Symptom Burden Is Higher for Patients With Breast Cancer Receiving Endocrine Therapy
The impact on quality of life for patients with breast cancer receiving adjuvant endocrine therapy (ET) should be given more attention, and clinicians should make better efforts to address patient-reported outcomes. These study findings were published online ahead of print in the Journal of Clinical Oncology.1
Patients taking adjuvant ET for breast cancer primary treatment experience a high symptom burden that may lower quality of life. This study examined patterns of health and symptoms associated with the initiation of adjuvant ET in this clinical setting.
The study assessed self-reported data on physical and mental health, ET-related symptoms, and depression, fatigue, and sleep at enrollment and 6 and 12 months later. At enrollment, patients had completed primary treatment, but had not initiated ET. Linear mixed models were used to compare longitudinal trajectories of outcome variables among 3 patient groups: patients not taking ET, patients taking an aromatase inhibitor (AI), or patients taking tamoxifen.
Of the 186 mind-body study observational cohort participants, two-thirds of patients started ET, evenly split between AI and tamoxifen. At baseline and in covariate-adjusted analyses, no significant differences were seen among the groups. Physical health scores were initially below normal levels and improved over time; however, the AI group's scores were significantly lower at 12 months. Mental health scores were within the normal range and were similar in all 3 groups, and did not change over time.
Symptom severity was stable or declining in the no-ET group, whereas increased symptom severity was seen in the ET groups over time. More severe musculoskeletal, hot flash, and cognitive problems were reported by the AI group at one or both follow-up points compared with the no-ET group. The tamoxifen group reported higher levels of hot flashes, cognitive problems, and bladder problems compared with the no-ET group.
The researchers conclude an increased symptom burden is associated with adjuvant ET for primary breast cancer treatment, and better efforts are needed to address these outcomes.
1. Ganz PA, Petersen L, Bower JE, Crespi CM. Impact of adjuvant endocrine therapy on quality of life and symptoms: observational data over 12 months from the Mind-Body Study [published online ahead of print January 19, 2016]. J Clin Oncol. doi:10.1200/JCO.2015.64.3866.