Breast cancer survivorship symptom management: current perspective and future development

Abstract

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.

Perspectives of Postmenopausal Breast Cancer Survivors on Adjuvant Endocrine Therapy-Related Symptoms

“…The type and nature of the AET-related symptoms discussed in the focus groups were consistent with previous clinical reports in the literature (Burstein et al, 2010; Hickey et al, 2008; Rechis et al, 2010; Stearns & Hayes, 2002; van Londen, 2013). However, the magnitude of bothersome symptoms was not always anticipated by patients, nor was the extent of interference with sleep, daily life activities, and functioning.…”

“…Breast cancer patients receiving any kind of AET can experience multiple, persistent, symptoms, including vasomotor symptoms, sexual dysfunction, insomnia, fatigue, anxiety, depression, and arthralgias (Amir, Seruga, Niraula, Carlsson, & Ocana, 2011; Burstein et al, 2010; Cella et al, 2006; Fontein et al, 2013; Hickey et al, 2008; Rechis et al, 2010; Stearns & Hayes, 2002; van Londen G, 2013). These symptoms negatively affect survivors' functional status and quality of life (QoL) (Cella et al, 2006; Conde et al, 2005; Ganz, Rowland, Desmond, Meyerowitz, & Wyatt, 1998; Gupta et al, 2006; Land et al, 2006; Perry, Kowalski, & Chang, 2007; Stein, Jacobsen, Hann, Greenberg, & Lyman, 2000; Wilson & Cleary, 1995).…”

“…To date however, there has been little patient-oriented research focused on breast cancer patients’ experiences of AET-related symptoms, how they try to manage symptoms, or how these experiences influence their decision making around AET continuation. This focus on symptom experience may be particularly relevant for those aged 50 and over who are already at risk for menopausal symptoms (Blumel et al, 2000; Chedraui, San Miguel, & Avila, 2009; Schwarz et al, 2007), comorbidities (Baumeister, Balke, & Harter, 2005; Mor, 1992), and/or effects of normal aging (Motl & McAuley, 2010; van Londen et al, 2013). …”

A clinical guide to the management of genitourinary symptoms in breast cancer survivors on endocrine therapy

“…Treatment of sexual complaints may require a multi-modal treatment approach [Vincent, 2015], including the use of lubricants [Hickey et al 2016] and moisturizers, liquid lidocaine [Goetsch et al 2015], ultralow concentration of vaginal estrogen (usually as a last resort, and only upon risk assessment and informed consent from patient) [van Londen et al 2013], counselling and sex therapy (alone or couple-based), PFMT and use of vaginal devices such as dilators or pessaries [North American Menopause Society, 2013] in addition to treatment of underlying depression and anxiety [North American Menopause Society, 2013]. Topical use of testosterone has been suggested but more research in breast cancer patients are needed [North American Menopause Society, 2013].…”

Breast Cancer: Management and Survivorship

“…Breast cancer is the most common noncutaneous form of cancer and principal cause of cancer related deaths among females worldwide [1,2]. Globally with an estimation of more than 1.38 million new cases (around 23%), the breast cancer ranks second (10.9%) among all cancers [1,3]. In 2017, approximately 252,710 women and 2470 men cases were diagnosed with breast cancer.…”