Tamoxifen:
Tablet vs. Injection Preferences Studied
Many breast cancer patients who are using hormone
therapies such as tamoxifen to cut the risk of recurrence prefer tablets
over injections, given a choice, says a new report in the Annals
of Oncology.
But if injections could reduce hot flashes, a side
effect of such treatments, more than 60 percent of the women surveyed
said they would choose the injections.
And if the injections would better control the cancer
than the tablets do, 74.5 percent would pick the injections.
The findings also reveal that women often skipped
their hormone treatments in tablet form.
"The take-home message is that unless we find some
way of helping women with breast cancer deal effectively with their
hot flashes and other menopausal side effects, then optimal doses of
anti-cancer drugs may not be reaching the patients," says Lesley Fallowfield,
Ph.D., lead author of the study and researcher at Brighton & Sussex
Medical School at the University of Sussex.
In the study, Dr. Fallowfield's team interviewed
208 women with early or advanced stage breast cancer who had been diagnosed
at least two years before.
When they were asked which medicine form they would
prefer if daily tablets or a double injection once a month were equally
effective and had equal side effects, 63 percent picked tablets, 24.5
percent chose injections and 12.5 percent had no preference.
But when presented with a hypothetical scenario
in which the injection of hormone treatments produced fewer hot flashes,
the responses changed, with only 27.4 percent choosing tablets and
60.6 percent picking the injections. Another 12 percent had no preference.
And when presented a scenario in which the injections
better controlled the cancer, even more, 74.5 percent, chose the injections.
Those who picked tablets in the initial scenario
said they were more convenient; and some said they disliked needles.
Those who preferred injections said they were more convenient and it
was easier to comply with the therapy.
But Dr. Fallowfield and her team also found that
taking the tablets as prescribed did not always happen.
Of the women who admitted they skipped their tablets,
48.7 percent said they sometimes forgot, and 13.1 percent admitted
they deliberately did not take their tablets some of the time.
The fact that women sometimes missed taking the
tablets was no surprise to Dr. Patricia Ganz, director of cancer prevention
and control research at the University of California, Los Angeles Jonsson
Comprehensive Cancer Center.
"Non-adherence to medication is common," she says,
although "women with breast cancer are more motivated [than some others]
to take their medication."
But the degree of non-adherence was of concern to
Dr. Fallowfield.
"We were very surprised to see the level of non-adherence
to tablet taking in women with life-threatening disease," she notes, "and
the fact that 25 percent preferred injections to ensure compliance."
Prescribing hormone treatment in tablet form rather
than shots is standard practice, comments Dr. Ganz.
"Right now there is no injectable that does not
cause hot flashes," she adds.
Always consult your physician for more information.
|
