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Study investigates the role of doctors in women’s decision on treatment

July 26th, 2017

Although hormone therapy is one of the key breakthroughs in breast cancer treatment, saving thousands of lives each year, 58 per cent of women stop their treatment before the recommended five year duration is up.

Hormone (also called endocrine) treatment is prescribed for women with hormone receptors on their breast cancer cells and, when taken for at least five years, it halves risk of their breast cancer returning. By stopping treatment early, women are putting themselves at risk of their breast cancer returning.

Side-effects are a reason for stopping treatment

The side-effects of hormone treatment are a key reason many women decide to stop their treatment, opting for improved quality of life over the risk their cancer could return.

The severity and types of side effects vary from woman to woman and depend on the type of hormone treatment they are on. Women may experience hot flashes, bone and muscle pain, vaginal dryness and loss of sex drive, tiredness and blood clots to name a few.

Researchers look for answers

A recent world-first study, co-funded by the National Breast Cancer Foundation and Cancer Australia investigated the timing of when women stopped taking their hormone treatment, to understand the role of their general practitioner and clinical specialists in their decision.

The researchers were interested to know if women consulted with clinicians or had checked for cancer recurrence or metastasis at or around the time they decided to discontinue their hormone therapy.

They were looking for insights into whether women and their doctors considered ways to manage the side-effects as well as the continued to benefit from the treatment during their consultation and decision making.

Dr Anna Kemp-Casey from the University of Western Australia, says the study aimed to show whether doctors are prescribing hormone therapies according to clinical guidelines and identify groups of women who are at risk of poor outcomes because they have stopped taking these medicines early or have big gaps in treatment.

“If it’s a matter of the side effects being intolerable, patients need to know they can go back to their doctors, rather than just stopping their medicines,” she says. “We hope our study will also raise awareness among clinicians about monitoring their patients and asking how they’re going with the therapies.

“There’s no point in developing effective treatments if we aren’t using them in the right way,” says Dr Kemp-Casey.

The findings

The study found no direct links between women visiting a doctor and discontinuing their medicine. However, it did see that women who stop taking their treatment early are less likely to see their GP or specialist in the six months after deciding to stop.

For women with receptor positive breast cancer the chance of recurrence later in life is high. Recurrence in most cases leads to death so staying on hormone treatment is these women’s best chance of avoiding dying from breast cancer.

“These are lifesaving medications and if there are reasons that women find it difficult to take them, I encourage them to speak to their doctor. It’s always their choice, of course, but it’s important they have all the information,” says Dr Kemp-Casey.