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 prescribed treatment."