Hot flushes distressing for breast cancer patients

By Megan Rauscher

NEW YORK (Reuters Health) – Hot flushes remain an important
and seriously under-played side effect of tamoxifen and other
hormone treatments for breast cancer, leading some women to
skip their medication, according to a UK survey of 200 women
with breast cancer.

“We underestimate just how distressing the menopausal side
effects of treatment are, and women acknowledge that they take
drug holidays when hot flushes get really bad,” Dr. Lesley
Fallowfield from the University of Sussex who conducted the
survey told Reuters Health.

“Women should let their healthcarers know how much of a
problem they find hot flushes. We need some really serious
investment in research to help prevent or alleviate them,” she
added.

Among the survey findings Fallowfield and her colleagues
found most interesting, nearly two-thirds of women on hormone
therapy said they would prefer to swallow one pill a day while
roughly one quarter said they’d prefer a monthly injection,
given that both treatments would be equally effective and have
similar side-effects.

However, a very different picture emerged when the women
were presented with a hypothetical scenario in which injections
would lead to fewer hot flushes. In this case, the number of
women opting for injections soared to around 60 percent while
those opting for tablets slumped to around 27 percent.

“Disturbingly,” Fallowfield and colleagues write in the
Annals of Oncology, the survey showed that even with a
life-threatening disease like breast cancer, women often fail
to take their medication. In this survey, nearly half of the
women currently on oral medication said they sometimes forget
to take their pills and more than one in ten admitted to
deliberately not taking their medication at times.

Hot flushes are by far the main reason why many women do
not adhere to their breast cancer treatments, Fallowfield said.
Some doctors are unconcerned about this, she admitted, because
“nobody ever died of a hot flush.”

But poor adherence to hormone therapy in breast cancer is a
serious problem, Fallowfield said, as these treatments play a
major role in reducing recurrence of breast cancer and
ultimately saving lives so it is “essential” that women adhere
fully to their treatment regimens.

“Personally,” Fallowfield said in a statement, “I would
give a Nobel prize to the doctor who could eliminate hot
flushes. It really is important.”

SOURCE: Annals of Oncology, October 20, 2005.