Hot Flushes Distressing for Breast Cancer Patients

NEW YORK (Reuters Health) - Hot flushes remain an important and seriously under-played side effect of tamoxifen and other hormone treatments for breast cancer, leading some women to skip their medication, according to a UK survey of 200 women with breast cancer.

"We underestimate just how distressing the menopausal side effects of treatment are, and women acknowledge that they take drug holidays when hot flushes get really bad," Dr. Lesley Fallowfield from the University of Sussex who conducted the survey told Reuters Health.

"Women should let their healthcarers know how much of a problem they find hot flushes. We need some really serious investment in research to help prevent or alleviate them," she added.

Among the survey findings Fallowfield and her colleagues found most interesting, nearly two-thirds of women on hormone therapy said they would prefer to swallow one pill a day while roughly one quarter said they'd prefer a monthly injection, given that both treatments would be equally effective and have similar side-effects.

However, a very different picture emerged when the women were presented with a hypothetical scenario in which injections would lead to fewer hot flushes. In this case, the number of women opting for injections soared to around 60 percent while those opting for tablets slumped to around 27 percent. "Disturbingly," Fallowfield and colleagues write in the Annals of Oncology, the survey showed that even with a life-threatening disease like breast cancer, women often fail to take their medication. In this survey, nearly half of the women currently on oral medication said they sometimes forget to take their pills and more than one in ten admitted to deliberately not taking their medication at times.

Hot flushes are by far the main reason why many women do not adhere to their breast cancer treatments, Fallowfield said. Some doctors are unconcerned about this, she admitted, because "nobody ever died of a hot flush."

But poor adherence to hormone therapy in breast cancer is a serious problem, Fallowfield said, as these treatments play a major role in reducing recurrence of breast cancer and ultimately saving lives so it is "essential" that women adhere fully to their treatment regimens.

"Personally," Fallowfield said in a statement, "I would give a Nobel prize to the doctor who could eliminate hot flushes. It really is important."

SOURCE: Annals of Oncology, October 20, 2005.