Ibm spss statistics 18 download3/22/2023 ![]() Nevertheless, and despite the relevance of the topic, data regarding the AHT impact on the QoL of BC survivors is scarce. Thus, for instance, they had a “disabling” effect 37 with severe emotional implications, like social withdrawal 19 and lack of professional confidence 16, 22, which in turn play a role in chronic pain, since it has been demonstrated that psychosocial factors play an important role in persistence and aggravation of pain 39, 40. As a consequence, some of these problems are underreported, making difficult its detection and treatment 10, 34, 35.įurthermore, these side-effects associated with AHT can severely affect the quality of life (QoL) and well-being of BC survivors 6, 9, 10, 13, 15, 22, 36, 37, 38. Indeed, one of the reasons why the impact of side-effects of oncology treatments is often overlooked is the non-inclusion of patient-reported outcomes (PROs) in the patient’s care protocols. However, these side-effects are often underestimated and overseen in follow-up visits, that mainly focus on the risk of recurrence 10, 33, 34. This pattern of poor adherence and early discontinuation of hormone therapy treatment are associated with a higher rate of relapse and mortality 6, 31, 32. Approximately 50% of women take less than 80% of the prescribed dosage 28 and up to 50% discontinue their treatment by the fifth year of prescription 29, 30. The presence and severity of the aforementioned AHT side-effects have been identified as barriers to treatment persistence and adherence 6, 8, 23, 24, 25, 26, 27. The flip side of AHT is that it can also cause a wide range of side-effects that even though they are less severe in comparison to those of other treatments such as chemotherapy, it should be kept in mind that the treatment period with AHT is considerably longer, ranging from 5 to 10 years 6.Īmong the main physical health related side-effects are joint pain 7, 8, 9, 10, 11, 12, musculoskeletal symptoms such as pain throughout the whole body 8, 9, 13, carpal tunnel syndrome 7, cognitive side-effects such as difficulty concentrating and memory loss 14, hot flushes and night sweats and the consequent loss of sleep 15, 16, 17, 18, 19, general lack of energy 10, 16, 20, 21, and body image concerns due to weight gain 22. In hormone receptor-positive BC patients, which account for the 70% of total BC 3, one of the mainstays of treatment is the Adjuvant Hormone Therapy (AHT), which either suppresses hormone production (aromatase inhibitors such as Letrozole, Anastrozole and Exemestane) or interferes with hormone receptor signalling (Selective Estrogen Receptor Modulators such as Tamoxifen) 4.ĪHT reduces the risk of BC recurrence by 40% and mortality by a third 5. According to the World Health Organization 1, age-standardized BC mortality in high-income countries dropped by 40% between the 1980s and 2020, making BC survivors the largest group of cancer survivors 2. At the same time, the availability of increasingly effective therapies has contributed to improve the rates of survival in BC. ![]() Thus, AHT side-effects should be routinely assessed by health care providers to gain accurate knowledge that allows improving the QoL of BC survivors.īreast cancer (BC) is the world’s most prevalent cancer 1. It is expected that the improvement in QoL throughout the different survival phases will have a significant impact on the adherence and maintenance of AHT and, consequently, the likelihood of survival. It seems there is a turning point around the fifth year after finalization of primary treatment, from which the survivors without AHT significantly improve in several areas and those with AHT do so to a lesser extent. When AHT was not prescribed, longer time elapsed was associated with a decrease in distress prevalence and an improvement in subjective well-being and QoL. Examination of interaction effect between AHT and time since end of primary treatment showed that many of the positive changes observed through the survival phases were experienced exclusively by survivors without AHT. ![]() Cross-sectional study with control group. To explore the modulatory role of Adjuvant Hormone Therapy (AHT) on health-related quality of life (QoL), subjective well-being and distress prevalence in Breast Cancer (BC) survivors, considering the survival phase. ![]()
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