Evidence-based approaches for the management of side-effects of adjuvant endocrine therapy in patients with breast cancer

Franzoi, Maria Alice; Agostinetto, Elisa; Perachino, Marta; Mastro, Lucia Del; Azambuja, Evandro de; Vaz-Luís, Inês; Partridge, Ann H.; Lambertini, Matteo

doi:10.1016/s1470-2045(20)30666-5

Cited by 152 publications

(140 citation statements)

References 84 publications

(118 reference statements)

Supporting

Mentioning

107

Contrasting

Unclassified

Order By: Relevance

“…This is supported by research showing that self-efficacy for coping with symptoms can reduce the negative impact of side effects in breast cancer survivors [38]. Interventions to support this include a range of pharmacological and nonpharmacological interventions to control the impact of hot flushes, sexual dysfunction, joint pain, weight management, and fatigue, and have been recently updated according to the best available evidence base [35].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, others tried different brands of the same medication to see if they could tolerate them better. Those that reported continuing with treatment (56%) usually referred to easing of side effects or succeeding with various coping mechanisms: creams, diet, adjunctive medication, psychological therapies, acupuncture, yoga, amongst others, some of which have been recently assessed as evidence-based interventions to alleviate specific symptoms [35]. In addition, fear of cancer recurrence was often mentioned as a reason for continuation.…”

Section: Discussionmentioning

confidence: 99%

“…Often oncologists were able to change their course of treatment from TAM to AI or vice versa, and if tolerant, they continued with the new drug. There is evidence that switching medication within AIs (Letrozole, Anastrozole, and Exemestane) is an effective intervention [35], yet for the association of continuation and switching between TAM and AIs, the evidence is still inconsistent [37].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Extending Adjuvant Endocrine Therapy for 10 Years: A Mixed-Methods Analysis of Women’s Decision Making in an Online Breast Cancer Forum

et al. 2021

View full text Add to dashboard Cite

An additional 5 years of treatment with adjuvant hormonal therapy, to complete 10 years of medication, is recommended to reduce the risk of breast cancer recurrence. Yet professionals and patients should balance this benefit against side effects and toxicities. Little is known about women’s decision making regarding persistence with extended endocrine therapy. In this study, we collected data from a UK online breast cancer forum to analyse patterns of persistence and its associated factors. A mixed-methods exploratory sequential design was used, with a qualitative analysis of text (n = 61 individuals) informing the development of a quantitative instrument to statistically analyse the prevalence of the findings (n = 130). Our findings identified three different groups of women who had to make decisions regarding persistence with treatment: those about to complete 5 years of therapy, those who decided to extend treatment, and those who were initially prescribed 10 years. Factors affecting persistence were, lack of self-efficacy in managing side effects, lack of reassurance about individual risk of recurrence, and impact on quality of life. Interventions such as training of healthcare professionals including risk communication, medication reviews by clinical pharmacists, and re-planning of services in follow-up care, should better support women’s needs in extended hormonal therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Extending Adjuvant Endocrine Therapy for 10 Years: A Mixed-Methods Analysis of Women’s Decision Making in an Online Breast Cancer Forum

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Healthcare professionals supporting the management of breast cancer survivors should counsel women that the evidence supporting most self-management strategies for AET side-effects have a weak and inconsistent evidence base. While many strategies are low risk, patients should be encouraged to seek healthcare professional support if they do not alleviate their symptoms, as evidence supporting pharmacological interventions appears stronger [78].…”

Section: Discussionmentioning

confidence: 99%

Strategies to self-manage side-effects of adjuvant endocrine therapy among breast cancer survivors: an umbrella review of empirical evidence and clinical guidelines

et al. 2021

View full text Add to dashboard Cite

Purpose Side-effects of adjuvant endocrine therapy (AET) are common in breast cancer survivors, and can affect adherence to treatment. We synthesised the evidence for strategies to self-manage these side-effects. Methods We searched for systematic reviews and clinical guidelines on self-management strategies for AET side-effects (arthralgia, fatigue, hot flashes, gastrointestinal discomfort, nausea, vulvovaginal symptoms, and sleep disturbance). We searched oncology organisation’s websites and eight databases (Inception-November 2020). Screening, data extraction and quality assessment were completed independently in duplicate. PROSPERO: 2019CRD4201914001. Results We identified 33 systematic reviews and 18 clinical guidelines. 21% of reviews were high quality, and the average quality score for guidelines was 44%. Evidence for most strategies was absent or weak. There was consensus from a low-quality review and multiple guidelines to recommend moisturisers, gels and lubricants for vulvovaginal symptoms. Evidence was weak for physical activity for self-managing most symptoms, although two high-quality reviews indicated yoga and aerobic exercise could reduce fatigue. Primary research was often biased by weak and underpowered study designs. Eleven reviews did not report information on adverse events. Conclusions Most self-management strategies for breast cancer survivors experiencing side-effects from AET lack evidence. Primary research is needed using high-quality well-powered designs focusing on implementable strategies. Implications for Cancer Survivors Patients and clinicians should be aware that although the risk of harm is low for these self-management strategies, the likelihood of benefit is often unclear. Women should consider moisturisers, gels or lubricants for self-managing vulvovaginal symptoms, and yoga or aerobic exercise for alleviating fatigue.

show abstract

“…Survivorship starts at diagnosis and continues throughout the entire lifespan 17 during which patients can experience the long-term side effects of previous anticancer treatments. For young women, treatment-related POI represents an important concern and should be discussed during the first medical consultation.…”

Section: Oncofertility Counsellingmentioning

confidence: 99%

Comparing the Gonadotoxicity of Multiple Breast Cancer Regimens: Important Understanding for Managing Breast Cancer in Pre-Menopausal Women

Martelli¹,

Latocca²,

Ruelle³

et al. 2021

BCTT

Self Cite

View full text Add to dashboard Cite

Over the last several decades, improvements in breast cancer treatment have contributed to increased cure rates for women diagnosed with this malignancy. Consequently, great importance should be paid to the long-term side effects of systemic therapies. For young women (defined as per guideline ≤40 years at diagnosis) who undergo chemotherapy, one of the most impactful side effects on their quality of life is premature ovarian insufficiency (POI) leading to fertility-related problems and the side effects of early menopause. Regimens, type, and doses of chemotherapy, as well as the age of patients and their ovarian reserve at the time of treatment are major risk factors for treatment-induced POI. For these reasons, childbearing desire and preservation of ovarian function and/or fertility should be discussed with all premenopausal patients before planning the treatments. This manuscript summarizes the available fertility preservation techniques in breast cancer patients, the risk of treatment-induced POI with different anticancer treatments, and the possible procedures to prevent it. A special focus is paid to the role of oncofertility counseling, as a central part of the visit in this setting, during which the patient should receive all the information about the potential consequences of the disease and of the proposed treatment on her future life.

show abstract

Evidence-based approaches for the management of side-effects of adjuvant endocrine therapy in patients with breast cancer

Cited by 152 publications

References 84 publications

Extending Adjuvant Endocrine Therapy for 10 Years: A Mixed-Methods Analysis of Women’s Decision Making in an Online Breast Cancer Forum

Extending Adjuvant Endocrine Therapy for 10 Years: A Mixed-Methods Analysis of Women’s Decision Making in an Online Breast Cancer Forum

Strategies to self-manage side-effects of adjuvant endocrine therapy among breast cancer survivors: an umbrella review of empirical evidence and clinical guidelines

Comparing the Gonadotoxicity of Multiple Breast Cancer Regimens: Important Understanding for Managing Breast Cancer in Pre-Menopausal Women

Contact Info

Product

Resources

About