The information and decision support needs of older women (&gt;75 yrs) facing treatment choices for breast cancer: a qualitative study

Burton, Maria; Collins, Karen; Lifford, Kate; Brain, Katherine Emma; Wyld, Lynda; Caldon, L J M; Gath, Jacqui; Revell, Deirdre; Reed, Malcolm

doi:10.1002/pon.3735

Cited by 43 publications

(76 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An important aspect in this decision process is the opinion of the patient. Burton et al studied the information needs of older women with breast cancer [ 38 •]. All patients wanted information on the impact of the treatment on independence, practicalities of treatment and healthcare professional’s recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…All patients wanted information on the impact of the treatment on independence, practicalities of treatment and healthcare professional’s recommendations. When patients were asked what treatment they preferred, there were two frequent answers: optimal disease control by surgery or minimal disruption of life by primary endocrine therapy [ 38 •]. Another study investigated surgeon’s opinions and concluded that 93% of surgeons believed that primary endocrine therapy should be limited to elderly women who are not fit for surgery.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Primary Endocrine Therapy in Older Women with Breast Cancer

et al. 2017

View full text Add to dashboard Cite

Purpose of ReviewBreast cancer incidence increases with age. In recent years, primary endocrine therapy has been increasingly used as a treatment option for frail elderly women with breast cancer, although surgery is still the guideline-recommended treatment. In this review, we discuss the evidence for primary endocrine therapy versus surgical treatment in older women with early breast cancer.Recent FindingsBoth randomised controlled trials and recent observational studies showed a favourable progression-free survival but not overall survival for surgery plus adjuvant endocrine therapy versus primary endocrine therapy. Information about quality of life with either treatment strategy is so far lacking. Deciding who is fit for surgery and has sufficiently long life expectation to be at risk of disease progression can be supported by performing an individual geriatric assessment.SummaryThis review suggests that primary endocrine therapy is a reasonable alternative to primary surgery in frail older women with breast cancer. Future studies should focus on the long-term effects on quality of life and physical functioning.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Primary Endocrine Therapy in Older Women with Breast Cancer

et al. 2017

View full text Add to dashboard Cite

show abstract

“…These suggestions require thoughtful implementation in order to be realized most optimally, since 1) the clinic environment can be quite busy and individual visits with oncology care providers are shorter than ideal; 2) a one-size-fits-all strategy will not be appropriate for risk communication or for side effect management; and 3) messaging must be continual and consistent to help support ET adherence and persistence for 5–10 years, as recommended. Strategies to address these challenges may include using more lay or peer navigators in the clinic (who can afford to spend more time with each individual patient), 18 , 19 tailoring risk communication 20 and side effects management to better fit with the individual patient’s experience, 21 , 22 and consolidating evidence-based information about effective management of ET-related side effects, including pharmacological and nonpharmacological options. 22 …”

Section: Discussionmentioning

confidence: 99%

Oncology providers’ perspectives on endocrine therapy prescribing and management

Wheeler¹,

Roberts²,

Bloom³

et al. 2016

PPA

View full text Add to dashboard Cite

PurposeAdjuvant endocrine therapy (ET) can reduce the risk of recurrence among females with hormone receptor-positive breast cancer. Overall, initiation and adherence to ET are suboptimal, though reasons are not well described. The study’s objective was to better understand ET decision making, prescribing, and patient management from oncology providers’ perspectives.MethodsUsing purposive sampling, we recruited oncology providers who saw five or more breast cancer patients per week (n=20). We conducted 30–45-minute telephone interviews, using a semistructured guide to elicit perspectives on ET use. We used thematic content analysis to systematically identify categories of meaning and double-coded transcripts using Atlas.ti.ResultsProviders recommend ET to all eligible patients except those with contraindications or other risk factors. Providers base their ET prescribing decisions on the patient’s menopausal status, side effects, and comorbidities. ET is typically discussed multiple times: at the onset of breast cancer treatment and in more detail after other treatment completion. Providers felt that the associated recurrence risk reduction is the most compelling argument for patients during ET decision making. While providers rarely perceived noninitiation as a problem, nonadherence was prevalent, often due to unresolvable side effects.ConclusionFrom the clinicians’ perspectives, side effects from ET are the dominant factor in nonadherence. Efforts to improve adherence should focus on strategies to minimize side effects and ensure clinicians and patients are well informed regarding optimal side effect management. This finding has important implications for novel endocrine regimens that offer improved outcomes through longer duration or more intensive therapy.

show abstract

“…An acknowledgement of having already lived a long life allowed some older women to pragmatically accept their diagnosis [25]. Four studies described how some women expressed shock, anxiety, and self-blame with the diagnosis [21,25,28,31]. Husain et al described how these women particularly feared dying, being left disfigured, not knowing what to do, and leaving others behind [25].…”

Section: Patient Experience During the Breast Cancer Diagnosis Phasementioning

confidence: 99%

“…Older women preferred information from their physicians, with specialist nurses also identified as trusted and useful [21,23]. Four studies reported how older women preferred written information over electronic [21,23,24,32].…”

Section: Patient Experience During the Decision-making Phasementioning

confidence: 99%

Older women’s experience with breast cancer treatment: A systematic review of qualitative literature

et al. 2020

View full text Add to dashboard Cite

Background The experience of older women during breast cancer treatment is insufficiently described by quantitative studies. This study aimed to systematically review qualitative data describing factors that influence older women’s (≥65 years old) experience with breast cancer treatment. Methods A systematic review was performed in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA) principles. MEDLINE, CINAHL, PsycINFO, and EMBASE were searched (inception – 2020). Quality assessment of essential item reporting was performed using the Standards for Reporting Qualitative Research (SRQR) criteria. Common ideas were coded, thematically organized, and synthesized within a theoretical framework. Results Of 7,773 studies identified, twelve were included. The median SRQR score was 13.4 (range 11.3–15.9) (maximum score: 21). Data synthesis revealed that older women experienced breast cancer as a journey with challenges during each phase. During diagnosis, they delayed seeking medical help despite symptoms. Age and experience gave them perspective on the impact of their diagnosis. During decision-making, preconceptions and personal values determined choices. In the treatment phase, women experienced medical and social barriers to care. During the post-treatment phase, many experienced treatment adverse effects, but could move on or compartmentalize as coping mechanisms. Conclusion Older women with breast cancer have unique challenges specific to each phase of their treatment journey. Older women may benefit from proactive treatment discussions with health care providers to address their specific needs, individualize care, and assist with cancer care navigation.

show abstract

The information and decision support needs of older women (>75 yrs) facing treatment choices for breast cancer: a qualitative study

Abstract: M (2014). The information and decision support needs of older women (>75 yrs) facing treatment choices for breast cancer : a qualitative study. 24 (8),[878][879][880][881][882][883][884]

Cited by 43 publications

References 38 publications

Primary Endocrine Therapy in Older Women with Breast Cancer

Primary Endocrine Therapy in Older Women with Breast Cancer

Oncology providers’ perspectives on endocrine therapy prescribing and management

Older women’s experience with breast cancer treatment: A systematic review of qualitative literature

Contact Info

Product

Resources

About

The information and decision support needs of older women (>75 yrs) facing treatment choices for breast cancer: a qualitative study

Abstract: M (2014). The information and decision support needs of older women (>75 yrs) facing treatment choices for breast cancer : a qualitative study. 24 (8),[878][879][880][881][882][883][884]

Cited by 43 publications

References 38 publications

Primary Endocrine Therapy in Older Women with Breast Cancer

Primary Endocrine Therapy in Older Women with Breast Cancer

Oncology providers&rsquo; perspectives on endocrine therapy prescribing and management

Older women’s experience with breast cancer treatment: A systematic review of qualitative literature

Contact Info

Product

Resources

About

Oncology providers’ perspectives on endocrine therapy prescribing and management