Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Decision to take tamoxifen difficult for many women

15.12.2004


Many women at high risk for breast cancer are foregoing tamoxifen, the first FDA-approved drug for prevention of breast cancer, due to concerns about side effects, increased risk of other cancers, and lack of information, a new study by researchers in Boston shows. The study will be published December 14 in the Journal of Clinical Oncology.



"While the availability of tamoxifen is a significant advance in breast cancer prevention, it also presents a complicated decision for women at high risk for the disease," said Sharon Bober, PhD, Clinical Instructor in the Department of Psychiatry at Harvard Medical School, Staff Psychologist at the Beth Israel Deaconess Medical Center and Dana-Farber Cancer Institute, and lead author of the study. "Our study underscores the need to address psychological factors that may influence decision-making, in order to help women feel confident and satisfied with their treatment choice."

Tamoxifen has been shown to reduce risk of invasive and non-invasive breast cancer by almost 50 percent. However, tamoxifen also increases the risk of endometrial cancer, blood clots, cataracts, and more severe menopausal symptoms, such as hot flashes and night sweats.


Researchers at Beth Israel Deaconess Medical Center evaluated health-related and psychological factors involved in decision-making among 129 women eligible to receive tamoxifen (women with a five-year risk of developing cancer of 1.7% or greater). Women received counseling from physicians about potential risks and benefits of tamoxifen therapy, and were asked to complete questionnaires assessing demographics, personal and family health history, and emotional factors, including level of distress, anxiety about breast cancer, and optimism about the potential outcome of treatment. Post-menopausal women in the study were given the option of taking tamoxifen or enrolling in the STAR trial, a randomized study comparing five years of tamoxifen and raloxifene, another drug in the same class as tamoxifen.

Researchers followed up with study participants at two and four months to assess their treatment decision and their satisfaction with that decision. After two months, 29% of study participants decided to take tamoxifen; 27% opted to enroll on the STAR trial; 24% declined treatment; and 20% remained undecided. After four months, some participants had changed their decision, with most ultimately deciding against treatment--a total of 25.6% chose tamoxifen, 25.6% enrolled on the STAR trial, 35% declined treatment, and 14% of women remained undecided.

Researchers assessed the influence of health-related variables on participant decision-making, finding that, contrary to expectations, a family history of breast cancer did not increase the likelihood that women would choose tamoxifen. However, personal history, such as an abnormal biopsy, was highly correlated with the decision to take tamoxifen. Physician advice also influenced decision-making, with women receiving a physician recommendation more likely to take the drug.

Researchers also found that perception of risk and a lack of information influenced decisions about tamoxifen:

  • Women in the study who declined treatment were more likely to report fear of side effects and believe that tamoxifen would not be an effective prevention strategy,
  • Women who felt uninformed about their options were more likely to remain undecided, and
  • Women who reported higher levels of anxiety about cancer and who perceived themselves to be at greater risk for breast cancer were more likely to choose tamoxifen.

Researchers also assessed how participants felt about their decision, finding that anxiety and psychological distress influenced whether or not they were satisfied with their decision. Women who cited fewer sources of information were more likely to feel dissatisfied with their decision. Although decision satisfaction did not vary between women who chose or declined treatment, those who experienced heightened anxiety about cancer or about treatment side effects were less likely to feel satisfied with their decision.

Researchers noted that previous studies suggest that dissatisfaction with their decision may lead some women to prematurely discontinue treatment, and underscored the need to help women make informed decisions.

"This study highlights the complexity of making important medical decisions, and underscores the need for improved patient-physician communication to help patients weigh the risks and benefits of therapy," Dr. Bober added. "Women are willing to grapple with difficult decisions in order to reduce their risk of breast cancer. But for many women, the benefits of the best available preventive medication are not sufficient."

Danielle Potuto | EurekAlert!
Further information:
http://www.asco.org

More articles from Health and Medicine:

nachricht Study suggests possible new target for treating and preventing Alzheimer's
02.12.2016 | Oregon Health & Science University

nachricht The first analysis of Ewing's sarcoma methyloma opens doors to new treatments
01.12.2016 | IDIBELL-Bellvitge Biomedical Research Institute

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

Im Focus: Molecules change shape when wet

Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water

In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...

Im Focus: Fraunhofer ISE Develops Highly Compact, High Frequency DC/DC Converter for Aviation

The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.

Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

UTSA study describes new minimally invasive device to treat cancer and other illnesses

02.12.2016 | Medical Engineering

Plasma-zapping process could yield trans fat-free soybean oil product

02.12.2016 | Agricultural and Forestry Science

What do Netflix, Google and planetary systems have in common?

02.12.2016 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>