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  • 21 October 2005
  • Hot flushes deter cancer patients from taking medication


                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      

    Hot flushes caused by hormone therapy leads to some cancer patients avoiding their medication, say researchers at Brighton and Sussex Medical School.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          

    A study of more than 200 breast cancer patients receiving hormone treatments such as tamoxifen found that that nearly half said they sometimes forgot their tablets and more than one in ten deliberately didn't take them at times, citing unwanted side effects as the main reason.

     

    "The principle reason that women are not adhering to their breast cancer treatments is hot flushes and this affects post and pre-menopausal patients," said lead researcher Professor Fallowfield, "Some doctors are unconcerned about this as nobody actually dies of a hot flush; but post menopausal women are embarking on treatment that brings back hot flushes and night sweats when they thought they had finished with them. For pre-menopausal women, possibly taking hormone tablets, who have also been hit by chemotherapy, the sudden onset of menopausal hot flushes and night sweats is a devastating assault on their well-being."

     

    The survey, published in the Annals of Oncology, found that nearly two-thirds of patients would prefer to take a tablet daily and around a quarter would prefer a monthly injection, given that both treatments would be equally effective and have similar side-effects.

     

    However, when presented with a hypothetical situation that injections would result in fewer hot flushes the choices reversed with those opting for tablets slumping to around 27% and those preferring injections soaring to around 60%.

     

    The proportion that would opt for injections also rose - to nearly three-quarters - when they were given a hypothetical situation in which a monthly double injection would control the cancer better. Only a fifth in this case would prefer daily tablets.

     

    "These findings provide two potentially important messages," said Professor Lesley Fallowfield, who is Cancer Research UK Professor of Psychosocial Oncology at Brighton and Sussex Medical School.  "The first is that the distress caused by the side-effect of the hot flushes that all endocrine treatments produce is seriously under-played. The second is that, although the assumption of many health professionals that patients generally dislike injections is correct, most patients are willing to sacrifice preference for efficacy. That information may be important if future research demonstrates a benefit for higher doses, which would necessitate injections."

     

    She added that patients concerns or preferences about treatment are rarely explored and the views of healthcare professionals varied widely.

     

     

    Notes for editors 

     

    Patients' preference for administration of endocrine treatments by injection or tablets: results from a study of women with breast cancer. Annals of Oncology. doi.101093/annonc/mdj044. http://www.annonc.oupjournals.org

    Media inquiries: Margaret Willson, 01536 772181 m.willson@communications.org.uk

     

     

    BSMS press contact  Rehanna Neky (01273) 877844, r.neky@bsms.ac.uk

     

    University of Sussex press office: Jacqui Bealing or Maggie Clune, (01273) 678888, email: press@sussex.ac.uk

     

     

     

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