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Camejo N, Castillo C, Santana D, Argenzio L, Amarillo D, Herrera G, Guerrina M, Krygier G. Arthralgia and myalgia associated with aromatase inhibitors: frequency and characterization in real-life patients. Ecancermedicalscience 2024; 18:1697. [PMID: 38774562 PMCID: PMC11108049 DOI: 10.3332/ecancer.2024.1697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Indexed: 05/24/2024] Open
Abstract
Introduction Adjuvant treatment with aromatase inhibitors (AI) in oestrogen receptor-positive and/or progesterone receptor-positive breast cancer (BC) has been shown to increase overall survival. However, arthralgias and myalgias are common adverse effects in patients treated with AI. Objective To evaluate the frequency and characteristics of arthralgias and myalgias in patients with early BC-treated adjuvantly with AI in the Mastology Unit of the Oncology Service of the Hospital de Clínicas and the Departmental Hospital of Soriano. Materials and methods A prospective, cross-sectional and descriptive study was performed. A questionnaire was administered to patients to assess the presence and characteristics of arthralgias and myalgias associated with AI. Statistical analysis 'Age' was described with measures of central tendency and dispersion. Qualitative variables were presented in absolute and relative frequencies. Logistic models were used to evaluate the association between patient characteristics, tumour characteristics, treatment characteristics and the presence of pain. Results were presented by odds ratio and p-value, using R software (version 4.1.2) with a significance threshold of 5%. Results 83 patients were included, with a median age of 69 years. 75.9% presented arthralgias and/or myalgias related to treatment, with an average intensity of 5-7. 80.9% received non-steroidal anti-inflammatory drugs (NSAIDs), achieving satisfactory analgesia. The presence of arthralgias and myalgias was significantly associated with age and time since the last menstrual period (LMP), being more frequent in patients older than 50 years and those with more than 5 years since the LMP. Conclusion Approximately 70% of the patients presented arthralgias or myalgias. These findings suggest a possible role of oestrogen withdrawal in its mechanism of development. Multidisciplinary and translational research is crucial to evaluate the ethology and therapeutic options for patients with AI-related arthralgia.
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Affiliation(s)
- Natalia Camejo
- Oncology Service, Hospital de Clínicas Dr. Manuel Quintela, Montevideo 11600, Uruguay
- Oncology Service, Departmental Hospital of Soriano “Zoilo A. Chelle” – U.E 30. Soriano, 75000, Uruguay
| | - Cecilia Castillo
- Oncology Service, Hospital de Clínicas Dr. Manuel Quintela, Montevideo 11600, Uruguay
| | - Diego Santana
- Oncology Service, Hospital de Clínicas Dr. Manuel Quintela, Montevideo 11600, Uruguay
| | - Lucia Argenzio
- Oncology Service, Hospital de Clínicas Dr. Manuel Quintela, Montevideo 11600, Uruguay
| | - Dahiana Amarillo
- Oncology Service, Hospital de Clínicas Dr. Manuel Quintela, Montevideo 11600, Uruguay
| | - Guadalupe Herrera
- Department of Quantitative Methods, School of Medicine, Montevideo 11800, Uruguay
| | - Maria Guerrina
- Oncology Service, Hospital de Clínicas Dr. Manuel Quintela, Montevideo 11600, Uruguay
| | - Gabriel Krygier
- Oncology Service, Hospital de Clínicas Dr. Manuel Quintela, Montevideo 11600, Uruguay
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Li X, Wei T, Zhang Y, Ren H, Liu X. Health-promoting behaviours and psychological distress in breast cancer with endocrine therapy: Mediating roles of menopausal symptoms and social support. Post Reprod Health 2024; 30:29-38. [PMID: 38379167 DOI: 10.1177/20533691241232055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To investigate the relationship between health-promotion behaviour and psychological distress and whether menopausal symptoms and social support mediate these relationships in patients with breast cancer receiving endocrine therapy. STUDY DESIGN This was a cross-sectional study involving convenience sampling that involved 226 patients with breast cancer. MAIN OUTCOME MEASURES Participants were investigated by self-reporting questionnaires that included demographic and clinical information, the Kessler psychological distress scale, the Health-Promoting Lifestyle Profile Ⅱ, the Menopause Rating Scale, and the Perceived Social Support Survey to measure psychological distress, health-promoting behaviour, menopausal symptoms, and social support, respectively. Mediation analyses were conducted with the bootstrapping method to test for mediating factors. RESULTS In total, 78.7% patients reported that they were suffering from psychological distress. Their health-promoting behaviours were directly and negatively associated with psychological distress. In addition, health-promoting behaviour had a significant indirect effect on psychological distress through menopausal symptoms and social support. Mediating effects accounted for 34.8% and 27.6% of the total effect, respectively. CONCLUSIONS There was a high prevalence of psychological distress in patients with breast cancer receiving endocrine therapy. Menopausal symptoms and social support mediated the association between health-promoting behaviour and psychological distress. Health professionals should evaluate menopausal symptoms and health lifestyles, and provide professional interventions to increase health-promoting behaviours and manage unpleasant somatic symptoms for patients and their caregivers; these actions may improve their psychological distress.
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Affiliation(s)
- Xia Li
- Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Tingting Wei
- Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Yan Zhang
- Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Hailing Ren
- Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Department of Breast Oncology, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Xinyu Liu
- Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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Zhao D, Ma Q, Li G, Qin R, Meng Y, Li P. Treatment-induced menopause symptoms among women with breast cancer undergoing chemotherapy in China: a comparison to age- and menopause status-matched controls. Menopause 2024; 31:145-153. [PMID: 38086004 DOI: 10.1097/gme.0000000000002296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
OBJECTIVE Whether women with breast cancer experience more severe menopause symptoms than comparison women without a history of breast cancer diagnosis remains unclear. We aimed to investigate whether women with breast cancer undergoing chemotherapy experience more severe menopause symptoms than comparison women and explore various factors influencing menopause symptoms in women with breast cancer undergoing chemotherapy. METHODS This cross-sectional observational study recruited 423 women with breast cancer undergoing chemotherapy and 1,829 community women without breast cancer. All participants completed a questionnaire assessing menopause symptoms using the Menopause Rating Scale and general characteristics (eg, sociodemographic and clinical data). Propensity score matching was used to reduce the confounders between the two groups. Student's t test or Mann-Whitney U test and chi-square tests were used to compare the differences in menopause symptoms between the two groups. Multivariate linear regression analysis was performed to explore various factors influencing menopause symptoms in women with breast cancer undergoing chemotherapy. RESULTS After propensity score matching, 808 participants were included. The mean ages of women with breast cancer undergoing chemotherapy and comparison women were 49.58 and 49.10 years, respectively. Women with breast cancer undergoing chemotherapy experienced significantly more severe vasomotor symptoms than comparison women. However, comparison women had higher Menopause Rating Scale scores and more severe menopause symptoms than women with breast cancer undergoing chemotherapy. Age, occupational status, chemotherapy-induced amenorrhea, family history of cancer, chemotherapy stage, mindfulness, resiliency, and illness perception were associated with menopause symptoms in women with breast cancer undergoing chemotherapy. CONCLUSIONS Vasomotor symptoms are prominent among women with breast cancer undergoing chemotherapy. Understanding the factors contributing to menopause symptoms is crucial for healthcare practitioners to develop supportive guidelines for the well-being of women with breast cancer undergoing chemotherapy.
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Affiliation(s)
- Di Zhao
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Qinghua Ma
- Department of Breast Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Guopeng Li
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Rui Qin
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Yingtao Meng
- Nursing Department, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Ping Li
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
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Ma Y, Lu Z, Qiu J, Luo H, Tang L, Li Y, Li P. Symptom experience in endocrine therapy for breast cancer patients: A qualitative systematic review and meta-synthesis. Asia Pac J Oncol Nurs 2024; 11:100364. [PMID: 38293603 PMCID: PMC10827404 DOI: 10.1016/j.apjon.2023.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024] Open
Abstract
Objective The purpose of this study was to systematically integrate the experience of symptoms of breast cancer patients receiving endocrine therapy, analyze the patients' understanding and coping status of symptoms, and provide information for the development of targeted symptom management measures. Methods We searched databases including PubMed/MEDLINE, MEDLINE (Ovid), Web of Science, EMBASE (Ovid), CINAHL (EBSCO), and ProQuest from inception to September 25, 2023. Literature was screened and analyzed using Endnote software, evaluated using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research, and the results were integrated using JBI's Pooled Integration Methodology. Results Three composite findings were derived from 10 studies: symptom distress during endocrine therapy; coping in symptom experience; and support needs. Conclusions Emphasis should be placed on the symptomatic experience of breast cancer patients undergoing endocrine therapy, and effective interventions should be developed to improve patients' medication compliance and quality of life. Finally, the long-term survival rate of patients is improved. Systematic review registration CRD42023466073.
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Affiliation(s)
- Yan Ma
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhenqi Lu
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiajia Qiu
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Huiyu Luo
- Department of Nursing, Fujian Cancer Hospital, Fujian, China
| | - Lichen Tang
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yun Li
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ping Li
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Li H, Schlaeger JM, Patil CL, Danciu O, Chen Z, Lif N, Gao S, Doorenbos AZ. Feasibility of implementing acupuncture in medically underserved breast cancer survivors (FAB): A protocol. Contemp Clin Trials 2024; 136:107387. [PMID: 37972754 PMCID: PMC10922295 DOI: 10.1016/j.cct.2023.107387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/24/2023] [Accepted: 11/04/2023] [Indexed: 11/19/2023]
Abstract
Nearly 94% of breast cancer survivors experience one or more symptoms or side effects during or after endocrine therapy. Joint pain, hot flashes, sleep disturbance, fatigue, depression, and anxiety are the most common concurrent symptoms, some of which can persist for 5 to 10 years. Acupuncture is a holistic modality that addresses multiple symptoms and side effects in a single therapy. Acupuncture has not yet been investigated for its effectiveness in treating the multiple symptoms experienced by breast cancer survivors receiving endocrine therapy. Medically underserved breast cancer survivors typically have limited access to acupuncture. The barriers limiting access to acupuncture need to be removed to enable equal access to breast cancer survivors for this evidence-based treatment. Thus, we developed a randomized controlled trial with a 5-week acupuncture intervention versus usual care for medically underserved breast cancer survivors. Mixed methods (semi-structured interviews, surveys, study notes) will be used to obtain in-depth understanding of barriers and facilitators for eventual implementation of the acupuncture intervention. This study will facilitate the widespread implementation, dissemination, and sustained utilization of acupuncture for symptom management among medically underserved breast cancer survivors receiving endocrine therapy.
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Affiliation(s)
- Hongjin Li
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA; University of Illinois Cancer Center, 818 South Wolcott Ave, Chicago, IL 60612, USA.
| | - Judith M Schlaeger
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
| | - Crystal L Patil
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
| | - Oana Danciu
- University of Illinois, Chicago College of Medicine, Department of Hematology/Oncology, 820 S. Wood Street Suite 172 CSN (M/C 712), Chicago, IL 60612, USA
| | - Zhengjia Chen
- University of Illinois Cancer Center, 818 South Wolcott Ave, Chicago, IL 60612, USA
| | - Natalie Lif
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
| | - Shuang Gao
- University of Illinois, Chicago College of Medicine, 1853 W Polk St, Chicago, IL 60612, USA
| | - Ardith Z Doorenbos
- University of Illinois Cancer Center, 818 South Wolcott Ave, Chicago, IL 60612, USA; University of Illinois, Chicago College of Nursing, Department of Biobehavioral Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
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Lund-Jacobsen T, Bentsen L, Schwarz P, Knop AS, Pappot H, Piil K. Aromatase Inhibitor-Related Symptoms Reported by Postmenopausal Women with Nonmetastatic, Estrogen Receptor-Positive Breast Cancer: A Systematic Review. Semin Oncol Nurs 2023; 39:151487. [PMID: 37612223 DOI: 10.1016/j.soncn.2023.151487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE The objective of this systematic review was to establish an overview of aromatase inhibitor-related symptoms reported by postmenopausal women with nonmetastatic, estrogen receptor-positive breast cancer. DATA SOURCES Eight databases (PubMed, Cochrane, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Ovid EMBASE, Ovid MEDLINE, PsycINFO, Scopus, and Web of Science) were searched for trials published between January 2004 and November 2021. Inclusion criteria were studies exploring patient-reported aromatase inhibitor-related symptoms in postmenopausal women with nonmetastatic estrogen receptor-positive breast cancer. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Mixed Method Appraisal Tool were used to rate the quality of the trials included. Of 325 full-text papers, 10 were included. Patient-reported symptoms were clustered by using the European Organization for Research and Treatment of Cancer Quality of Life C30 questionnaire domains. Additional domains were used to cluster other symptoms mentioned: menopausal, sex-related, body alteration, and eye-related. The following clusters were the most frequently presented: sex-related (14 symptoms), pain (9 symptoms), insomnia (5 symptoms), and menopausal (5 symptoms). CONCLUSION The target group reported a variety of symptoms related to aromatase inhibitors. No tools are currently available to measure all the symptoms reported, indicating a need to revise the tools to acknowledge additional symptoms. Prospective studies are needed to investigate the prevalence of aromatase inhibitor-related symptoms in women with breast cancer. IMPLICATION FOR NURSING PRACTICE Identification of patient-reported clinically relevant symptoms can enable targeted symptom assessment and management strategies for women with breast cancer undergoing aromatase inhibitor treatment.
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Affiliation(s)
- Trine Lund-Jacobsen
- BSN, MSc, PhD student, Department of Endocrinology and Metabolism, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Line Bentsen
- MD, PhD student, Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Peter Schwarz
- Professor, MD, DMSc, Department of Endocrinology and Metabolism, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Denmark, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ann Søegaard Knop
- MD, PhD, Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Helle Pappot
- Professor, MD, DMSc, Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karin Piil
- MHScN, associate professor, Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark and Department of Publich Health, Faculty of Health, University of Aarhus, Aarhus C, Denmark
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Jing F, Zhu Z, Qiu J, Tang L, Xu L, Xing W. Symptom Profiles and Related Factors Among Breast Cancer Patients Undergoing Endocrine Therapy: A Latent Profile Analysis. Cancer Nurs 2023; 46:E297-E304. [PMID: 37607380 DOI: 10.1097/ncc.0000000000001125] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND To provide person-centered symptom management, the interindividual variability in breast cancer patients merits further exploration. However, how sociodemographic and clinical characteristics influence symptom profile membership in endocrine therapy for breast cancer is still unknown. OBJECTIVES This study aimed to explore symptom profiles of breast cancer patients undergoing endocrine therapy and to identify sociodemographic and clinical characteristics among symptom subgroup members. METHODS A cross-sectional study was conducted, and participants were invited to complete a general information questionnaire and Functional Assessment of Cancer Therapy-Endocrine Subscale. Latent profile analysis, univariate analysis, and multinomial logistic regression were performed to explore symptom profiles and identify interindividual variability. RESULTS Three distinct subgroups were identified: "all high" (9.8%), "all moderate but high sexual symptoms" (25.4%), and "all low" (64.8%). Age, body mass index, main payment source for medical expenses, type of endocrine therapy, and history of breast cancer treatment were factors that determined membership in these 3 symptom subgroups. CONCLUSION Patients' demographic and clinical characteristics were associated with their endocrine therapy-related symptom profiles. In general, those younger in age who pay out of pocket for medical expenses, use aromatase inhibitors, present a history of chemotherapy, and have a higher body mass index have a greater risk of symptom burden. IMPLICATION FOR PRACTICE The findings of this study will contribute to implementing individual cancer care based on the characteristics and needs of patient subgroups, which may improve the allocation of medical resources and provide interventions tailored to patients' unique needs.
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Affiliation(s)
- Feng Jing
- Author Affiliations: School of Nursing and Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Fudan University (Ms Feng Jing, Mr Zheng Zhu, Ms Lei Xu, and Ms Weijie Xing); Department of Nursing Administration, Shanghai Cancer Center, Fudan University (Ms Jiajia Qiu); Department of Oncology, Shanghai Medical College, Fudan University (Ms Jiajia Qiu and Dr Lichen Tang); and Department of Breast Surgery, Shanghai Cancer Center, Fudan University (Dr Lichen Tang), Shanghai, China
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Jing F, Zhu Z, Qiu J, Tang L, Xu L, Xing W, Hu Y. Symptom Clusters and Quality of Life in Patients With Breast Cancer Receiving Endocrine Therapy in China. Semin Oncol Nurs 2023; 39:151443. [PMID: 37173235 DOI: 10.1016/j.soncn.2023.151443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES Breast cancer patients undergoing endocrine therapy experience various symptoms that have long-term effects on their quality of life. However, which symptom clusters are expressed and affect patients' quality of life remain significantly controversial. Therefore, we aimed to explore symptom clusters among breast cancer patients receiving endocrine therapy and identify the impact of these clusters on their quality of life. DATA SOURCES This secondary analysis of data from a cross-sectional study aimed to explore the symptom experiences and quality of life of breast cancer patients receiving endocrine therapy. The participants were invited to complete the Functional Assessment of Cancer Therapy-Breast (FACT-B) and Endocrine Subscale (ES). Principal component analysis, Spearman correlation analyses, and multiple linear regression were used to explore symptom clusters and identify their influence on quality of life. CONCLUSION Data from 613 participants were obtained, and 19 symptoms were included in the principal component analysis, which identified five symptom clusters: the systemic, pain and emotional, sexual, vaginal, and vasomotor symptom clusters. Adjustment for covariates revealed that the systemic and pain and emotional symptom clusters were negative predictors of quality of life. The fitted model explained approximately 38.1% of the variance. IMPLICATIONS FOR NURSING PRACTICE This study demonstrated that breast cancer patients receiving endocrine therapy experienced symptoms that tended to occur in five clusters (i.e., systemic, pain and emotional, sexual, vaginal, and vasomotor symptoms). Developing interventions for the systemic and pain and emotional symptom clusters may effectively improve patients' quality of life.
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Affiliation(s)
- Feng Jing
- Fudan University School of Nursing, Shanghai, China and Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China
| | - Zheng Zhu
- Fudan University School of Nursing, Shanghai, China and Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China
| | - Jiajia Qiu
- Department of Nursing Administration, Shanghai Cancer Center, Fudan University, Shanghai, China and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lichen Tang
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, China and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lei Xu
- Fudan University School of Nursing, Shanghai, China and Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China
| | - Weijie Xing
- Fudan University School of Nursing, Shanghai, China and Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China.
| | - Yan Hu
- Fudan University School of Nursing, Shanghai, China and Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China.
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Jing F, Zhu Z, Qiu J, Tang L, Xu L, Xing W, Hu Y. Contemporaneous symptom networks and correlates during endocrine therapy among breast cancer patients: A network analysis. Front Oncol 2023; 13:1081786. [PMID: 37064124 PMCID: PMC10103712 DOI: 10.3389/fonc.2023.1081786] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
Background Endocrine therapy-related symptoms are associated with early discontinuation and quality of life among breast cancer survivors. Although previous studies have examined these symptoms and clinical covariates, little is known about the interactions among different symptoms and correlates. This study aimed to explore the complex relationship of endocrine therapy-related symptoms and to identify the core symptoms among breast cancer patients. Methods This is a secondary data analysis conducted based on a multicenter cross-sectional study of 613 breast cancer patients in China. All participants completed the 19-item Chinese version of the Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES). Multivariate linear regression analysis was performed to identify significant factors. A contemporaneous network with 15 frequently occurring symptoms was constructed after controlling for age, payment, use of aromatase inhibitors, and history of surgery. Network comparison tests were used to assess differences in network structure across demographic and treatment characteristics. Results All 613 participants were female, with an average age of 49 years (SD = 9.4). The average duration of endocrine therapy was 3.6 years (SD = 2.3) and the average symptom score was 18.99 (SD = 11.43). Irritability (n = 512, 83.52%) and mood swings (n = 498, 81.24%) were the most prevalent symptoms. Lost interest in sex (mean = 1.95, SD = 1.39) and joint pain (mean = 1.57, SD = 1.18) were the most severe symptoms. The edges in the clusters of emotional symptoms ("irritability-mood swings"), vasomotor symptoms ("hot flashes-cold sweats-night sweats"), vaginal symptoms ("vaginal discharge-vaginal itching"), sexual symptoms ("pain or discomfort with intercourse-lost interest in sex-vaginal dryness"), and neurological symptoms ("headaches-dizziness") were the thickest in the network. There were no significant differences in network structure (P = 0.088), and global strength (P = 0.330) across treatment types (selective estrogen receptor modulators vs. aromatase inhibitors). Based on an evaluation of the centrality indices, irritability and mood swings appeared to be structurally important nodes after adjusting for the clinical covariates and after performing subgroup comparisons. Conclusion Endocrine therapy-related symptoms are frequently reported issues among breast cancer patients. Our findings demonstrated that developing targeted interventions focused on emotional symptoms may relieve the overall symptom burden for breast cancer patients during endocrine therapy.
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Affiliation(s)
- Feng Jing
- School of Nursing, Fudan University, Shanghai, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China
| | - Jiajia Qiu
- Department of Nursing Administration, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Lichen Tang
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Lei Xu
- School of Nursing, Fudan University, Shanghai, China
| | - Weijie Xing
- School of Nursing, Fudan University, Shanghai, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China
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Ge Y, Zhan Z, Ye M, Jin X. The crosstalk between ubiquitination and endocrine therapy. J Mol Med (Berl) 2023; 101:461-486. [PMID: 36961537 DOI: 10.1007/s00109-023-02300-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 03/25/2023]
Abstract
Endocrine therapy (ET), also known as hormone therapy, refers to the treatment of tumors by regulating and changing the endocrine environment and hormone levels. Its related mechanism is mainly through reducing hormone levels and blocking the binding of hormones to corresponding receptors, thus blocking the signal transduction pathway to stimulate tumor growth. However, with the application of ET, some patients show resistance to ET, which is attributed to abnormal accumulation of hormone receptors (HRs) and the production of multiple mutants of HRs. The targeted degradation of abnormal accumulation protein mediated by ubiquitination is an important approach that regulates the protein level and function of intracellular proteins in eukaryotes. Here, we provide a brief description of the traditional and novel drugs available for ET in this review. Then, we introduce the link between ubiquitination and ET. In the end, we elaborate the clinical application of ET combined with ubiquitination-related molecules. KEY MESSAGES: • A brief description of the traditional and novel drugs available for endocrine therapy (ET). • The link between ubiquitination and ET. • The clinical application of ET combined with ubiquitination-related molecules.
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Affiliation(s)
- Yidong Ge
- The Department of Medical Oncology, The First Hospital of Ningbo University, Ningbo University, Ningbo, 315010, China
- Department of Biochemistry and Molecular Biology, Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Medical School of Ningbo University, Ningbo University, Ningbo, Zhejiang, 315211, China
| | - Ziqing Zhan
- The Department of Medical Oncology, The First Hospital of Ningbo University, Ningbo University, Ningbo, 315010, China
- Department of Biochemistry and Molecular Biology, Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Medical School of Ningbo University, Ningbo University, Ningbo, Zhejiang, 315211, China
| | - Meng Ye
- The Department of Medical Oncology, The First Hospital of Ningbo University, Ningbo University, Ningbo, 315010, China.
- Department of Biochemistry and Molecular Biology, Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Medical School of Ningbo University, Ningbo University, Ningbo, Zhejiang, 315211, China.
| | - Xiaofeng Jin
- The Department of Medical Oncology, The First Hospital of Ningbo University, Ningbo University, Ningbo, 315010, China.
- Department of Biochemistry and Molecular Biology, Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Medical School of Ningbo University, Ningbo University, Ningbo, Zhejiang, 315211, China.
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Wei T, Li X, Qiang W, Zhang Y, Ren H, Zhang Q, Jin X. Menopausal symptoms in breast cancer patients receiving adjuvant endocrine therapy and their relationships with health-promoting behaviors and social support. Menopause 2023; 30:289-295. [PMID: 36728825 DOI: 10.1097/gme.0000000000002130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the prevalence and severity of menopausal symptoms in patients with breast cancer undergoing adjuvant endocrine therapy and explore the relationships of these symptoms with health-promoting behaviors and social support. METHODS This cross-sectional study investigated 226 participants from December 2020 to December 2021 in China. Data were collected using the sociodemographic information questionnaire, Menopause Rating Scale, the Health-Promoting Lifestyle Profile II, and Perceived Social Support Survey. Multivariate step regression was used to analyze the potential factors of menopausal symptoms. RESULTS In our sample of 226 patients, 92.9% reported at least one menopausal symptom with a mean score of 13 points (interquartile range, 9-18 points). The highest prevalence of most symptoms included hot flashes/night sweats, fatigue, joint and muscular discomfort, irritability, and sleep problems. In the regression models, health responsibility ( β = -0.15, P = 0.03), spiritual growth ( β = -0.28, P < 0.01), friend support ( β = -0.43, P < 0.01), and other support ( β = -0.31, P = 0.01) were negatively associated with menopausal symptoms. CONCLUSIONS The prevalence and severity of menopausal symptoms are high in breast cancer patients undergoing adjuvant endocrine therapy. Higher health-promoting behaviors and social support are associated with fewer menopausal symptoms. The findings highlight the clinical implications in terms of developing appropriate strategies for managing menopausal symptoms.
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Affiliation(s)
- Tingting Wei
- From the Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Xia Li
- From the Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Wanmin Qiang
- Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Nursing Department, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Yan Zhang
- From the Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Hailing Ren
- Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Department of Breast Oncology, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Qiupeng Zhang
- From the Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Xue Jin
- From the Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, The Third Department of Breast Surgery, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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12
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Zhu Y, Loggia ML, Edwards RR, Flowers KM, Muñoz-Vergara DW, Partridge AH, Schreiber KL. Increased Clinical Pain Locations and Pain Sensitivity in Women After Breast Cancer Surgery: Influence of Aromatase Inhibitor Therapy. Clin J Pain 2022; 38:721-729. [PMID: 36136765 PMCID: PMC9649865 DOI: 10.1097/ajp.0000000000001073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 09/13/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Aromatase inhibitors (AIs), which potently inhibit estrogen biosynthesis, are a standard treatment for hormone sensitive early-stage breast cancer. AIs have been associated with substantial joint pain and muscle stiffness (aromatase inhibitor-associated musculoskeletal syndrome). However, the link between AIs and number of clinical pain locations and pain sensitivity are less well understood. The aim of this study was to compare longitudinal changes in clinical pain and quantitative pain sensitivity between women who did or did not receive AI therapy. METHODS Women with early-stage breast cancer were prospectively enrolled and assessed for clinical pain in surgical and nonsurgical body areas using the Brief Pain Inventory and Breast Cancer Pain Questionnaire, and for pain sensitivity using quantitative sensory testing preoperatively and at 1 year postoperatively. Pain outcomes between participants who did and did not begin adjuvant AI therapy were compared using Wilcoxon Signed-Ranks and generalized estimating equation linear regression analyses. RESULTS Clinical pain and pain sensitivity were comparable between AI (n=49) and no-AI (n=106) groups preoperatively. After adjusting for body mass index, AI therapy was associated with a greater increase in the number of painful nonsurgical body sites (significant time by treatment interaction, P =0.024). Pain location was most frequent in knees (28%), lower back (26%), and ankles/feet (17%). Quantitative sensory testing revealed a significant decrease in pain sensitivity (increased pressure pain threshold) in the no-AI group over time, but not in the AI group. CONCLUSIONS AI therapy was associated with increased diffuse joint-related pain and greater post-treatment pain sensitivity, potentially implicating central sensitization as a contributing pain mechanism of aromatase inhibitor-associated musculoskeletal syndrome worthy of future investigation.
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Affiliation(s)
- Yehui Zhu
- Department of Radiology, Massachusetts General Hospital, A. A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts, USA
| | - Marco L. Loggia
- Department of Radiology, Massachusetts General Hospital, A. A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert R. Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kelsey M. Flowers
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Dennis W. Muñoz-Vergara
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ann H. Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kristin L. Schreiber
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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13
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McCall MK, Sereika SM, Snader S, Lavanchy A, Rosenzweig MQ, Conley YP, Beumer JH, Bender CM. Trajectories of neuropsychological symptom burden in postmenopausal women prescribed anastrozole for early-stage breast cancer. Support Care Cancer 2022; 30:9329-9340. [PMID: 36085422 PMCID: PMC10148985 DOI: 10.1007/s00520-022-07326-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 08/09/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Aromatase inhibitors (AIs) prolong survival for postmenopausal women with hormone receptor-positive breast cancer (HR + BC) but also burden patients with symptoms, a major reason for suboptimal AI adherence. This study characterizes inter-relationships among symptom measures; describes neuropsychological symptom burden trajectories; and identifies trajectory group membership predictors for postmenopausal women prescribed anastrozole for HR + BC. METHODS This study utilized prospectively collected data from a cohort study. Relationships among various self-reported symptom measures were examined followed by a factor analysis to reduce data redundancy before trajectory analysis. Four neuropsychological scales/subscales were rescaled (range 0-100) and averaged into a neuropsychological symptom burden (NSB) score, where higher scores indicated greater symptom burden. Group-based trajectory modeling characterized NSB trajectories. Trajectory group membership predictors were identified using multinomial logistic regression. RESULTS Women (N = 360) averaged 61 years old, were mostly White, and diagnosed with stage I HR + BC. Several measures were correlated temporally but four neuropsychological measures had strong correlations and dimensional loadings. These four measures, combined for the composite NSB, averaged (mean ± standard deviation) 17.4 ± 12.9, 18.0 ± 12.7, 19.5 ± 12.8, and 19.8 ± 13.0 at pre-anastrozole, 6, 12, and 18 months post-initiation, respectively. However, the analysis revealed five NSB trajectories-low-stable, low-increasing, moderate-stable, high-stable, and high-increasing. Younger age and baseline medication categories (pre-anastrozole), including anti-depressants, analgesics, anti-anxiety, and no calcium/vitamin D, predicted the higher NSB trajectories. CONCLUSION This study found relationships among neuropsychological symptom measures and distinct trajectories of self-reported NSB with pre-anastrozole predictors. Identifying symptom trajectories and their predictors at pre-anastrozole may inform supportive care strategies via symptom management interventions to optimize adherence for women with HR + BC.
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Affiliation(s)
- Maura K McCall
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
- Case Western Reserve University, Cleveland, OH, USA.
| | - Susan M Sereika
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
- University of Pittsburgh Public Health, Pittsburgh, PA, USA
| | | | - Alexa Lavanchy
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Margaret Q Rosenzweig
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Yvette P Conley
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
- University of Pittsburgh Public Health, Pittsburgh, PA, USA
| | - Jan H Beumer
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
| | - Catherine M Bender
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
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14
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Association of sarcopenia with endocrine therapy toxicity in patients with early breast cancer. Breast Cancer Res Treat 2022; 196:323-328. [DOI: 10.1007/s10549-022-06741-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/05/2022] [Indexed: 11/26/2022]
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15
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Sung S, Min YH, Park SK, Lee SB. Hot flushes and sweating, sleep problems, joint and muscular discomfort, and physical and mental exhaustion in breast cancer survivors during the first 24 months of tamoxifen therapy: a prospective observational study. Front Oncol 2022; 12:844926. [PMID: 35982968 PMCID: PMC9380584 DOI: 10.3389/fonc.2022.844926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose This study aimed to explore symptom trajectories over 24 months for hot flushes and sweating, sleep problems, joint and muscular discomfort, and physical and mental exhaustion experienced by premenopausal women diagnosed with tamoxifen-treated breast cancer. Methods A total of 104 patients participated in the study. The menopausal symptoms were examined using the Menopausal Rating Scale at baseline, 3–6, 12, and 18–24 months after initiating tamoxifen. The changes over four time points were analyzed using repeated measures analysis of variance. The chi-square test was used to examine the differences between “no symptom-to-mild” and “moderate-to-extremely severe” 3–6 months after initiating tamoxifen according to the patients’ chemotherapy treatment experiences. Results All menopausal symptoms occurred in > 70% of patients with breast cancer and persisted until 24 months. More than 50% of patients experienced four menopausal symptoms, with at least two at a serious severity level after initiating tamoxifen. Hot flushes and sweating occurred in the highest number of patients, recording high scores. Sleep problems and physical and mental exhaustion exhibited relatively high scores, even before tamoxifen initiation. There were significant changes over four time points in all symptoms. Young patients aged < 40 years experienced more severe sleep problems, and patients who had previously received chemotherapy experienced more severe joint and muscular discomfort. Conclusions This study’s findings may assist in alerting healthcare providers to menopausal symptoms that develop during tamoxifen therapy and the need for early and active intervention to minimize symptom occurrence and distress.
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Affiliation(s)
- Sumi Sung
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Yul Ha Min
- College of Nursing, Kangwon National University, Kangwon-do, South Korea
- *Correspondence: Yul Ha Min,
| | - Seul Ki Park
- Department of Nursing, Daejeon University, Daejeon, South Korea
| | - Sae Byul Lee
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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16
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Fleming L, Agnew S, Peddie N, Crawford M, Dixon D, MacPherson I. The impact of medication side effects on adherence and persistence to hormone therapy in breast cancer survivors: A quantitative systematic review. Breast 2022; 64:63-84. [PMID: 35609380 PMCID: PMC9130570 DOI: 10.1016/j.breast.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hormone Therapy (HT) is recommended for most women with HR-positive primary breast cancer. When taken as intended, HT reduces breast cancer recurrence by 40% and mortality by one-third. The recommended duration of treatment ranges from 5 to 10 years depending on risk of recurrence and the specific HT regimen. However, recent data indicates that rates of HT non-adherence are high and research suggests this may be due to the impact of HT side effects. The contribution of side effects to non-adherence and non-persistence behaviours has rarely been systematically explored, thereby hindering the implementation of targeted intervention strategies. Our aim is to identify, evaluate and summarise the relationship between HT side effects and patterns of adherence and persistence. METHODS Electronic searches were conducted from inception and were completed by September 2021, utilising Cochrane CENTRAL, Medline, Embase, Web of Science and PsycINFO databases. Searches included a combination of terms related to breast cancer, adherence, hormone therapy and side effects. RESULTS Sixty-two eligible papers were identified and study quality varied by study type. Most observational and cross-sectional studies were rated good quality, whereas most controlled intervention studies were rated fair quality. Three studies were rated poor quality. The most frequently measured side effects were pain, low mood, hot flashes, insomnia, anxiety, fatigue, weight gain, concentration/memory problems. CONCLUSIONS This review identified a lack of consistency in the measurement of adherence and the definition of persistence across studies. The instruments used to measure side effects also varied significantly. This variation and lack of consistency makes it difficult to evaluate and summarise the role of HT side effects in HT adherence and persistence behaviour.
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Affiliation(s)
| | - Sommer Agnew
- University of Strathclyde, George Street, Glasgow, UK
| | - Nicola Peddie
- University of Strathclyde, George Street, Glasgow, UK
| | | | - Diane Dixon
- University of Aberdeen, Kings College, Aberdeen, UK
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17
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Nakao M, Komatsu H, Hayashida T, Takahashi M, Seki T, Yagasaki K. The Relationship between Work-Related Outcomes and Symptoms in Early Breast Cancer Survivors Receiving Adjuvant Endocrine Therapy. Asia Pac J Oncol Nurs 2022; 9:174-178. [PMID: 35494090 PMCID: PMC9052840 DOI: 10.1016/j.apjon.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 01/09/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Methods Results Conclusions
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Affiliation(s)
- Mayumi Nakao
- Keio University Graduate School of Health Management Course for Nursing, Kanagawa, Japan
- Corresponding author.
| | - Hiroko Komatsu
- Japanese Red Cross Kyushu International College of Nursing, Munakata, Japan
| | - Tetsu Hayashida
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Maiko Takahashi
- Keio Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Tomoko Seki
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kaori Yagasaki
- Faculty of Nursing and Medical Care, Keio University, Kanagawa, Japan
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18
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Berkowitz MJ, Thompson CK, Zibecchi LT, Lee MK, Streja E, Berkowitz JS, Wenziger CM, Baker JL, DiNome ML, Attai DJ. How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support. J Cancer Surviv 2020; 15:29-39. [PMID: 32804353 PMCID: PMC7430212 DOI: 10.1007/s11764-020-00908-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/14/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE Many patients with hormone receptor-positive (HR+) breast cancer do not adhere to endocrine therapy (ET), and treatment-related side effects are often discussed by participants in online breast cancer forums. Our aim was to survey this unique group of patients about their ET-related experiences. METHODS We partnered with patients active in breast cancer social media communities to develop a survey assessing ET-related side effects and medical team communication. Patients with a history of HR+ breast cancer who had received a recommendation to take ET were eligible to participate in the anonymous, online survey. RESULTS Respondents included 2353 women and 54 men. Aromatase inhibitors were the most commonly used medication. Side effects were reported by 91.2%, were more often experienced by women than men (p < 0.001), and were primarily related to medication type. Approximately one-third of respondents discontinued therapy early. While most felt supported by their medical team, 31.5% reported that their side effects were dismissed or minimized. Survey respondents most frequently reported that a healthy diet and exercise, yoga/acupuncture, and vitamins/supplements were helpful in managing ET-related side effects. CONCLUSIONS ET-related side effects are very common, and one-third discontinued treatment early. Lifestyle changes and complementary therapies can be important tools for side effect management. One-third of patients did not feel that their side effects were taken seriously. IMPLICATIONS FOR CANCER SURVIVORS This is the largest survey of ET use by participants in online breast cancer communities. Further research is needed to identify strategies to improve treatment adherence and to better manage ET-related side effects.
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Affiliation(s)
- Maurice J Berkowitz
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Carlie K Thompson
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Laura T Zibecchi
- Department of Nursing, University of California Los Angeles, Los Angeles, USA
| | - Minna K Lee
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Elani Streja
- Department of Medicine, University of California Irvine School of Medicine, Irvine, USA
| | - Jacob S Berkowitz
- Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, USA
| | - Cachet M Wenziger
- Department of Medicine, University of California Irvine School of Medicine, Irvine, USA
| | - Jennifer L Baker
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Maggie L DiNome
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Deanna J Attai
- Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
- UCLA Health Burbank Breast Care, 191 S. Buena Vista #415, Burbank, CA, 91505, USA.
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19
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Ahlstedt Karlsson S, Wallengren C, Olofsson Bagge R, Henoch I. Women's coping strategies during the first three months of adjuvant endocrine therapy for breast cancer. Nurs Open 2020; 7:605-612. [PMID: 32089858 PMCID: PMC7024630 DOI: 10.1002/nop2.430] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 11/18/2019] [Indexed: 11/26/2022] Open
Abstract
Aim The aim was to explore stressful events, experienced problems and used coping strategies during the first three months of undergoing ET. Design This study used a mixed method design. Methods A consecutive sample of 39 women newly diagnosed with breast cancer were included at the start of their adjuvant endocrine therapy. A daily coping assessment was used to create daily reports about stressful events or experienced problems and coping strategies. Results The most frequently reported physical problems were sleeping difficulties. Anxiety was the most reported emotional problem. Patients used both emotion-and problem-focused coping, and sleeping difficulties were coped by relaxing, and anxiety was coped by thinking about something else. Conclusions Patients experienced a variety of stressful events or problems during the first three months of endocrine therapy. They also used several coping strategies to endure the treatment.
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Affiliation(s)
- Susanne Ahlstedt Karlsson
- Department of SurgerySahlgrenska University HospitalGothenburgSweden
- Institute of Health and Care SciencesSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Catarina Wallengren
- Institute of Health and Care SciencesSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Roger Olofsson Bagge
- Department of SurgerySahlgrenska University HospitalGothenburgSweden
- Department of SurgeryInstitute of Clinical SciencesSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Ingela Henoch
- Institute of Health and Care SciencesSahlgrenska Academy at the University of GothenburgGothenburgSweden
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