Symptoms of hormonal therapy and social support: Is there a connection? Comparison of symptom severity, symptom interference and social support among breast cancer patients receiving and not receiving adjuvant hormonal treatment

7 Background: Exceedingly little research has examined associations between social support and adherence to adjuvant hormonal therapy (AHT) in breast cancer patients. We evaluated associations of social support and noninitiation and discontinuation of, and nonadherence to, AHT in a large, Northern California cohort. Methods: This study included 3,382 women from the Pathways Study who were diagnosed with stages I-III hormone receptor positive breast cancer from 2006-2013 and responded to the Medical Outcomes Study social support survey approximately two months following diagnosis. We used logistic regression to evaluate associations between social support and noninitiation ( < 2 consecutive prescription fills within the first year after diagnosis). Among those who initiated treatment, we used proportional hazards regression to evaluate associations of social support, discontinuation ( > 90 day gap), and nonadherence ( < 80% medical possession ratio) to treatment. Results: Of those who initiated treatment (79%), approximately one fourth either discontinued AHT or were nonadherent. In multivariable-adjusted analyses, adjusted for sociodemographic characteristics, disease severity, other treatment, and presence of comorbidity, women with low (OR = 1.31, 95% CI: 1.06-1.62) and moderate (OR = 1.18, 95% CI: 0.96-1.46) levels of social support were more likely not to initiate AHT treatment, compared to those with high support. Emotional/informational support, tangible support, and positive interaction were each significantly related to noninitiation; affection was not. Of those who initiated treatment, women with low (HR = 1.30, 95% CI: 1.07-1.58) or moderate (HR = 1.19, 95% CI: 0.98-1.44) levels of support were more likely to discontinue treatment. Furthermore, women with low (HR = 1.37, 95% CI: 1.11-1.88) or moderate (HR = 1.24, 95% CI: 1.01-1.52) support had higher nonadherence to treatment. Conclusions: Hormone receptor positive breast cancer patients with low levels of social support had higher noninitiation and discontinuation of, and nonadherence to, AHT. Information on social support may help clinicians determine who is at greater risk of AHT nonadherence.

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Hospital Processes and the Nurse-Patient Interaction in Breast Cancer Care. Findings from a Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158224 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8224

Author(s):

Johanna Sophie Lubasch ◽

Susan Lee ◽

Christoph Kowalski ◽

Marina Beckmann ◽

Holger Pfaff ◽

...

Keyword(s):

Breast Cancer ◽

Social Support ◽

Cancer Patients ◽

Perceived Social Support ◽

Patient Characteristics ◽

Patient Survey ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Patient Interaction ◽

Hospital Structures

(1) Background: Evidence suggests that organizational processes of hospitals have an impact on patient-professional interactions. Within the nurse-patient interaction, nurses play a key role providing social support. Factors influencing the nurse-patient interaction have seldomly been researched. We aimed to examine whether the process organization in hospitals is associated with breast cancer patients’ perceived social support from nurses.; (2) Methods: Data analysis based on a cross-sectional patient survey (2979 breast cancer patients, 83 German hospitals) and information on hospital structures. Associations between process organization and perceived social support were analyzed with logistic hierarchical regression models adjusted for patient characteristics and hospital structures.; (3) Results: Most patients were 40–69 years old and classified with UICC stage II or III. Native language, age and hospital ownership status showed significant associations to the perception of social support. Patients treated in hospitals with better process organization at admission (OR 3.61; 95%-CI 1.67, 7.78) and during the hospital stay (OR 2.11; 95%-CI 1.04; 4.29) perceived significantly more social support from nurses.; (4) Conclusions: Designing a supportive nursing work environment and improving process organization in hospitals may create conditions conducive for a supportive patient-nurse interaction. More research is needed to better understand mechanisms behind the associations found.

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Extended adjuvant hormonal therapy with exemestane has no detrimental effect on the lipid profile of postmenopausal breast cancer patients: final results of the ATENA lipid substudy

Breast Cancer Research ◽

10.1186/bcr2320 ◽

2009 ◽

Vol 11 (3) ◽

Cited By ~ 19

Author(s):

Christos Markopoulos ◽

Urania Dafni ◽

John Misitzis ◽

Vasilios Zobolas ◽

Evagelos Tzoracoleftherakis ◽

...

Keyword(s):

Breast Cancer ◽

Lipid Profile ◽

Cancer Patients ◽

Hormonal Therapy ◽

Detrimental Effect ◽

Postmenopausal Breast Cancer ◽

Adjuvant Hormonal Therapy ◽

Breast Cancer Patients

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What mediates the racial/ethnic disparity in psychosocial stress among breast cancer patients?

Cancer Causes & Control ◽

10.1007/s10552-021-01392-7 ◽

2021 ◽

Author(s):

C. T. Sánchez-Díaz ◽

S. Strayhorn ◽

S. Tejeda ◽

G. Vijayasiri ◽

G. H. Rauscher ◽

...

Keyword(s):

Breast Cancer ◽

Social Support ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Psychosocial Stress ◽

Breast Cancer Diagnosis ◽

Support Needs ◽

Breast Cancer Patients ◽

Hispanic Patients ◽

Racial Ethnic

Abstract Background Prior studies have observed greater levels of psychosocial stress (PSS) among non-Hispanic (nH) African American and Hispanic women when compared to nH White patients after a breast cancer diagnosis. We aimed to determine the independent and interdependent roles of socioeconomic position (SEP) and unmet support in the racial disparity in PSS among breast cancer patients. Methods Participants were recruited from the Breast Cancer Care in Chicago study (n = 989). For all recently diagnosed breast cancer patients, aged 25–79, income, education, and tract-level disadvantage and affluence were summed to create a standardized socioeconomic position (SEP) score. Three measures of PSS related to loneliness, perceived stress, and psychological consequences of a breast cancer diagnosis were defined based on previously validated scales. Five domains of unmet social support needs (emotional, spiritual, informational, financial, and practical) were defined from interviews. We conducted path models in MPlus to estimate the extent to which PSS disparities were mediated by SEP and unmet social support needs. Results Black and Hispanic patients reported greater PSS compared to white patients and greater unmet social support needs (p = 0.001 for all domains). Virtually all of the disparity in PSS could be explained by SEP. A substantial portion of the mediating influence of SEP was further transmitted by unmet financial and practical needs among Black patients and by unmet emotional needs for Hispanic patients. Conclusions SEP appeared to be a root cause of the racial/ethnic disparities in PSS within our sample. Our findings further suggest that different interventions may be necessary to alleviate the burden of SEP for nH AA (i.e., more financial support) and Hispanic patients (i.e., more emotional support).

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Received and perceived support subscales of the Berlin Social Support Scales in women diagnosed with breast cancer attending the breast clinic at Tygerberg hospital: structure and correlates

South African Journal of Psychology ◽

10.1177/0081246319831819 ◽

2019 ◽

Vol 50 (1) ◽

pp. 54-66

Author(s):

Rizwana Roomaney ◽

Ashraf Kagee ◽

Nina Knoll

Keyword(s):

Breast Cancer ◽

Social Support ◽

South Africa ◽

Cancer Patients ◽

Care Facility ◽

Public Health Care ◽

Perceived Support ◽

Breast Cancer Patients ◽

Validity And Reliability ◽

Breast Clinic

Research in the field of psycho-oncology in South Africa is increasing, and there is a need for validated measures that assess factors associated with cancer, such as social support. The Berlin Social Support Scales are a battery of instruments that measure various types and functions of social support. The measure was originally developed for use among adult cancer patients, and their partners but has also been used among other clinical populations and healthy adults. We investigated the psychometric properties of the English version of the perceived and received sub-scales, Berlin Social Support Scales. Our sample included South African women ( N = 201) who were diagnosed with breast cancer and receiving treatment at a public health care facility. We administered several measures, including a demographic questionnaire, the Berlin Social Support subscales, the Duke-UNC Functional Social Support Questionnaire, and The Functional Assessment of Cancer Therapy to participants. Validity and reliability analyses were conducted. Factor analysis resulted in the retention of 17 items that clustered on two factors, namely received support and perceived support. The 17-item version of the Berlin Social Support Scale demonstrated strong reliability and validity in the sample. The two subscales are quick to administer, easy to interpret, and are a reliable measure of social support among breast cancer patients in South Africa.

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Adherence and persistence to adjuvant hormonal therapy in early stage breast cancer patients: A population-based retrospective cohort study in Israel.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e12051 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e12051-e12051

Author(s):

Tal Sella ◽

Gabriel Chodick

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hormonal Therapy ◽

Breast Cancer Survivors ◽

Early Stage ◽

Population Based ◽

Early Stage Breast Cancer ◽

Adjuvant Hormonal Therapy ◽

Breast Cancer Patients ◽

Suboptimal Adherence

e12051 Background: Adjuvant hormonal therapy has been consistently proven to improve multiple outcomes in early breast cancer. Nonetheless, data on rates of adherence and persistence with therapy outside West Europe and North America are scarce. We assessed the adherence and persistence with adjuvant hormonal in a retrospective population based cohort of breast cancer survivors in Maccabi Health Services (MHS), Israel. Methods: We identified women who were diagnosed with breast cancer and initiated adjuvant hormonal therapy between January 2000 and November 2008. Subjects were followed retrospectively from first dispensed tamoxifen or aromatase inhibitor (AI) and up to the earliest of the following events: disease recurrence (indicated by surgery, radiotherapy, chemotherapy or other related therapies), leaving MHS, death, or completion of 5 years of treatment. Discontinuation of therapy was defined as a 180-day or longer treatment gap. Adherence with therapy was assessed using proportion of days covered (PDC) during follow-up period. Survival analysis was used to determine the effect of adherence on all-cause mortality. Results: A total of 4178 women with breast cancer were followed for a median 7.8 years. Over 90% of patients received tamoxifen as the initial hormonal agent. Mean PDC was 84% with lower rates associated with younger age, smoking status, comorbidities and year of diagnosis. Residential area did not affect adherence. Differences were not found. Discontinuation of therapy occurred in 23% of study patients. Among persistent patients, 70% were optimally adherent with therapy (PDC>=80%). Association between adherence with therapy and survival is investigated. Conclusions: Adherence to adjuvant hormonal therapy among Israeli breast cancer patients with national health insurance is high in comparison to international reports. Nevertheless, suboptimal adherence was identified among younger (<45y) patients. Because of the efficacy of hormonal therapy in preventing recurrence and death in women with early-stage breast cancer, interventions are necessary to identify and prevent suboptimal adherence among high risk subgroups.

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Suggested modifications in the management of breast cancer patients in the era of COVID-19 pandemic: a web-based survey. (Preprint)

10.2196/preprints.27073 ◽

2021 ◽

Author(s):

Shereef Elsamany ◽

Mohamed Elbaiomy ◽

Ahmed Zeeneldin ◽

Emad Tashkandi ◽

Fayza Hassanin ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

United Arab Emirates ◽

Hormonal Therapy ◽

Breast Cancer Patients ◽

Her2 Positive ◽

Web Based ◽

Cancer Management ◽

Breast Cancer Management ◽

Positive Breast Cancer

BACKGROUND Management of cancer patients in the current era of COVID-19 pandemic poses a significant challenge on health care systems. OBJECTIVE We explored the views of oncologists for the management of breast cancer patients during COVID-19 pandemic. METHODS A web-based questionnaire using SurveyMonkey was submitted to licensed oncologists involved in breast cancer management in Saudi Arabia, Egypt and United Arab Emirates. The survey focused on characteristics of participants, infection risk among cancer patients and possible treatment modifications related to different types of breast cancer RESULTS The survey was completed by 82 participants. For early HR positive, HER2-negative breast cancer,74.4% supported using neoadjuvant hormonal therapy in selected patients, and 58.0% preferred giving 6 over 8 cycles of adjuvant chemotherapy when indicated. Only 42.7% preferred CDK4/6 inhibitor with hormonal therapy as first line in all patients with metastatic HR-positive disease. 67.1% of participants supported using adjuvant trastuzumab for 6 instead of 12 months in selected patients with HER2-positive breast cancer. For metastatic HER2-positive, HR-positive breast cancer, 80.5% of participants supported the use of hormonal therapy with dual anti-HER2 blockade in selected patients. The preferred choice of 1st line treatment in metastatic triple negative patients with BRCA mutation and PDL1<1%, was PARP inhibitor according to 42.5% of the participants, and atezolizumab with nabpaclitaxel if the PDL1>1% according to 70.4% of the participants. CONCLUSIONS Several modifications in breast cancer management is supported by the survey participants. These modifications need to be discussed on local basis taking into account the local infrastructure and available resources. CLINICALTRIAL none

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