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Adjuvant chemotherapy for breast cancer patients: Patients’ expectations and physicians’ attitudes

Published online by Cambridge University Press:  24 February 2012

Frida Barak ,
Lev A. Ostrowsky  and
Shulamith Kreitler
Frida Barak*
Affiliation:
Oncology Institute, Barzilai Medical Center, affiliated to Ben-Gurion University of the Negev, Ashkelon, Israel
Lev A. Ostrowsky
Affiliation:
Leumit Health Fund, Ashdod, Israel
Shulamith Kreitler
Affiliation:
Psychooncology Research Center, Sheba Medical Center, Department of Psychology, Tel-Aviv University, Tel Hashomer, Israel
*
Address correspondence and reprint requests to: Frida Barak, Oncology Institut, Barzilai Medical Center, Ashkelon 78278, Israel. E-mail: frida_bar@barzi.health.gov.il
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Abstract

Objective:

Findings show that there is a certain degree of refusal on the part of breast cancer patients to undergo adjuvant therapy. Accordingly, the major goals of the study were, first, to learn more about the beliefs of breast cancer patients in regard to adjuvant therapy; second, to find out about the sources of the patients’ beliefs; and third, to learn about the attitudes of oncologists concerning the same aspects of adjuvant therapy to which the patients’ beliefs referred.

Method:

The participants were 92 breast cancer patients (mean age 61.2) and 57 doctors of both genders specialized in oncology or affiliated domains. Both groups were administered questionnaires referring to goals of adjuvant treatment, the chances of attaining these goals, side effects, and difficulty of the treatment. Doctors were specifically asked about the views they thought proper to communicate to patients in regard to the mentioned issues. Patients were also asked about whether they had doubts about the treatment and sources of information.

Results:

The findings showed disparities between the views of patients and doctors in regard to goals, chances of attainment, side effects, and difficulty of treatment. Patients endorsed more goals than doctors and tended to assign to them lower chances of attainment. Doctors were divided in their views about whether to communicate the side effects and difficulties.

Significance of results:

The results reveal the importance of outlining goals for patients undergoing adjuvant treatment and the disagreements between doctors about what should be communicated to patients, and highlight the complexity of providing to patients information that is both scientifically correct and emotionally helpful.

Keywords

Adjuvant therapyChemotherapyBreast cancerExpectations
Type
Original Articles
Information
Palliative & Supportive Care , Volume 10 , Issue 2 , June 2012 , pp. 107 - 114
Copyright
Copyright © Cambridge University Press 2012

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References

REFERENCES

Altekruse, S.F., Kosary, C.L., Krapcho, M., et al. (2010). SEER Cancer Statistics Review, 1975–2007. http://seer.cancer.gov/csr/1975_2007/.Google Scholar
Ankem, K. (2006). Use of information sources by cancer patients: Results of a systematic review of the research literature. http://InformationR.net/ir/113/paper254.html.Google Scholar
Berry, D.A., Corin, K.A., Plevritis, S.K., et al. (2005). Effect of screening and adjuvant therapy on mortality from breast cancer. New England Journal of Medicine, 353, 1784–1792.CrossRefGoogle Scholar
Bickell, N.A., LePar, F., Wang, J.J., et al. (2007). Lost opportunities: Physicians’ reasons and disparities in breast cancer treatment. Journal of Clinical Oncology, 25, 2516–2521.CrossRefGoogle ScholarPubMed
Bickell, N., Weidmann, J., Fei, K., et al. (2009). Underuse of breast cancer adjuvant treatment: Patient knowledge, beliefs, and medical mistrust. Journal of Clinical Oncology, 31, 5160–5167.CrossRefGoogle Scholar
Burstein, H.J. & Griggs, J.J. (2010). Adjuvant hormonal therapy for early-stage breast cancer. Surgical Oncology Clinics of North America, 19, 639–647.CrossRefGoogle ScholarPubMed
Carlson, W., Brown, E., Burstein, H.J., et al. (2006). NCCN Task Force Report: Adjuvant therapy for breast cancer. Journal of the National Comprehensive Cancer Network, 4(Suppl. 1), S1–S28.Google ScholarPubMed
Cassileth, B.R., Lusk, E.J., Bodenheimer, B.J., et al. (1985). Chemotherapeutic toxicity: The relationship between patients’ pretreatment expectations and posttreatment results. American Journal of Clinical Oncology, 8, 419–425.CrossRefGoogle ScholarPubMed
Chaitchik, S., Kreitler, S., Schwartz, I., et al. (1992). Doctor–patient communication in a cancer ward. Journal of Cancer Education, 7, 41–54.CrossRefGoogle Scholar
Curtis, E., Quale, C., Haggstrom, D., et al. (2008). Racial and ethnic differences in breast cancer survival: How much is explained by screening, tumor severity, biology, treatment, comorbidities, and demographics? Cancer, 112, 171–180.CrossRefGoogle ScholarPubMed
Early Breast Cancer Trialists’ Collaborative Group. (2005). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: An overview of the randomised trials. Lancet, 365, 1687–1717.CrossRefGoogle Scholar
Eifel, P., Axelson, J.A., Costa, J., et al. (2001). National Institutes of Health Consensus Development Conference Statement: Adjuvant therapy for breast cancer, November 1–3, 2000. National Cancer Institutes, 93, 979–989.Google ScholarPubMed
Fink, A.K., Gurwitz, J., Rakowski, W., et al. (2004). Patient beliefs and Tamoxifen discontinuance in older women with estrogen receptor-positive breast cancer. Geriatric Nursing, 25, 372.Google Scholar
Hawley, S.T., Lantz, P.M., Janz, N.K., et al. (2007). Factors associated with patient involvement in surgical treatment decision making for breast cancer. Patient Education & Counseling, 65, 387–395.CrossRefGoogle ScholarPubMed
Iconomou, G., Viha, A., Koutras, A., et al. (2002). Information needs and awareness of diagnosis in patients with cancer receiving chemotherapy: A report from Greece. Palliative Medicine, 16, 315–321.CrossRefGoogle ScholarPubMed
Kreitler, S., Chaitchik, S., Kovner, F., et al. (1992). Information in breast cancer patients: The good and the bad news (Abstract). Journal of Cancer Education, 7(Suppl. 1), 25.Google Scholar
Lannin, D.R., Mathews, H.F., Mitchell, J., et al. (1998). Influence of socioeconomic and cultural factors on racial differences in late-stage presentation of breast cancer. JAMA, 279, 1801–1807.CrossRefGoogle ScholarPubMed
Margolis, M.L., Christie, J.D., Silvestri, G.A., et al. (2003). Racial differences pertaining to a belief about lung cancer surgery. Results of a multicenter survey. Annals of Internal Medicine, 139, 558–563.CrossRefGoogle ScholarPubMed
Pollard, A. (2009). Supportive care during adjuvant treatment. In Adjuvant Therapy for Breast Cancer, Vol. 151. Castiglione, M. & Piccart, M.J. (eds.), pp. 219–238. New York: Springer.CrossRefGoogle Scholar
Satterlund, M.J., Kevin, B.S., McCaul, D., et al. (2003). Information gathering over time by breast cancer patients. Journal of Medical Internet Research, 5, e15.CrossRefGoogle ScholarPubMed
Schummer, M., Beatty, D. & Urban, N. (2010). Breast cancer genomics: normal tissue and cancer markers. Annals of the New York Academy of Sciences, 1210, 78–85.CrossRefGoogle ScholarPubMed
Shavers, V.L., Harlan, L.C. & Stevens, J.L. (2003). Racial/ethnic variation in clinical presentation, treatment and survival among breast cancer patients under age 35. Cancer, 97, 134–147.CrossRefGoogle ScholarPubMed
Silvestri, G.A., Knittig, S., Zoller, J.S., et al. (2003). Importance of faith on medical decisions regarding cancer care. Journal of Clinical Oncology, 21, 1379–1382.CrossRefGoogle ScholarPubMed
Tabar, L. & Dean, P.B. (2010). A new era in the diagnosis and treatment of breast cancer. Breast Journal, 16(Suppl. 1), S2–4.CrossRefGoogle ScholarPubMed
Taylor, W.C. & Muss, H.B. (2010). Adjuvant chemotherapy of breast cancer in the older patient. Oncology, 24, 608–613.Google ScholarPubMed
Tubiana-Hulin, M. & Gardner, M. (2009). Adjuvant chemotherapy. In Adjuvant Therapy for Breast Cancer, Vol. 151. Castiglione, M. & Piccart, M.J. (eds.), pp. 121–138. New York: Springer.CrossRefGoogle Scholar
Vervoort, M.M., Draisma, G., Fracheboud, J., et al. (2004). Trends in the usage of adjuvant systemic therapy for breast cancer in the Netherlands and its effect on mortality. British Journal of Cancer, 91, 242–247.CrossRefGoogle ScholarPubMed
Walsh, M.C., Trentham-Dietz, A., Schroepfer, T.A., et al. (2010). Cancer information sources used by patients to inform and influence treatment decisions. Journal of Health Communication: International Perspectives, 15, 445–463.CrossRefGoogle ScholarPubMed