Adherence With Oral Meds-An Issue In Breast Cancer "Drugs don't work in patients who don't take them."

In the battle against breast cancer, patients are increasingly 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. Taking 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.-may not be reaping the full 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 (CSI), addressed issues that lead to medication non-compliance among breast cancer patients, and it identified possible solutions to these issues. Representatives from leading patient advocacy organizations and professional healthcare associations, as well as oncology experts and survivors from across the nation, gathered to share their perspectives. 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 Surgical Adjuvant Breast and Bowel Project. "And yet, studies also show that not all patients stay on hormonal therapy as prescribed. It is important that healthcare providers understand why women make that decision, so we can address the issue with the information, resources and support needed to help them through this part of their treatment."

Based on results of the meeting, participants gained a better understanding of the factors that contributed 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 may not be 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. Healthcare providers and patients each play pivotal roles. Through education and communication, they can begin to take the steps that will help some breast cancer patients reduce their risk of recurrence.

Two in five breast cancer patients don't take their medication properly.

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