What's new to come out of San Antonio breast cancer conference

The good news is it’s official ~

 

Drug side effects can be devastating

 

For years, patients have complained doctors don’t seem able to help them with side effects of oancer treatment.

Side effects come from radiotherapy, chemotherapy or hormone therapy:  all can be devastating.

So why do so many patients find it difficult to get doctors to give advice about mitigating the problems?

One reason aired at the recent San Antonio Breast Cancer Symposium.  Researchers reported doctors may have been going on old data that reported only 5 % of patients experienced moderate to severe side effects while taking cancer drugs.  Using these old stats, may well be why patients today report that doctors can sometimes brush aside their problems with side effects.

Now, the good news for patients is that at the latest Symposium, presentations given in front of thousands of the world’s top oncologists proved what patients have known all along:  side effects of cancer drugs can be devastating.

What is San Antonio?

The San Antonio Symposium is where, every year, the latest research on breast cancer and its treatment is unveiled;  where eminent practitioners  discuss their latest procedures in front of their peers, and from where the latest breast cancer treatment options eventually filter down to us, the patient.

So when, as reported at San Antonio, a recent study of the number of women who said their cancer drug side effects were unbearable was much higher than originally reported – oncologist will listen.

Google shows this story is going global – and coming to a medical journal near you.  So if you have found medics don’t show much sypmathy – you have up-to-date research on your side!

Side Effects

Now we’re appreciating that there’s a significant gap between

  1. patient-reported symptoms
  2. and provider-reported symptoms

Lynne Wagner, of Northwestern University of Feinberg School of Medicine  said, “that gap widens when we’re talking about more subjective symptoms, things like pain or fatigue that only a patient can report.”  For instance, nearly 35 % of women reported severe joint pain.

Wagner said no matter how unbearable women find a drug’s side effects, many will not report their troubles to their doctors for fear that they will be viewed as complainers or as difficult patients. On the other side of the table, doctors with waiting rooms full of patients may neglect to devote time to probing a patient about her experience with a drug.

“I think what this would tell us is, you do need to make time, you do need to tell your patients that it’s O.K. to mention these side effects to you, and that they can expect some side effects from these drugs,” said Dr. Jay Brooks, chairman of hematology and oncology for the Ochsner Health System in Baton Rouge, La.

“Patients often do not volunteer that kind of information. It’s up to the doctor or nurse to directly ask them,” said Dr. Harold Burstein, a breast oncologist at Dana-Farber Cancer Institute in Boston. “And it’s important to do that because they may be able to take an alternative treatment that doesn’t have those side effects.”

 

Aromatase Inhibitors

Aromatase inhibitors have been shown to improve a woman’s chance of survival, after breast cancer, by 30 %, a powerful reason to continue treatment. But doctors say reports of intolerable side effects are equally important to consider.

“These pills have very profound benefit against breast cancer, but if people don’t take the pills, they don’t work,” Brooks said. “I can tell you that this study will change my perception to ask questions of patients as we’re treating them.”

You are not alone

For patients, all over the world, who talk about side effects but find doctors may not seem sympathetic, this study is something to show them – and repeat that the study shows were are complainers;  we really do have major problems.

So for cancer patients whose doctors won’t/don’t believe them  – just go through to web address www.sabcs.org/PressReleases/index.asp#top

There are a whole range of easy-to-understand releases, covering many aspects of treatment.  Print out those that are relevant and show to your Oncologist.  They can’t sneer – this comes right from the top.

More – and more

Jeremy Moore of the AACR (American Association of Cancer Research) sends out the most lucid and well-written press releases direct from the San Antonio Symposium, to doctors all over the world.  Our Dept. of Health could learn a lot from him!

So if you go to  http://www.sabcs.org/PressReleases/index.asp#top

Up comes a long list of the press releases to come out of this Symposium.  And I can assure you they are written in patient-friendly English;  Jeremy is clever enough to realise that using too much medical jargon (which can be different in every country) makes life difficult for oncologists searching the web from all over the world.

Go down the list  and you will see different topics listed.  There are bound to be some that refer to your type of cancer and might come up with solutions.

  • There are several papers this year on breast cancer and diabetes, and this is certainly something our oncologists should be looking at.  As Ash Soni (member of the Govt’s Future Forum) says, oncologists must treat patients with diabetes better.
  • There is the latest on the type of diet that might better suit cancer patients.
  • And why many women don’t undergo Breast reconstruction.

News from elsewhere

A new analysis has found that breast cancer survivors may experience problems with certain mental abilities several years after treatment, regardless of whether they were treated with chemotherapy plus radiation or radiation only. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study indicates that there may be common and treatment-specific ways that cancer therapies negatively affect cancer survivors’ mental abilities.

Previous research suggests that chemotherapy can cause problems with memory and concentration in breast cancer survivors. To compare the effects of different types of cancer treatment on such mental abilities, Paul Jacobsen, PhD, of the Moffitt Cancer Center and Research Institute in Tampa, and his colleagues examined 62 breast cancer patients treated with chemotherapy plus radiation, 67 patients treated with radiation only, and 184 women with no history of cancer. Study participants completed neuropsychological assessments six months after completing treatment and again 36 months later, which is further out from the end of treatment than most previous studies of this type.

The study confirmed that chemotherapy can cause cognitive problems in breast cancer survivors that persist for three years after they finish treatment. In addition, the investigators found that breast cancer survivors who had been treated with radiation (and not chemotherapy) often experienced problems similar to those in breast cancer survivors treated with both chemotherapy and radiation. They did not find that hormonal therapy (such as tamoxifen) caused cognitive difficulties.

“These findings suggest that the problems some breast cancer survivors have with their mental abilities are not due just to the administration of chemotherapy,” said Dr. Jacobsen. “Our findings also provide a more complete picture of the impact of cancer treatment on mental abilities than studies that did not follow patients as long or look at mental abilities in breast cancer survivors who had not been treated with chemotherapy,” he added.

At last what we are saying is being taken seriously!

Article: “Cognitive functioning after cancer treatment: A three-year longitudinal comparison of breast cancer survivors treated with chemotherapy or radiation and non-cancer controls.” Kristin M. Phillips, Heather S. Jim, Brent J. Small, Christine Laronga, Michael A. Andrykowski, and Paul B. Jacobsen. CANCER; Published Online: December 12, 2011 (DOI: 10.1002/cncr.26432).

Author Contact: Patricia Kim of the Moffitt Cancer Center and Research Institute’s media relations office at patricia.kim@moffitt.org or +1 (813) 745-7322.

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