Breast cancer patients fail to complete radiotherapy
Researchers: Clinicians can make a difference
Adherence to therapy is critical to preventing recurrence in breast cancer patients, but new findings suggest that as many as 13% of women fail to complete the recommended course of radiation following breast cancer surgery.1
The data are based on an analysis of the records of more than 24,000 women over age 66 who were diagnosed with breast cancer between 1992 and 2002. Investigators found that following surgery, 87% of the group completed their radiation therapy. The remaining women discontinued their therapy early, and it is not entirely clear why.
"When we looked at different factors that could have influenced radiotherapy completion, there were several [possibilities] that we discovered," explains Tomasz Srokowski, MD, a fellow at the University of Texas, MD Anderson Cancer Center in Houston, TX, and the lead author of the research. For example, researchers saw a connection between mastectomy and a failure to complete radiotherapy, which led the researchers to suspect that women and their physicians might not think that completing radiotherapy treatments following mastectomy is particularly crucial, says Srokowski.
Researchers also observed that women who are admitted to the hospital, perhaps for an acute illness, are less likely to complete therapy. And race appears to have an impact as well. The researchers found that 16% of black women failed to complete therapy, whereas just 12% of white women failed to complete their treatment. The reasons for this discrepancy are not entirely clear, as socioeconomic factors such as income and education level did not explain the gap.
Added support can help
Srokowski indicates that more research is needed to pinpoint the specific reasons why women fail to complete their radiation therapy, but he emphasizes that clinicians can make a difference in this area.
"I think it is very important to emphasize to patients that completion of therapy is important, as we demonstrated that people who complete therapy have a lower risk of recurrence," Srokowski says. He also emphasizes that appropriate support needs to be provided to assist patients with the side effects of therapy. In some cases, social services can help with issues such as transportation.
There was some positive news in the findings. Researchers discovered that women who were diagnosed and underwent surgery in the later years of the study were more likely to complete their recommended course of radiation than women who were diagnosed and treated earlier. The reasons for this improvement are unclear, but researchers speculate that it may have to do with improved knowledge on the importance of radiotherapy as well as improvements in radiotherapy that have made the treatment easier to tolerate.
Reference
- Srokowski T, Fang S, Zhigang D, et al. Completion of adjuvant radiation therapy among women with breast cancer. Cancer 2008; 113:22-29.
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