s experiences. Integr Cancer Ther 17(1):16–30CrossRefPubMed
36.
Zurück zum Zitat Rogers LQ et al (2023) Physical activity intervention benefits persist months post-intervention: Randomized trial in breast cancer survivors. J Cancer Survivorship p. 1–13 Rogers LQ et al (2023) Physical activity intervention benefits persist months post-intervention: Randomized trial in breast cancer survivors. J Cancer Survivorship p. 1–13
37.
Zurück zum Zitat Galantino ML et al (2012) Impact of yoga on functional outcomes in breast cancer survivors with aromatase inhibitor–associated arthralgias. Integr Cancer Ther 11(4):313–320CrossRefPubMed Galantino ML et al (2012) Impact of yoga on functional outcomes in breast cancer survivors with aromatase inhibitor–associated arthralgias. Integr Cancer Ther 11(4):313–320CrossRefPubMed
38.
Zurück zum Zitat Stout NL et al (2021) A systematic review of rehabilitation and exercise recommendations in oncology guidelines. CA Cancer J Clin 71(2):149–175CrossRefPubMed Stout NL et al (2021) A systematic review of rehabilitation and exercise recommendations in oncology guidelines. CA Cancer J Clin 71(2):149–175CrossRefPubMed
Metadaten
Titel
The lived experience of patients with breast cancer on adjuvant endocrine therapy: side effects and coping strategies during the first year of medication initiation
verfasst von
Sameh Gomaa
AnaMaria Lopez
Rachel Slamon
Rita Smith
Emmanuel Lapitan
Ginah Nightingale
Suzanne M. Miller
Kuang-Yi Wen
Publikationsdatum
01.12.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 12/2023
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-023-08170-y

Weitere Artikel der Ausgabe 12/2023

Supportive Care in Cancer 12/2023 Zur Ausgabe

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

15% bedauern gewählte Blasenkrebs-Therapie

29.05.2024 Urothelkarzinom Nachrichten

Ob Patienten und Patientinnen mit neu diagnostiziertem Blasenkrebs ein Jahr später Bedauern über die Therapieentscheidung empfinden, wird einer Studie aus England zufolge von der Radikalität und dem Erfolg des Eingriffs beeinflusst.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.