Study: Nearly half of breast cancer patients experience a severe side effect after treatment
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At a glance | In-depth |
Findings | Limitations |
Clinical trials | Resources |
Questions for your doctor |
STUDY AT A GLANCE
This study is about:
Documenting the frequency, severity, and burden of side effects (including nausea/vomiting, diarrhea, constipation, pain, arm swelling, difficulty breathing, and breast skin irritation) that women experience after treatment for (I or II) invasive breast cancer.
Why is this study important?
Few studies have looked at the full spectrum of side effects that women experience after treatment for breast cancer. It is important that health care providers are aware of the side effects that breast cancer patients can experience after treatment so they can incorporate this information into their treatment and survivorship plans with patients and provide early intervention when necessary.
Study findings:
- 45% of breast cancer patients reported at least one “severe” or “very severe” side effect after treatment.
- Factors associated with a more severe side effect after treatment were:
- Receiving chemotherapy alone or in combination with radiation
- Latina ethnicity
What does this mean for me?
This study showed that a substantial number of women experience side effects after breast cancer treatment. More work needs to be done to better understand and characterize the side effects associated with treatment. In the meantime, patients who experience side effects or who are about to start treatment should discuss their symptoms and /or concerns with their health care providers.
Posted 4/11/17
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References
Friese CR, Harrison JM, Janz NK, et al. “Treatment-Associated Toxicities Reported by Patients with Invasive Breast Cancer.” Cancer. Published online first on January 24, 2017.
This article is relevant for:
People diagnosed with early stage breast cancer
This article is also relevant for:
men with breast cancer
people with triple negative breast cancer
people with ER/PR + cancer
people with Her2-positive cancer
people with a genetic mutation linked to cancer risk
people with breast cancer
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IN DEPTH REVIEW OF RESEARCH
Study background:
Health care providers always take care to ensure that a treatment is greater than its potential risks, but treatment can be more difficult with drugs such as cancer treatments where the dose needed often causes side effects.
While information is available regarding treatment side effects from clinical trial studies and health care claims, few studies have thoroughly examined the side effects that breast cancer patients experience after treatment outside of those settings. Additionally, participants of these studies are typically patients with breast cancer. Christopher Friese and colleagues from the University of Michigan School of Nursing and other institutions published research in 2017 in the journal Cancer that studied the side effects of women who were treated for their breast cancer.
Researchers of this study wanted to know:
What are the side effects, severity of those side effects, and patient burden associated with treatment for (I or II) invasive breast cancer?
Population(s) looked at in the study:
This study used data from 1,884 women, ages 20-79, with (I or II) invasive breast cancer of any type. Women who had III or IV cancer or tumors bigger than 5 cm were excluded. The data was taken from the Los Angeles County and Georgia Surveillance, Epidemiology, and End Results () programs. Among the participants, 1,057 women were white, 321 were black, 315 were Latina, 141 were Asian and 50 were of unknown race or ethnicity. The patients received primary breast surgery (, unilateral or mastectomy) and may or may not have had radiation, chemotherapy, or both radiation and chemotherapy.
The researchers mailed surveys about two months after each woman’s surgery, asking patients to rank the severity of their side effects, including nausea/vomiting, diarrhea, constipation, pain, arm swelling, difficulty breathing, and breast skin irritation. Patients were also asked to fill out a survey about their physical health (the measure) and health care services they used because of side effects. This allowed the researchers to measure the patient burden of side effects after treatment.
Study findings:
- 45% of breast cancer patients reported that they experienced at least one “severe” or “very severe” side effect after treatment.
- Factors associated with a more severe side effect were:
- Receiving chemotherapy alone or in combination with radiation
- Latina ethnicity
- An association was observed between patients’ score (measure of physical health) and side effects experienced. Patients who did not experience side effects had higher scores, indicating better physical health, while patients who did experience side effects had lower scores, indicating worse physical health.
- 9% of women reported unscheduled visits to their health care providers to manage their side effects; 5% of women visited an emergency department or hospital for their side effects.
Limitations:
This study was conducted through patient surveys; researchers did not have access to patients’ health records. Studies such as these that rely solely on patients’ memories can include errors due to patients’ recall (for example, not remembering a side effect experienced or remembering it as more or less severe than it would be classified by a health care provider). Additionally, while the researchers recruited a fairly diverse group of women, because the study was limited to two geographic regions (Los Angeles and Georgia), the study conclusions may not be applicable to other areas. Finally, this study only included women with breast cancer; most had ER+/HER2- tumors. Additional work is needed to examine the effect in more advanced breast cancers. The researchers’ analysis did not separate breast cancers into different subtypes—depending on a patient’s subtype, individuals may have received different treatments compared to other patients, so the results may not be widely applicable to all patients.
Conclusions:
This study suggests that almost half of women with invasive breast cancer experience at least one severe or very severe side effect after treatment. The study authors identified many clinical implications from this study, writing: “The burden faced by patients may be greater than acknowledged by clinicians, and warrants routine assessment during and between clinical visits. Differential patterns identified in this diverse, population-based sample of women may help clinicians when they review the risks and benefits of breast cancer treatment options.”
Posted 4/11/17
Share your thoughts on this review by taking our brief our brief survey
- Who should I call if I experience a side effect?
- Do all women experience side effects after breast cancer treatment?
- What are potential side effects I may have after breast cancer treatment?
- What are ways to alleviate the side effects that I may experience after breast cancer treatment?
The following studies look at management of side effects:
Multiple cancers
- NCT02296450: Quality of Life (QoL) Assessment in Cancer Patients and Survivors With Dermatologic Conditions Using Dermatologic QoL Instruments. This large study examines how skin conditions that are related to different kinds of cancer or cancer treatments affect a patient's overall well-being.
- NCT05056077: Tools to be Fit. This quality-of-life study examines fwhat tools work best for helping cancer survivors improve their diet and exercise for people with bladder, breast, colon, endometrial, kidney (renal cell carcinoma), ovarian, or rectal cancer.
- NCT03996265: Bupropion in Reducing Cancer Related Fatigue in Cancer Survivors. This study tests how well the drug bupropion (welbutrin) reduces cancer-related fatigue for cancer survivors.
Breast cancer
- NCT04621721: Physical Activity at Home for Relief from Neuropathy Caused by Taxanes in People with Breast Cancer. This study looks at the effects of gain and balance training and resistance exercise (using bands) on gait, balance and lower extremity muscle strength after a 16-week home-based exercise program compared to educational materials without an exercise program.
- NCT04586530: Telehealth and Memory Study (TAMS). This trial seeks to confirm the effectiveness of a cognitive-behavioral therapy, the Memory and Attention Adaptation Training (TAMS), as a treatment for chemotherapy-related dysfunction among breast cancer survivors.
- NCT02290834: Chemotherapy-induced and brain changes in older adults with breast cancer. The study investigates abilities and brain images before and after chemotherapy to identify people at risk for side effects and to better understand the effects of treatment on brain structure and function.
- NCT04906200: Web-Based Symptom Monitoring and Self-Management Portal for Adolescent and Young Adult Breast Cancer Survivors. This compares a web-based patient-reported symptom-monitoring and self-management portal to standard therapy in young breast cancer survivors.
- NCT04837820: The Effect of Acupuncture on Cancer-Related Difficulties. This study tests whether acupuncture improves thinking and insomnia for breast cancer survivors. This study also looks at insomnia's link to difficulties.
- NCT03879629: TrAstuzumab Cardiomyopathy Therapeutic Intervention With Carvedilol (TACTIC). Breast cancer patients receiving Herceptin or other HER2-directed therapy are at risk of heart damage. This study looks at whether beta-blocker drugs could help prevent this from happening.
Colorectal cancer
- NCT05239338: Preserving Fertility After Colorectal Cancer Study (PREFACE). This study investigates the reproductive health and clinical outcomes among individuals diagnosed with colorectal cancer ages 18 to 49.
- NCT06420726: Resistance Exercise and Creatine in Colorectal Cancer. This study assesses the feasibilty of combining creatine supplementation with resistance training versus resistance training alone in colorectal cancer survivors.
Ovarian cancer
- NCT04533763: Living WELL: A Web-Based Program for Ovarian Cancer Survivors. This project studies whether a group-based and web-delivered tool increases quality of life and decreases stress, depressive mood, anxiety and fatigue across a 12-month period for ovarian cancer survivors.
- NCT05047926: Prehabilitation for Advanced Ovarian Cancer Patients. This study tests whether structured activity for women undergoing chemotherapy improves their physical state prior to surgery and thus improve outcomes.
cancer
- NCT03971591: Men Moving Forward: A Lifestyle Program for African-American Cancer Survivors (MMF). This study looks at Men Moving Forward (MMF), a community-based lifestyle intervention that supports adherence to nutrition and physical activity guidelines to promote improved body composition and lessen the side effects of treatment.
- NCT05155501: Pelvic Fascia spARing Radical Prostatectomy TrIAL (PARTIAL). This clinical trial studies whether pelvic fascia-sparing radical prostatectomy has similar cancer control and sexual function outcomes; and significantly better urinary function, less penile deformity and inguinal hernia risks as compared to radical prostatectomy.
Updated: 08/28/2024
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