Patients’ preferences for adjuvant endocrine therapy in early breast cancer: what makes it worthwhile?

Abstract

Adjuvant endocrine therapy improves recurrence and survival rates, but has side effects and is inconvenient. The aim of this study was to determine the preferences of premenopausal women who had adjuvant endocrine therapy in a randomised trial. In all, 85 (or eighty-five) women completed semistructured interviews 6 -30 months after finishing adjuvant endocrine therapy. Hypothetical scenarios based on known potential survival times (5 or 15 years) and rates (60% or 80% at 5 years) without adjuvant endocrine therapy were used to determine the smallest gains women judged necessary to make their adjuvant endocrine therapy worthwhile. Although a third of the women considered gains of 1% in survival rates or 6 months in survival times sufficient to make their adjuvant endocrine therapy worthwhile, more than half the women required gains of at least 5% in survival rates or 3 years in survival time as necessary to make adjuvant endocrine therapy worthwhile. Larger benefits were required by women who had longer treatment, worse side effects, and by those who were treated with goserelin alone. The route of administration (tablet vs injection) did not affect preferences and some women judged small benefits sufficient to make their adjuvant endocrine therapy worthwhile, but many women required larger benefits than their counterparts in similar studies of preferences for adjuvant chemotherapy.

Are the colors and shapes of current psychotropics designed to maximize the placebo response?

“…More recently, Fallowfield et al (2005) reported that female breast cancer patients who preferred to receive endocrine therapy by injections rather than tablets more frequently mentioned adherence and efficacy as the reason for their preference as compared to those who preferred tablets over injections. Although both Fallowfield et al and Duric et al (2005) reported trends towards a higher percentage of patients favoring tablets over injections, close to 50% of patients in the Fallowfield et al study who preferred tablets also mentioned missing doses on occasion.…”

Factors affecting health-related quality of life in women with recurrent breast cancer in Korea

“…These results are consistent with those of prior studies. Women receiving adjuvant chemotherapy for breast cancer consider that the benefits of such treatment outweigh the significant side-effects and inconvenience [11,12]. Adjuvant endocrine therapy improves overall survival in women with hormonereceptor positive breast cancer [18].…”

Quality of life issues in relation to the aromatase inhibitor

“…many side-effects are under-recognized, under-reported and consequently, under-treated [3,4]. The litany of side-effects associated with cytotoxic treatment for example nausea, vomiting and alopecia, are fairly immediate and obvious, and many will abate at the end of the course of treatment.…”