"Hot Girls Pearls" and other coping strategies for women experiencing adverse effects from endocrine therapy in the treatment of breast cancer.

Abstract

197 Background: While endocrine therapy can significantly improve outcomes for women with hormone receptor-positive breast cancer, as few as 50% of patients take the medication as prescribed. Studies have shown that physical side effects contribute to non-adherence with hormone therapy. This study draws on prospective, qualitative interviews with patients to identify coping strategies patients employ to manage concerns over current and anticipated side effects, and suggests methods for encouraging adherence. Methods: Interviews were conducted with breast cancer patients (n = 41) at four time points throughout their treatment, resulting in over 150 patient narratives. Using a grounded theory approach, data were coded and analyzed to identify influential factors in decision-making. Here we present data from a subset of our participants (n = 18) focused on the role of side effects in patients' endocrine therapy decision-making. Results: Patients expressed a variety of concerns about current and anticipated side effects associated with endocrine therapy. Our data suggest five categories of coping strategies participants employed to manage these concerns: 1) emphasizing control over their choice to remain adherent; 2) focusing on a future free from side effects and cancer instead of current concerns or discomfort; 3) "familiarizing" side effects to make current and potential treatment risks feel less strange and/or intimidating; 4) making lifestyle changes to mitigate physical discomfort; and 5) seeking help from both medical and social sources. Patients often described using these multiple strategies to help navigate the functional, social and physical responses to side effects, and remain adherent to their treatment regimen. Conclusions: Our data describe the diverse coping strategies employed by women to manage current or anticipated side effects, and maintain adherence to prescribed endocrine therapy. Discussion of these different coping strategies by clinicians with patients may help to improve adherence rates by personalizing approaches to managing side effects.