"Breast Cancer Patients Not Informed About Treatment Options: Presented at ESMO"
By Jill Stein
ISTANBUL, TURKEY -- September 30, 2006 -- Most women with breast cancer have not been apprised of their treatment options nor are they involved in the decision to start adjuvant endocrine therapy, according to survey results here released at the 31[st European Society for Medical Oncology (ESMO) congress.
Yvette Wengstrom, PhD, head, nursing division, Karolinska Institute, Stockholm, Sweden, presented on September 30th the results of questionnaires completed by 547 postmenopausal women with early breast cancer as part of the Gathering Information on Adjuvant Endocrine therApy Initiative (GAEA). The program aims to delineate women's knowledge and experience of adjuvant endocrine therapy and develop programs aimed at meeting their needs.
"Adjuvant endocrine therapy is used in the treatment of women with hormone-responsive breast cancer, to reduce the risk of recurrence," Dr. Wengstrom, who is also President of the European Oncology Nursing Society, pointed out. "Women generally remain on therapy for 5 years, although there is emerging evidence that suggests the value of lengthening the duration of treatment."
Because of the availability of multiple types of therapy, it is important that patients understand the various options for adjuvant endocrine therapy and their risk-benefit profiles, she added.
The survey, conducted in 9 European countries, found that 22% of women were fully or highly involved in the decision to start adjuvant endocrine therapy, with the lowest levels of involvement documented in women over 60 years of age.
Overall, younger women, women with a higher level of education, and those with Internet access were more likely to have been actively involved in treatment decision making.
In addition, the provision of information about adjuvant endocrine therapy at the start of breast cancer treatment was suboptimal, with 44% of women receiving information on how the treatment works. And 25% were informed about the potential severity of adverse effects, 20% about the duration of adverse effects, and 22% about the risk of a breast cancer recurrence at the end of adjuvant endocrine therapy.
Women who were more actively involved in treatment decision-making were significantly more likely not be told about treatment-related adverse effects, long-term consequences of treatment, and the risk of recurrence compared to those who had little or no involvement (P less than or equal to.05).
Thirty-four percent of those surveyed stated that they were not informed about support services at the time of diagnosis. Even though breast cancer support groups were shown to be a valuable source of information and support for women in the study, 44% were made aware about the existence of such groups when they were diagnosed.
"All patients, regardless of age or educational level, should be helped to understand how adjuvant endocrine therapy works, the different treatments available, the possible side effects and their risk of recurrence so that they can make informed decisions about their treatment," Dr. Wengstrom said. "Better communication between patients and professionals and the development of high-quality patient education materials on adjuvant endocrine therapy will facilitate this process."
The study was funded by Novartis Oncology.
[Presentation title: A European Survey on the Knowledge and Perceptions of Adjuvant Endocrine therapy for Early Breast Cancer. Abstract 262P]
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