Qualitative assessment of information and decision support needs for managing menopausal symptoms after breast cancer

Abstract

PurposeFor breast cancer (BrCa) survivors, premature menopause can result from conventional cancer treatment. Due to limited treatment options, survivors often turn to complementary therapies (CTs), but struggle to make informed decisions. In this study, we identified BrCa survivors’ CT and general information and decision-making needs related to menopausal symptoms.MethodsThe needs assessment was informed by interpretive descriptive methodology. Focus groups with survivors (n = 22) and interviews with conventional (n = 12) and CT (n = 5) healthcare professionals (HCPs) were conducted at two Canadian urban cancer centers. Thematic, inductive analysis was conducted on the data.ResultsMenopausal symptoms have significant negative impact on BrCa survivors. Close to 70 % of the sample were currently using CTs, including mind-body therapies (45.5 %), natural health products (NHPs) and dietary therapies (31.8 %), and lifestyle interventions (36.4 %). However, BrCa survivors reported inadequate access to information on the safety and efficacy of CT options. Survivors also struggled in their efforts to discuss CT with HCPs, who had limited time and information to support women in their CT decisions. Concise and credible information about CTs was required by BrCa survivors to support them in making informed and safe decisions about using CTs for menopausal symptom management.ConclusionsHigh quality research is needed on the efficacy and safety of CTs in managing menopausal symptoms following BrCa treatment. Decision support strategies, such as patient decision aids (DAs), may help synthesize and translate evidence on CTs and promote shared decision-making between BrCa survivors and HCPs about the role of CTs in coping with menopause following cancer treatment.

Body image mediates the relationship between post-surgery needs and health-related quality of life among women with breast cancer: a cross-sectional study

“…The two primary needs (i.e., respect/self-esteem and rehabilitation needs) indicate that patients received requisite acceptance and care from health professionals and family members. However, the most commonly important unsatisfied need was information, further indicating that information is one of the most critical support sources during treatment and rehabilitation [18][19][20]. It suggests that improving access to information must be seriously considered via target interventions.…”

Information Needs of Women with Breast Cancer: A Review of the Literature

“…Interruptions during recovery can increase the burden of the disease and respond to this need is very important in initiating treatment [32]. Among the different patient groups, literate and employed women and survivors at the age of menopause were among the groups whose information needs on complementary therapies was important [32,51]. In the Miyashita study, only 25.2% of participants received information about dietary supplements and alternative diets [52].…”

Opportunities for personalised follow‐up care among patients with breast cancer: A scoping review to identify preference‐sensitive decisions

“…Menopausal symptoms following from breast cancer therapies (Balneaves et al, 2016;Sayakhot et al, 2012). 0) Identification and treatment of menopausal symptoms.…”

“…4) The potential risks of hormone replacement therapy, which is the customary and most effective treatment option, could be high. This option is usually avoided for breast cancer patients as it increases recurrence risks (Balneaves et al, 2016;Sayakhot et al, 2012). 3) Although 80% of women were given breast cancer information, only 54% were given menopause information at diagnosis.…”

“…3) In addition to being inundated by the large volume of information, the women were frustrated by the lack of conclusive information, particularly regarding complementary therapies. The majority of women were also frustrated by their inability to differentiate between credible and non-credible information sources (Balneaves et al, 2016 1) One-third of mastectomy-treated patients choose delayed reconstruction as they focussed on more on other treatment modalities (Alderman et al, 2011;Flitcroft et al, 2016). Two-thirds of patients without reconstruction said this procedure was of no importance to them (Alderman et al, 2011); other reasons were that it was were "unnecessary" and "being practical" (Flitcroft et al, 2016), poor timing (25%), indecision (17%), desired method of reconstruction not available at treating facility (10%), persistent obesity (8.3%), continued smoking (4%), and reason not specified (35%) (Ogrodnik et al, 2016), it is not essential for their mental state, or they fully accepted their appearance after mastectomy (Zielinski et al, 2015).…”