Side Effects Trouble Breast Cancer Patients on Hormone Therapy
If injections could reduce hot flashes, women would opt for shots, study finds
FRIDAY, Oct. 21, 2005 (HealthDay News) -- Many breast cancer patients who are using hormone therapies like tamoxifen to cut the risk of recurrence prefer pills over injections, given a choice.
But if injections could reduce hot flashes, a side effect of such treatments, more than 60 percent of the women surveyed said they would choose the shots.
And if the shots would better control the cancer than the pills do, 74.5 percent would pick the injections.
Those are the findings of a British study published in the Oct. 20 edition of the Annals of Oncology, in which the team also found that women often skipped their hormone treatments in pill form.
"The take-home message is that unless we find some way of helping women with breast cancer deal effectively with their hot flashes and other menopausal side effects, then optimal doses of anti-cancer drugs may not be reaching the patients," said Lesley Fallowfield, lead author of the study and Cancer Research UK Professor of Psychosocial Oncology at Brighton & Sussex Medical School at the University of Sussex.
In the study, Fallowfield's team interviewed 208 women with early or advanced stage breast cancer who had been diagnosed at least two years before. When they were asked which medicine form they would prefer if daily tablets or a double injection once a month were equally effective and had equal side effects, 63 percent picked pills, 24.5 percent chose injections and 12.5 percent had no preference.
But when presented with a hypothetical scenario in which the injection of hormone treatments produced fewer hot flashes, the responses changed, with only 27.4 percent choosing pills and 60.6 percent picking the shots. Another 12 percent had no preference.
And when presented a scenario in which the shots better controlled the cancer, even more, 74.5 percent, chose the injections.
Those who picked pills in the initial scenario said they were more convenient; and some said they disliked needles. Those who preferred shots said they were more convenient and it was easier to comply with the therapy.
But Fallowfield and her team also found that taking the pills as prescribed didn't always happen. Of the women who admitted they skipped their pills, 48.7 percent said they sometimes forgot, and 13.1 percent admitted they deliberately didn't take their pills some of the time.
The fact that women sometimes missed taking the pills was no surprise to Dr. Patricia Ganz, director of cancer prevention and control research at the University of California, Los Angeles Jonsson Comprehensive Cancer Center. "Non-adherence to medication is common," she said, although "women with breast cancer are more motivated [than some others] to take their medication."
But the degree of non-adherence was startling to Fallowfield. "We were very surprised to see the level of non-adherence to tablet taking in women with life-threatening disease," she said, "and the fact that 25 percent preferred injections to ensure compliance."
Prescribing hormone treatment in tablet form rather than shots is standard practice, Ganz said. "Right now there is no injectable that does not cause hot flashes," she said.
Ganz also wondered if the motivation for the study, funded by pharmaceutical company AstraZeneca -- maker of anastrozole, one of the medications prescribed for women after breast cancer -- was to see if there was a market to develop such an injectable drug.
AstraZeneca spokeswoman Katie Neff said the company is not developing such a drug at this time.
To learn more about breast cancer, visit the American Cancer Society.