Women on breast cancer treatment opt for injections to curb hot flashes

Apparently, given a choice, many breast cancer patients using hormone therapies such as Tamoxifen to cut the risk of recurrence, would opt for pills rather than injections.

However the British study reveals that if injections reduced hot flashes, a side effect of such treatments, more than 60 percent of the women surveyed would choose the shots.

If the shots promised better control of the cancer than the pills, 74.5 percent would again pick the injections.

The study team also found that women often skipped their hormone treatments in pill form.

Lesley Fallowfield, lead author of the study and Cancer Research UK Professor of Psychosocial Oncology at Brighton & Sussex Medical School, at the University of Sussex says the message is that unless some way is found of helping women with breast cancer deal effectively with their hot flashes, and other menopausal side effects, then optimal doses of anti-cancer drugs may not be reaching the patients.

For the study, Fallowfield's team interviewed 208 women with early or advanced stage breast cancer who had been diagnosed at least two years before.

When asked which medicine form they would prefer if daily tablets or a double injection once a month were equally effective and had equal side effects, 63 percent picked pills, 24.5 percent chose injections and 12.5 percent had no preference.

But when presented with a hypothetical scenario in which the injection of hormone treatments produced fewer hot flashes, the responses changed, with only 27.4 percent choosing pills and 60.6 percent picking the shots. Another 12 percent had no preference.

However when presented with a scenario in which the shots better controlled the cancer, even more, 74.5 percent, chose the injections.

Those who picked pills in the initial scenario said they were more convenient, while some said they disliked needles.

Those who preferred shots said they were more convenient and it was easier to comply with the therapy.

But according to the researchers it was also found that taking the pills as prescribed did not always happen.

Of the women who admitted they skipped their pills, 48.7 percent said they sometimes forgot, and 13.1 percent admitted they deliberately didn't take their pills some of the time.

Dr. Patricia Ganz, director of cancer prevention and control research at the University of California, Los Angeles Jonsson Comprehensive Cancer Center, is not surprised that women sometimes missed taking the pills, she says this is quite common, even though women with breast cancer are more motivated than others to take their medication.

But the level non-adherence was a surprise to Fallowfield.

Ganz says that prescribing hormone treatment in tablet form rather than shots is standard practice, but presently there is no injection that does not cause hot flashes.

Ganz also raises the question of whether the motivation for the study, funded by pharmaceutical company AstraZeneca, the producer of Anastrozole, one of the medications prescribed for women after breast cancer, was in order to evaluate if a market exists for the development of such an injectable drug.

According to AstraZeneca spokeswoman Katie Neff the company is not presently developing such a drug.

The study is published in the current edition of the Annals of Oncology.