Breast Cancer Therapy Hard to Complete for Some

Fewer than 50 percent of women with early-stage breast cancer complete their full prescribed course of hormone treatment, says a new study. This puts them at risk for cancer recurrence, according to the report.

Women stop hormone therapy early for a variety of reasons, including side effects such as joint pain, hot flashes, and fatigue, researchers explain in the Journal of Clinical Oncology.

In addition, reasons may include being unaware of benefits of the therapy, and the high cost of medications and insurance co-payments.

"Physicians are often unaware of patient compliance, and this is becoming an increasingly important issue in cancer," says lead author Dr. Dawn Hershman, at Columbia University Medical Center.

Learning the Specifics

In the study, researchers looked at the pharmacy records of 8,769 women diagnosed with stage 1, 2, or 3 hormone-sensitive breast cancer between 1996 and 2007.

Each woman filled at least one prescription for hormone therapy within a year of breast cancer diagnosis. The women used tamoxifen (43 percent), aromatase inhibitors (26 percent), or both (30 percent).

The study shows about 49 percent of the women finished their full prescribed regimen of hormone therapy. However, after 4.5 years, 32 percent of the women had stopped taking their hormone therapy.

Of those who did not stop, 72 percent finished on schedule (meaning they took their medication more than 80 percent of the time).

Those most likely to stop hormone therapy early were found to be women younger than age 40.

Among the young women and women older than 75, those who had a lumpectomy rather than a mastectomy, and those who had other medical illnesses were more likely to stop the therapy.

Those most likely to complete 4.5 years of hormone therapy included several groups: Asian/Pacific Islanders, women who had undergone chemotherapy in the past, those who were married, and women who had longer prescription refill intervals.

Efforts Needed to Help Women

Studies have found that adjuvant hormonal therapy for hormone-sensitive breast cancer is key in reducing recurrence and death, the study authors say.

"It's very disturbing that patients under 40 had the highest discontinuation rates because those patients have the longest life expectancy," says Dr. Hershman.

Ways to help women comply with the full term of hormonal therapy are needed, especially for younger women, say the study authors.

"If we can better understand the issues surrounding compliance with hormonal therapy, this might help us understand why patients don't adhere to other treatments that are moving out of the clinic and into the home, such as oral chemotherapy,” she says.

Always consult your physician or other healthcare provider for more information.