Following Doctor’s Orders? Adherence With OralMeds—An Issue In Breast Cancer “Drugs don't work in patients show that not all patients stay on hormonal therapy as prescribed. who dont take them.” Former U.S. Surgeon General C. Everett Koop (NAPSA)—In the battle against breast cancer, patients are increas- It is important that healthcare providers understand why women make that decision, so we can address the issue with the information, resources and support ingly prescribed oral medications, such as hormonal therapy, to limit the risk of disease recurrence. Research has indicated that patients should stay on these drugs for five years to gain maximum benefits. But recently, the healthcare community has started to ask a question once limited to managing common colds, not cancer: Do breast cancer patients take their medications as prescribed? According to the American Cancer Society, more than 200,000 new cases of breast cancer are diagnosed every year in the U.S. Of those, approximately 100,000 have cancer types that are likely to respond to hormonal therapy. Tak- ing the therapy as prescribed for the full five years can reduce their risk of recurrence. Easier Said than Done Based on findings from a recent symposium on medication adherence among breast cancer patients, candidates for hormonal therapy— some 500,000 women in the U.S.— maynot be reapingthefull benefits of their drug regimens. According to some research studies, non-compliance rates have reached as high as 40 percent. The Symposium, called the Compliance Strategic Initiative (CSD, addressed issues that lead to medication non-compliance among needed to help them through this part of their treatment.” Based on results of the meeting, yw 2 .. ook Two in five breast cancer patients don’t take their med- ication properly. breast cancer patients, and it iden- tified possible solutions to these issues. Representatives from leading patient advocacy organizations and professional healthcare associ- ations, as well as oncology experts and survivors from across the nation, gathered to share their per- spectives. The CSI was led by a Steering Committee which included representatives from the American Cancer Society, CancerCare, the National Surgical Adjuvant Breast and Bowel Project (NSABP), and Y-ME National Breast Cancer Organization. “Through research, we know that five years of adjuvant hormonal therapy in women with estrogen receptor-positive breast cancer prolongs survival and reduces recurrence,” said D. Lawrence Wickerham, MD, associate chairman of the National Sur- gical Adjuvant Breast and Bowel Project. “And yet, studies also participants gained a better understanding of the factors that con- tributed to non-compliance. Among those factors: patients often do not feel empowered to talk with their doctors about tough issues, such as side effects; doctors and other healthcare professionals aren’t equipped with resources to assist patients in coping with or eliminating side effects; and after their acute phase of treatment, women may often feel they are left to manage therapy on their own. Physicians are under increasing pressures of time and performance and may not always have the skill set to listen well to their patients, or, simply not realize their patients maynotbe taking their medication. These factors combine to create communication gaps through which compliance issues can fall. In conclusion, breast oncology advocates and experts who attended the symposium agreed that patient support mechanisms can and must be improved. Health- care providers and patients each play pivotal roles. Through educa- tion and communication, they can begin to take the steps that will help some breast cancer patients reduce their risk of recurrence.
