Breast Cancer Recurrence: What You Should Know
When women quit breast cancer treatment early, they take a big risk.
Toughing Out the Side Effects continued...
"Doctors need to reinforce the fact that chemotherapy and other targeted
therapies help to kill microscopic cancer cells, to prevent a recurrence,"
Caplan tells WebMD. "If you quit treatment, you don't know you've given
yourself the full benefit. Talking about it will help women who are struggling
to stay the course."
In recent years, studies have found that women are quitting two types of
hormone therapy drugs -- aromatase inhibitors (Femara, Aromasin and Arimidex)
and the anti-estrogen drug
tamoxifen -- because of side effects.
One study suggested that nearly one-half of women taking aromatase
inhibitors quit because of severe muscle aches and joint pains. The drugs block
an enzyme the body uses to make estrogen, which fuels some breast cancers. They
can substantially slash the risk of recurrence if taken for the prescribed
length of time.
Another study showed that, although a five-year course of tamoxifen is
typically recommended, some
women took the drug for less than three years. One in 10 women filled 70% or
fewer of their tamoxifen prescriptions -- which increased their risk of death
by 16%. Women were not asked why they stopped taking tamoxifen, but it is known
to cause difficult hot flashes, researchers note.
These drugs affect each woman differently, Vogel explains. "Some
patients feel fine with the drugs, but some have really, really obnoxious side
effects," he tells WebMD. "Some are just miserable with arthritis
symptoms from aromatase inhibitors. Some women taking tamoxifen have really bad
hot flashes, sexual symptoms. They also worry about risk of uterine cancer and
blood clots, which put them at risk for stroke."
If side effects are bothersome, discuss it with your doctor, Vogel says.
"There are a few options to reduce side effects." It may be possible to
switch to a different medication in the same class of drugs -- one that
produces fewer side effects, he adds.
For relief from serious bone and joint problems, painkillers and drugs like nonsteroidal
anti-inflammatory drugs (NSAIDs) can help control the pain.
It's not always side effects that prompt women to quit treatment, Vogel
adds. For some women, it's a false sense of confidence. "When women don't
have bad side effects, they're feeling fine, and start thinking, 'Do I really
have to worry about breast cancer?'" he tells WebMD. "They don't see
the need to continue treatments."
Even women with "good prognosis" cancers have a slight risk of
recurrence, Vogel says. "Others may have a higher likelihood of recurrence,
but even the best-prognosis patients have the risk. You will have a
significantly less chance of recurrence if you don't stop the treatment. That's
what gives us all hope -- and why we convince our patients to stay on their