Severity Of Side Effects In Cancer Treatment Is Influenced By Patient's Expectations

Every time someone is about to experience something for the first time, the line "expect the worst" is usually one of the many things they hear. However, a new study on women receiving hormone therapies has revealed that those women who had an increased expectation of more and worse side-effects before treatment began suffered more side-effects after two years of hormone therapy.

According to Science Daily, the study published in the leading cancer journal, Annals of Oncology found that women who expected to suffer more and worse side-effects before beginning their treatment experienced more after two years of adjuvant hormone therapy. It was found that these women suffered almost twice the number of side-effects than women with positive expectations or who thought the effects would be bearable.

The study, led by Professor Yvonne Nestoruic from the Department of Psychosomatic Medicine and Psychotherapy at the University Medical Centre in Hamburg, Germany, says: "Our results show that expectations constitute a clinically relevant factor that influences the long-term outcome of hormone therapy." These findings are important according to Prof. Nestoruic because these bad experiences the side-effects bring can make these women stop taking their treatment, which could affect the treatment's success and survival.

The research team studied 111 women who are participating in a clinical trial at the Breast Cancer Centre at the University of Marburg, Germany. All the patients had undergone surgery for hormone receptor-positive breast cancer and is about to start adjuvant hormone therapy with cancer drugs tamoxifen or aromatase inhibitors, exemestane, when they were asked about their expectations of the possible side-effects. Medical News Today reported the team assessing 107 women again after 3 months and then 88 women after 2 years.

When the study started, 8 percent (9 women) of the patients said they did not expect any side-effects from their treatment, 63 percent (70 patients) said they expect to have mild side-effects and 29 percent (32 patients) expressed that they were expecting moderate to severe side effects. During the 3 month follow-up, the 19 patients who later exited out of the trial reported significant number of side effect from the hormone therapy than the 88 patients who continued with the treatment.

At the 2-year follow-up, the team found that the women's devotion to the therapy, the extent to how much they followed their medication schedule, was related to the side-effects they experienced during the 3^rd month of the trial and also when their expectations were asked. Furthermore, medication adherence during the second year was higher in those who had low expectations of the side effect (87 percent) than those in women who expected the worse side-effects of the treatment (69 percent).

Some of the common side-effects women experienced included joint pain, weight gain and hot flushes, although there were reports of symptoms which could not be directly attributed to their medication such as, back pain, breathing problems and dizziness, International Business Times reported.

"This substantiates the conclusion that psychological mechanisms such as negative expectations about the treatment play a significant role in the side-effects breast cancer patients experience," said Nestoriuc. "Higher negative expectations, formed by patients before the start of their adjuvant therapy, seem to have a pronounced influence on long-term tolerability, especially once they are confirmed by initially high side-effects after three months."