What Helps Women Stick to Hormonal Therapy Treatment Plans After Surgery?
What Helps Women Stick to Hormonal Therapy Treatment Plans After Surgery?
August 25, 2023
Lowering medicine prices seems to be one of the best ways to help women stick to their hormonal therapy treatment plans after breast cancer surgery. Read more…
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I think it would also holp if they'd take the side effects seriously that some women develop. We have good medication to counteract the side effects of chemo but with the lack of estrogen, it's hit or miss. I'm lucky enough to have very few if any side effects so sticking with it isn't a big deal. But I know some women are crippled due to it.
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I am on anastrozole as well as Lupron and the hot flashes are intolerable, practically every hour on the hour. The only thing that I have found that actually works is taking cold water baths. If I go in for 2-3 min at about 50-55 degrees I have a dramatic reduction in frequency and severity of my hot flashes. I use a feed trough attached to chiller/pump/filter but you can totally try it in a bathtub. Depending on how cold your groundwater is, you may not need to add much ice. I won’t pretend it’s easy but I would rather have a few minutes of discomfort every day than suffer every hour with hot flashes, especially at night because they interfere so much with my sleep.
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"The researchers pointed out that depression is a known risk factor for non-adherence. Still, only a small number of the studies targeted depression or anxiety. None of the studies looked at using social support or improving the relationship between a woman and her doctor as strategies to improve adherence…."
Thank heavens they included that limitations/comments section. My past career was in research development (and feminist activism) and I've been appalled over the past four months at the level of implicit sexism in journal articles and conference presentations about women and hormone therapy, compared to how male prostate cancer patients on hormone therapy are treated.
I've yet to see a study where it's suggested that male side effects are a result of placebo. I've seen male placebo response on the screen during a prostate cancer conference presentation on male side effects, but no snide mention of them by the presenter—in fact, the guy was piloting an official "intermittent androgen deprivation therapy" approach, explicitly without proof, because their side effects were so "challenging." I'm sure their side effects are unpleasant, but the list always starts w/ "sex life," so it's hard not to be resentful right off the bat. And by description they aren't as widespread and severe as ours on average. (Beyond that, a recent study of other cancers concluded that women experience 38% worse side effects than men from the same treatment.)
Yet, there's an infamous "placebo" study, cited A LOT, that concluded that "half" of women's reported side effects from hormone therapy were attributable to placebo. The study is conceptually flawed, at best insensitive and probably intentionally misogynistic. Their placebo group had just finished cancer tx and I suspect many were weaning off HRT, none of which was teased out as a variable (to my knowledge). So, many group members were probably just kicked into menopause—thus when the placebo group reported unpleasant symptoms that already happen in menopause after BC TX and can feel disabling anyway, the authors gleefully concluded that 50% of ALL OF THE STUDY PARTICIPANTS' HT SIDE EFFECTS WERE ATTRIBUTABLE TO A PLACEBO EFFECT. In other words, in our heds. What the study needed was a third, age-matched female control group w/o cancer, to provide daily symptom logs across the same side effect profile. But the whole point of the study & article was clearly to shame women, to psychopathologize our reported symptoms.I have YET seen an article set out to prove that prostate cancer patients are making up their side effects.
More sexism: a more recent German study literally connected women's written "expectations of side effects" with their actual side effects over 3, 6, 12, 24 month periods . . . and immediately concluded that when most women's negative expectations were accurate, their ATTITUDE MUST HAVE CAUSED THE SIDE EFFECTS. At least somone suggested in the limitations that gee, maybe women know their bodies and how they react to less estrogen? But worse than the fact that this was only a footnote observation such that the original specious "conclusion" could be cited all over, is the utter blindness to the reality of women's lives as we age. Maaaaaaybe, if we're used to not being believed by the medical establishment for our symptoms, we have to learn a lot about our body and medicine in order to advocate for our own health. Instead, the authors treat the women like children, or mice, who aren't self-aware enough to accurately predict their response to a hormonal drug and especially aren't attuned to avoiding basic expectation bias. What a condescending study, considering that 90% of the participants were probably more emotionally intelligent than the PI's.
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When I was stage on breast cancer I be ame aggressive and suicidal one aromatase inhibitors and the pain was so bad in my back I could not stand up my straight. My MO told me I needed to learn to live with it. I quit the med. 8 years later I have a distant met. Now they give me effexor for the side effects and I feel like me on the med.
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