Doctors play key role keeping women breast cancer-free longer

Researchers from The University of Western Australia believe General Practitioners can play an important role in ensuring women persist with cancer treatment.

The study published today in Public Health Research & Practice looked at women diagnosed with invasive breast cancer who had undergone endocrine therapy to determine if follow-up contact with clinicians or screening services may have influenced their decision to cease the treatment.

Endocrine therapy is a treatment for women with hormone-dependant breast cancer. Despite clinical trials showing that endocrine therapy halves the risk of cancer recurrence and reduces cancer-related mortality when taken for at least five years, many women discontinue early - often because of side-effects.

The team from the UWA School of Population and Global Health examined a combination of Medicare, pharmacy and hospital records for a group of women from the Sax Institute's 45 and Up Study to investigate what influenced this behaviour. They found no evidence to suggest women discontinued endocrine therapy following recent contact with a doctor, suggesting discontinuation was not due to clinical advice or medical results.

In addition, women who discontinued endocrine therapy were then between 20-38 per cent less likely to visit their doctors following discontinuation than those who remained on therapy.

Women who discontinued treatment early and those having ongoing treatment appeared to present the same way up until the moment they stopped treatment. It was only after ceasing treatment that contact with doctors dropped off.

This suggests there is a role for doctors to continue to check how a patient is coping with therapy at every opportunity, as they can't assume that a woman will persist simply because they attend consultations.

Study co-author Professor David Preen said the results highlight the importance for doctors, especially GPs, to maintain good relationships with patients and support their persistence in cancer treatment.

"Women who discontinue endocrine therapy without consulting their doctors are placing themselves at risk of breast cancer recurrence," Professor Preen said.

"Communication should be a two-way street between doctors and patients to ensure appropriate decisions are made regarding the ongoing use of these medicines."