Side Effects Of Hormone Therapy Research Articles

HORMONE THERAPY WITH USAGE OF AGONISTS AND ANTAGONISTS OF LUTEINIZING HORMONE RELEASING HORMONE IN PATIENTS WITH PROSTATE CANCER

Prostate cancer (PC) is one of the most actual problems of modern oncourology. Hormone therapy (HT) using medical castration is the main method of treatment of patients with metastatic PC. HT with usage of the new class of drugs that block the receptors for luteinizing hormone releasing hormone (LHRH) is a promising and effective method of castration therapy that has a number of significant advantages over the use of analogues LHRH. This article presents a review of studies that compared the effectiveness and side effects of HT using antagonists and analogues LHRH.

ГОРМОНАЛЬНАЯ ТЕРАПИЯ С ИСПОЛЬЗОВАНИЕМ АГОНИСТОВ И АНТАГОНИСТОВ ЛЮТЕИНИЗИ- РУЮЩЕГО ГОРМОНА РЕЛИЗИНГ ГОРМОНА У БОЛЬНЫХ РАКОМ ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ

Prostate cancer (PC) is one of the most actual problems of modern oncourology. Hormone therapy (HT) using medical castration is the main method of treatment of patients with metastatic PC. HT with usage of the new class of drugs that block the receptors for luteinizing hormone releasing hormone (LHRH) is a promising and effective method of castration therapy that has a number of significant advantages over the use of analogues LHRH. This article presents a review of studies that compared the effectiveness and side effects of HT using antagonists and analogues LHRH.

Support not corresponding to transition to a new treatment: Women's perceptions of support provided by their male partners during hormonal therapy

Women with breast cancer receive support from their partners to deal with the side effects of therapies over the cancer trajectory. Hormonal therapy (HT) is usually given after completing other treatments, and women receiving HT reclaim their normal life. This may lead to changes in support from their partners. Therefore, we explored women's perceptions of the support provided by their male partners in managing the side effects of adjuvant HT. We conducted semi-structured interviews with 10 women who received HT and recognized their partners as a main source of support. An interview guide was used to explore their experiences of treatment side effects, the contents of support received from their partners, their need for support, and their overall relationship with their partners. Interviews were analysed by content analysis. A theme on how participants perceived support from their partners was formulated as “Support not corresponding to transition to a new treatment” with the following categories: “Shrinking support,” “Primacy of partner,” and “Solitary new treatment.” Participants felt lack of support from their partners because their partners did not understand their experience of the side effects induced by HT. Unlike the side effects of past treatments such as surgery and chemotherapy, side effects of HT cannot be observed and are highly subjective. Their partners often failed to notice these symptoms and provided little support. Nevertheless, participants aimed to accept the existing support without asking for more. They were left alone in the continuing trajectory of breast cancer. After starting HT, women entered a new treatment phase in which less understanding and support was provided by partners. Educational support for couples may enable sharing of subjective symptoms that are not obvious to partners and improve outcomes by facilitating partner engagement and support.

Informing women with breast cancer about endocrine therapy: effects on knowledge and adherence.

Adherence to adjuvant endocrine therapy in women with breast cancer is low, and patients are not informed sufficiently. This study analyzes the effects of a structured treatment information on patients' satisfaction, knowledge, and adherence. An interventional single cohort study of postoperative women with estrogen-receptor-positive breast cancer was conducted to study the effects of enhanced information about endocrine therapy given additionally to clinical routine information. Knowledge and satisfaction with additional information given 1-3 weeks after surgery were assessed before and after informing patients; adherence and knowledge were measured 3 months after start of treatment. A total of 137 patients were analyzed before and after provision of enhanced treatment information as well as 3 months after start of endocrine therapy. Enhanced information increased satisfaction with information and knowledge. The percentage of patients who knew their estrogen receptor status increased from 50% to 93%. At 3 months follow-up, 60% still had correct knowledge. Patients who learned their receptor status were older, and those who forgot had lower cognitive abilities and lower educational level. Patients with higher satisfaction, better learning, and comprehension directly after enhanced information showed better adherence at 3 months follow-up. Patients, especially older ones, can benefit from enhanced treatment information given additionally to routine care. Enhanced information about mode of action and potential side effects of endocrine therapy when included into clinical routine might foster patient autonomy and prevent early disruptions in adherence.

Group medical appointments: A novel approach in patient education for adjuvant endocrine therapy.

133 Background: Group medical appointments (GMA) are currently practiced for a wide range of medical conditions such as diabetes, hypertension, asthma, and cardiovascular disease. Previously, postmenopausal estrogen receptor positive breast cancer patients (ERBCP) attended individual physician clinic appointments to learn about their options for adjuvant endocrine therapy. This resulted in variable education provided, lengthy medical oncologist (MO) clinic visits and significant wait-lists to attend clinic. Accordingly, we embarked on a pilot program to determine the feasibility and acceptability of GMA in this patient population. Methods: Since 2010, ERBCP requiring endocrine therapy were referred and scheduled in the biweekly GMA program. Education regarding choices, risks, benefits and side effects of endocrine therapy were provided by a nurse practitioner (NP) and/or pharmacist (RX). After questions were solicited from the group, individual ERBCP were provided with prescriptions and scheduled for guideline-based follow-up. Results: Approximately 900 ERBCP have attended GMA, with 100% of MOs referring eligible patients. Surveys indicate high levels of satisfaction with the information provided and the GMA format. Conclusions: GMA provided by NP and/or RX is feasible and acceptable to both ERBCP and MOs. Health system benefits include increased efficiency and reduced cost, with MO clinic reserved for complex patient needs. Patient benefits include timely access to care and high levels of reported satisfaction. Future work will examine the effects of GMA on patient compliance and medication reconciliation with endocrine therapy.

Symptom Burden Clusters: A Challenge for Targeted Symptom Management. A Longitudinal Study Examining Symptom Burden Clusters in Breast Cancer

ContextAlthough there has been a growing interest in cancer symptom clusters, less is known about symptom burden clusters. ObjectivesTo explore clusters of burdensome symptoms over time, the impact on health status and quality of life, and coping capacity in patients with breast cancer. MethodsIn this longitudinal study, a sample of 206 patients completed the Memorial Symptom Assessment Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and the Sense of Coherence scale, at diagnosis of primary or recurrent breast cancer, and at one-, three-, and six-month follow-ups. ResultsThree clusters of burdensome symptoms were identified: emotional symptom burden, gastrointestinal symptom burden, and unwellness symptom burden. Most burdensome were emotional symptoms, with worrying, feeling sad, and feeling nervous as the core or defining symptoms. Over time, additional symptoms escalated the emotional symptom burden. The gastrointestinal symptom burden, with “change in the way food tastes” as a core symptom, was more often associated with chemotherapy. Less stable over time, the unwellness symptom burden could be interpreted as short- and long-term side effects of hormonal therapy. Of these clusters, only the emotional symptom burden cluster significantly diminished health status and quality of life. Patients reporting lower coping capacity experienced higher levels of symptom burden. ConclusionThis study provides insights into symptom burden clusters over time. A challenging approach toward symptom management in clinical oncology is to target the burden of a symptom cluster and to recognize the need for individually designed interventions to ameliorate symptom burden in cancer patients.

Predictors of patient-reported toxicities from endocrine therapy: Importance of illness perceptions, treatment beliefs, and fear of recurrence.

542 Background: Numerous studies have documented the toxicities of endocrine therapy (ET) for early breast cancer (EBC) and their deleterious impact on quality of life and adherence. However, little is known about the factors that underlie patient's susceptibility to report toxicities. The identification of risk factors for toxicities from ET is important as it would allow early targeting of symptom management interventions for women more vulnerable to adverse effects of ET. This prospective study aims to examine the impact of pre-treatment perceptions of EBC, ET beliefs and fear of breast cancer (BC) recurrence (FBCR) on toxicities reported after 6 months of ET. Methods: Women diagnosed with EBC completed a survey prior to initiating endocrine therapy, then at 3, 6 and 12 months. Standardized self-report instruments were used to assess EBC perceptions, ET beliefs, FBCR and toxicities. Clinical and treatment variables were also evaluated. Univariate analyses and mulitivariate regression were conducted to identify factors associated (p<0.1) with side effects at 6 months. Results: Since 9/2010, 173 patients have consented and 84 (mean age = 60 y) have completed the questionnaires at baseline and after 6 months of ET. Controlling for age, none of the clinical or treatment variables (stage of disease, type of surgery, receipt of chemotherapy and radiation therapy) were significant univariate predictors of toxicities. In multiple regression, stronger perceptions that BC has serious consequences on their lives (β=0.218, p<0.05), greater concerns about the adverse effects of ET (β=0.215, p<0.05) and higher levels of FBCR (β=0.316, p<0.01) at baseline were associated with higher levels of reported toxicities. Conclusions: Baseline psychological factors predicted level of patient-reported toxicities to a larger extent than clinical/treatment factors. How patients perceived their illness, their beliefs about ET side effects and their fear of cancer recurrence are strongly associated with side effects experienced after 6 months of ET. These results could facilitate the identification of a subgroup of patients for early interventions to improve symptom management.

Oral Information About Side Effects of Endocrine Therapy for Early Breast Cancer Patients at Initial Consultation and First Follow-Up Visit: An Online Survey

This study was initiated to identify how physicians inform women about specific side effects of endocrine therapy for early breast cancer. It is recommended that women with early breast cancer receive endocrine treatment for at least 5 years. Although this medication is an important step in curing breast cancer, continued application by patients is far below 100%; 30–50% of all women prematurely end their prescribed therapy. In an online survey, physicians specializing in treating breast cancer (members of the Austrian Breast and Colorectal Cancer Study Group, ABCSG) were asked about their practice of informing patients about potential side effects of endocrine therapy for breast cancer. Two hundred and five members of the ABCSG completed the online questionnaire. The physicians indicated that patients were primarily informed regarding joint pain/muscle pain and flushes/sleep disturbances during the initial consultation as well as during the first follow-up visit. Patients were informed considerably less regarding side effects that influence quality-of-life areas, such as pain during intercourse, reduced orgasm capability, and hair loss. During the initial consultation, and during first follow-up visit, patients are not uniformly and are insufficiently informed about substantial side effects of endocrine therapy.

The side effects of hormonal therapy at the patients with carcinoma of prostate cancer

Prostate cancer is one of most frequent malignant tumours at men. The androgen-deprivation therapy is the part of cancer treatment. It could be used both in the early stage of prostate cancer and in the bone metastates. From this reason the antiandrogen drugs waste systematically grows. Unfortunately androgen-deprivation therapy has numerous side effects such as: the inferior quality of live, sexual disturbances, the fatigue, the anaemia, the bone mineral density loss and the increase of the risk of breaks the bone, the increase of body mass, insulinresistance, hypercholesterolemia, the increase risk of cardiac disorders. The aim of this article is the introduction of the reader with possibly complications androgen-deprivation therapy and with possibilities in diagnosis and treatment.

Efficacy and side effects of chinese herbal medicine for menopausal symptoms: a critical review.

This study evaluates 23 (9 Chinese and 14 non-Chinese) randomized controlled trials for efficacy and side effects of Chinese herbal medicine on menopausal symptoms. Menopause was diagnosed according to western medicine criteria in all studies while seven Chinese studies and one non-Chinese study further stratified the participants using traditional Chinese medical diagnosis “Zheng differentiation.” Efficacy was reported by all 9 Chinese and 9/14 non-Chinese papers. Side effects and adverse events were generally mild and infrequent. Only ten severe adverse events were reported, two with possible association with the therapy. CHM did not increase the endometrial thickness, a common side effect of hormone therapy. None of the studies investigated long-term side effects. Critical analysis revealed that (1) high-quality studies on efficacy of Chinese herbal medicine for menopausal syndrome are rare and have the drawback of lacking traditional Chinese medicine diagnosis (Zheng-differentiation). (2) Chinese herbal medicine may be effective for at least some menopausal symptoms while side effects are likely less than hormone therapy. (3) All these findings need to be confirmed in further well-designed comprehensive studies meeting the standard of evidence-based medicine and including Zheng-differentiation of traditional Chinese medicine.

Aging, Physical Activity, and Disease Prevention 2012

Aging, Physical Activity, and Disease Prevention 2012

PD04-04: Sexual Dysfunction in Women with Early Stage Breast Cancer on Endocrine Therapy: Encouraging Results from a Prospective Study.

Abstract Background: While the side effects of endocrine therapy (ET) for early stage breast cancer (EBC) have been extensively studied, the link between ET and sexual dysfunction (SD) remains a contentious issue. Most studies have focused on documenting only the presence of problems in specific domains of endocrine symptoms (ES) (e.g. hot flushes, vaginal dryness) and sexual functioning (SF) (interest, satisfaction, arousal, lubrication) without also taking sexual distress into account. To our knowledge, there have been no prospective longitudinal studies evaluating SF and SD before the onset of ET and after treatment initiation. We report the initial 6 month results of this study of SD in women initiating ET for EBC. Methods: Hormone receptor positive EBC post-menopausal women were approached for a larger study of SF aimed at comparing the prevalence of SD across endocrine agents (tamoxifen vs aromatase inhibitor) and at evaluating the impact of anxious predisposition and ES on SD. Here we report on changes in ES, SF and SD after 6 months of ET. SF was evaluated with the Female Sexual Function Index (FSFI) while sexual distress was assessed with the Female Sexual Distress Scale. ES were measured with FACT-B ES subscale. Participants completed questionnaires prior to initiation (T0) of ET and at 6 months (T1). SD was assessed using the APA classification. Results: Between January 2009 and May 2011, 118 EBC patients entered the study and 83 have completed both assessments (mean age 62; 30% received chemotherapy). Over time, the levels of ES increased (p <0.001). Despite the worsening of ES at T1, no decline in SF was observed, this for each FSFI domain (desire, arousal, lubrication, discomfort during intercourse and satisfaction). There was no change in the percentage of women reporting 1 or more sexual problems over time (85% vs 87%, ns) nor in the percentage who were sexually distressed (32% vs 34%, ns). The prevalence of SD did not increase after 6 months of ET (T0=28% vs T1=33%, ns). There were no differences in the percentage of women who worsened (i.e., no SD at T0 but SD at T1, 12%) and those who improved (SD at T0 but no SD at T1, 7%) over time (McNemar X2, p >.5) Importantly, women classified as experiencing SD at T0 were more likely to also experience SD at T1 (OR=4.5, 95% CI=2.162 to 9.366) than women who had no SD at T0. Discussion: This is the first prospective case cohort study evaluating ES, SF and SD in women with EBC on ET. The good news for women is that although ES increased during ET (p < 0.001), this did not have a negative impact on sexual problems (85% vs 87%, ns) or SD (32% vs 34%, ns). This is encouraging news but longer follow-up of these women will provide further insight into the impact of ET on ES and SD over time (> 6 months). The impact of specific types of ET on ES, and SD will also be evaluated. Of interest, the high uptake and high completion rate (>80%) of questionnaires, indicate this is a matter of relevance and importance to women taking adjuvant ET and merits acknowledgement and sensitive discussion. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD04-04.

Aging, Physical Activity, and Disease Prevention

Aging, Physical Activity, and Disease Prevention

A randomized trial of weekly high-dose calcitriol and weight-bearing exercise for cancer treatment–induced bone loss (CTIBL) and bone metabolism in ER+ breast cancer (BC) patients.

9100 Background: CTIBL is a long-term side effect of hormone therapy (HT) and occurs in up to 80% of women being treated for BC. Daily calcitriol (active vitamin D) therapy improves bone metabolism and bone mineral density (BMD), but hypercalcemia is a common side effect. Weight-bearing exercise also enhances bone metabolism and BMD. The aim of this pilot trial is to examine the effect of novel weekly, high-dose calcitriol therapy in combination with weight-bearing exercise on bone metabolism in BC patients. Methods: 40 female ER+, non-metastatic BC patients receiving HT were randomized to 1 of 4 arms for 12 weeks: 1) weekly, high- dose calcitriol (45 μg QW), 2) an individualized weight-bearing exercise program, 3) both, or 4) a daily multivitamin (control). Bone resorption (N- telopeptide of Type I Collagen [NTx]) and bone formation (bone-specific alkaline phosphatase [BSAP]) were measured and changes from baseline to week 12 were calculated. We also created a bone metabolism index [BOMI] (Δ BOMI= Δ Z-score BSAP - Δ Z-score NTx), which comprehensively represents the balance between resorption and formation. Results: Data from the first 16 patients show calcitriol therapy was well-tolerated, with only 8% indicating grade 1 hypercalcemia and no instances of hypercalcemia at grade ≥ 2. A significant increase in bone formation was found for individuals receiving calcitriol + exercise (Δ BSAP= +11.1 μ g/L; p=0.03) and calcitriol (Δ BSAP= +8.6 μ g/L; p=0.04) compared to the control group (Δ BSAP= -4.8 μ g/L). Increases in the bone metabolism index were greater for participants receiving calcitriol + exercise (BOMI=0.98; p=0.24), calcitriol (BOMI=0.58; p=0.49), and exercise (BOMI=0.39; p=0.71) compared to participants in the control group (BOMI=0.16). Conclusions: Calcitriol therapy at 45 μ g QW was well tolerated and interim analyses demonstrate that the combination of calcitriol and weight-bearing exercise may be effective at improving bone metabolism and reducing CTIBL. Clinical trials are warranted to determine the effect of weekly high-dose calcitriol therapy and weight-bearing exercise on BMD in ER+ BC patients. Funding: NCI R25CA10618. No significant financial relationships to disclose.

The Clinical Study on Management of Side effects of Endocrine Therapy (Tamoxifen) on Breast Cancer Patients in Post Surgery with TCM Treating Principle of Regulating Liver Qi and Tonifying Kidney Yin

Objective By previous overview of patients treated in our hospital, this study highlights on the intervention effects of TCM treating principle of regulating liver Qi and tonifying kidney Yin on the adverse reaction of TAM on breast cancer patients in post surgery. Methods Perspective study with the measures of randomization, and paralleling and synchronization control was conducted in the research. Results symptoms such as flush, insomnia, night sweat, palpitation, depression and heat sensation in the chest, palms and soles were improved significantly; while manifestations such as nausea, vomiting, irregular menstruation, bitter taste and dry mouth showed no significant changes. QOL changed significantly. Conclusion The application of treating principle of regulating liver Qi and tonifying kidney Yin is effective in reducing side effects caused by TAM. This result further improved the theory of TCM that the nature of liver is active, although the liver belongs to Yin in physique and but Yang in function. Key words: Breast cancer; Tamoxifen; TCM

Prevalence and Severity of Urogenital Symptoms in Postmenopausal Women Receiving Endocrine Therapy for Breast Cancer

Background Data from randomized trials in postmenopausal women receiving endocrine therapy for breast cancer would suggest that the incidence of significant urogenital symptoms is around 40%. As there are inherent reporting biases associated with clinical trials, we sought to assess the prevalence, severity, and effect of urogenital side effects of endocrine therapy in the non-trial setting. Patients and Methods A cross-sectional survey study was undertaken and questionnaires used to assess vulvovaginal and urinary tract symptoms in a group of postmenopausal women receiving endocrine therapy for breast cancer. Results A total of 251 women were surveyed. Sixty-three percent (158) reported urogenital symptoms. Vaginal dryness was the most common vaginal symptom, occurring in 121 women (48%). This was rated as severe or very severe in 56 of 121 (46%). Thirty-one of 251 (12%) women experienced urinary symptoms. A total of 68 women (27%) had used some form of treatment for vaginal symptoms. Nine women (4%) had considered discontinuing treatment because of urogenital side effects. Conclusion Urogenital side effects are common and often severe in women receiving endocrine therapy for breast cancer. The prevalence in this study was 63%, which is higher than that reported in the clinical trial literature. Less than one third of patients had used some form of treatment for these symptoms. This highlights the need for increased recognition and management of the urogenital side effects of estrogen deprivation therapy and raises the concern of the risk of non-compliance with potentially curative adjuvant therapy.

Initial treatment and changes in adjuvant endocrine therapy for early stage breast cancer

Clinical trials have shown that aromatase inhibitors (AIs) are an important advance in the treatment of early stage breast cancer (ESBC), but practice patterns and the impact of treatment side effects of endocrine therapy in the community setting have not been extensively explored. This retrospective chart review describes practice patterns among patients receiving adjuvant endocrine therapy for ESBC. Charts of 200 patients with confirmed stage I–IIIA breast cancer were reviewed. Patients received first-line treatment with tamoxifen ( n = 96) or AIs ( n = 104). Fifty-one patients completed a structured interview regarding symptom burden during therapy. Time to discontinuation or switching from first-line therapy did not vary by drug class (tamoxifen vs. AI). Musculoskeletal symptoms predicted time to switching among AI patients. Tamoxifen patients who switched to AIs tended to do so following clinical guidelines for use of AIs. Interview results showed that more anastrozole than tamoxifen patients cited side effects as the reason for switching.

Dosimetric outcomes in prostate brachytherapy: Is downsizing the prostate with androgen deprivation necessary?

Objectives A large prostate volume has historically been a relative contraindication to prostate brachytherapy (PB) because of concerns of toxicity and potential pubic arch interference. Common practice has been to downsize large prostates with androgen deprivation therapy (ADT) before proceeding with brachytherapy. The present study compares postimplant dosimetry in patients with prostate volumes >50 cc with those with prostate volumes ≤50 cc. Methods A review of all patients who underwent PB at our institution from 2001 to 2006 was performed. Postimplant dosimetry was obtained approximately 4 weeks after brachytherapy. Results One-hundred forty-five out of a total of 148 patients had available dosimetry. In the 113 patients with prostate volumes ≤50 cc (mean, 35.4 cc, range, 14.2–49.7 cc); the mean D 90 (dose which covers 90% of the prostate), V 100 (volume of prostate receiving 100% of the prescribed dose), V 150 (volume of prostate receiving 150% of the prescribed dose), and V 200 (volume of prostate receiving 200% of the prescribed dose) was 128.9%, 95.6%, 73.9%, and 51.2%, respectively. In the 32 patients with prostate volumes >50 cc (mean 58.1 cc, range 50.2–86.0 cc); the mean D 90, V 100, V 150, and V 200 was 125.1%, 95.2%, 68.2%, and 41.7%, respectively. The rectal V 100 was 1.0 cc for both cohorts. There was no statistically significant difference between the cohorts with respect to postimplant dosimetry for D 90, V 100, and V 150. The V 200 for prostate volumes >50 cc was significantly lower ( p < 0.05). Conclusions In the present study, patients with prostate volumes >50 cc have postimplant dosimetry parameters similar to patients with prostate volumes ≤50 cc for D 90, V 100, and V 150; and significantly lower values for V 200. These results suggest that patients with large prostate volumes may not need to be routinely placed on hormonal therapy; sparing patients the side effects of hormonal therapy, and sparing the health care system the costs of luteinizing hormone-releasing hormone agonist injections.

Adherence to endocrine therapy in women with breast cancer in a clinical practice setting.

Abstract Abstract #3108 Background: Recommendations for treatment of estrogen receptor-positive (ER+) breast cancer include tamoxifen for 5 years or, in postmenopausal women, an aromatase inhibitor either as the primary treatment, sequentially after 2 to 3 years of tamoxifen, or after 5 years of tamoxifen. Despite the demonstrated efficacy of endocrine therapy in reducing both recurrence of and mortality from breast cancer, studies suggest that adherence to recommended treatment has been poor. Studies of patients with 4 or more years of follow-up show that patients in clinical trials terminate therapy early 23% to 28% of the time, and in clinical settings 30% to 50% of the time. This study sought to determine the rate of adherence to and predictors of discontinuation of endocrine therapy in a cohort of early-stage breast cancer patients treated in an academic clinical setting.&amp;#x2028; Material and Methods: Subjects in this preliminary study were women with ER+ breast tumors for whom endocrine therapy was prescribed between December, 2000 and December, 2002. Eligibility criteria included being female and &amp;gt;18 years of age, having ER+ Stages I to IIIA breast cancer and having no prior history of breast cancer. Women were eligible with any type of breast surgery with or without axillary surgery and with or without radiation to the breast or chest wall. Patients were identified from the Ireland Cancer Center tumor registry. Eligible patients received letters from their oncologists describing the study and asking them to participate. Those who agreed completed questionnaires, either online or by mail, assessing demographic and medical variables (including length of endocrine therapy), adherence and health beliefs. Self-reported discontinuation of therapy was validated by medical records.&amp;#x2028; Results: To date, 86 potential subjects were eligible with valid contact information and were sent letters requesting their participation. Sixty subjects completed questionnaires (8 online), a response rate of 70%. Subjects' mean age was 65 years (SD=12). Most (85%) were Caucasian and 15% were African-American. Sixty-two per cent were married, 55% were employed, 93% had at least a high school education and 73% had some prescription drug coverage. Thirteen per cent reported discontinuing therapy while it still was precribed. Seventy per cent took endocrine therapy for &amp;gt;5 years. Women who discontinued therapy prematurely were more likely to be married (Fisher's exact test;p=0.04), less likely to perceive the benefits of endocrine therapy (Wilcoxon exact test; p=0.0024) and reported more vaginal symptoms and bone pain (Cochran-Armitage trend test; p=0.028 and p=0.0035, respectively).&amp;#x2028; Conclusion: This preliminary study suggests that most women follow their physicians' recommendation of endocrine therapy for treatment of ER+ breast cancer. Interventions designed to educate women about the benefits as well as side-effects of endocrine therapy may further increase adherence. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3108.

Management of the side effects of hormone therapy

Une mise a jour sur les effets secondaires de l’hormonoprivation androgenique est presentee. Le traitement standard consiste a abaisser la testosteronemie au taux de castration. Les principales complications potentielles de la suppression androgenique sont les bouffees de chaleur, la dysfonction sexuelle, l’osteoporose, la perte de la masse musculaire, la prise de poids associee a une modification du metabolisme des graisses et du cholesterol etune anemie. Dansdes cas selectionnes, le traitement intermittent et les anti-androgenes peripheriques en monotherapie pourraient diminuer l’incidence des complications de la suppression androgenique. Les conseils a donner au patient, lorsque l’on initie une suppression androgenique ainsi que la prise en charge des effets secondaires, sont discutes.