A recent study reports 36% of women quit breast cancer therapy early due to the medications’ side effects, which are more severe and widespread than previously known. Plus, the Northwestern Medicine research reveals a disparity between what women tell their physicians regarding side effects and what women actually experience.
“Clinicians consistently underestimate the side effects associated with treatment,” said lead investigator Lynne Wagner, PhD, an associate professor in medical social sciences at Northwestern University Feinberg School of Medicine and a clinical psychologist at Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “They give patients a drug they hope will help them, so they have a motivation to underrate the negative effects. Patients don’t want to be complainers and don’t want their doctor to discontinue treatment. So no one knew how bad it really was for patients.”
Joint pain was the symptom most likely to cause women to stop using the aromatase therapy drugs. Other side effects reported to affect quality of life were hot flashes, decreased libido, weight gain, feeling bloated, breast sensitivity, mood swings, irritability, and nausea.
According to the study, women still experiencing residual side effects from recent chemotherapy or radiation therapy when they start aromatase therapy are at highest risk for quitting medications before the recommended 5 years.
“The more miserable they were before they started, the more likely they were to quit,” Wagner said. “By the time they get through chemotherapy or radiation, they have to face five more years of another medication that will make them feel lousy. They feel like they already lost enough time to cancer and have reached their threshold for feeling bad.”
“This is a wake-up call to physicians that says if your patient is feeling really beaten up by treatment, the risk of her quitting early is high,” Wagner said. “We need to be better at managing the symptoms of our patients to improve their quality of life.”
Due to side effects, 36% of the women discontinued treatment before an average of 4.1 years. After 2 years, 10% had stopped therapy. The remaining women quit treatment between 25 months and 4.1 years.
“These findings can help us identify women at risk for quitting the therapy, counsel them about the importance of staying on it and provide treatment for troubling side effects,” Wagner noted.