SUMMARY Increasing numbers and longevity of cancer survivors has furthered our insight into the factors affecting their health outcomes, suggesting that multiple factors play a role (e.g., effects of cancer treatments and health behaviors). Emotional and physical symptoms may not always receive sufficient attention. In this short narrative review highlighting recent literature, we describe the most common physical and emotional symptoms of breast cancer survivors aged 50 years and older and outline a multidisciplinary symptom management approach, regardless of symptom etiology.

Medication adherence to oral cancer therapy is a critical component to achieving optimal patient outcomes. As the US population ages, growing numbers of patients will be prescribed oral cancer therapy regimens, highlighting the need for innovative and scalable solutions. Clinical pharmacists offer tremendous promise to help patients improve their adherence to oral cancer therapy. Moreover, addition of oral chemotherapy to Centers for Medicare & Medicaid Services (CMS) medication adherence quality measures has the potential to improve care and result in better therapeutic outcomes with fewer costs for patients and payers. Future research is needed to test the use of pharmacist-managed interventions to improve adherence to oral cancer therapy.

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To prospectively assess the impact of gene expression-based assay Breast Cancer Index (BCI) on extended endocrine therapy (EET) decision-making. Patients & methods: The BCI-tested samples from primary tumors (Stage I-III, hormone receptor positive breast cancer, >3.5 year endocrine therapy). Patients and physicians completed questionnaires on EET preferences and decision conflict. Using these data, a fact-based economic model was developed to project the cost impact of BCI. Results: The BCI results affected treatment recommendations for 42/141 patients (overall mean, 62 year; 83% postmenopausal; 63% Stage I). Patient decision conflict decreased pre-to post-test. The BCI-related projected net savings (US$5190/patient) was robust under sensitivity analysis. Conclusion: Incorporating BCI into clinical practice meaningfully impacted physician EET recommendations and decreased patient decision conflict, with projected cost savings.