High-Risk Women May Often Avoid Using Tamoxifen

FRIDAY Dec. 4, 2009 -- Worries about side effects are a major reason why only 6 percent of American women at high risk for breast cancer are willing to take the drug tamoxifen to prevent the disease, a new study finds.

In an effort to inform women about the risks and benefits of tamoxifen, researchers at the University of Michigan Comprehensive Cancer Center created a decision aid, which was tailored to the health history of each of the 632 women in the study.

"That means, when women read this decision aid, they learned about how the drug was likely to affect them given their age, race, breast cancer history and medical history," study author Angela Fagerlin, an associate professor of internal medicine at the University of Michigan Medical School and a research investigator at the VA Ann Arbor Healthcare System, said in a university news release.

The researchers found that the decision aid helped inform the women about the risks and benefits of tamoxifen, with 63 percent correctly answering at least five of the six questions about the drug and 41 percent getting all six questions right.

However, although the women apparently achieved a high level of understanding about the risks and benefits of tamoxifen therapy, only 29 percent said they were likely to look for more information about the drug, 29 percent said they'd talk to their doctor about it and only 6 percent said they were likely to take tamoxifen. When questioned about the drug again three months later, fewer than 1 percent of the women had started taking the drug and fewer than 6 percent had sought more information or talked to their doctor about tamoxifen.

Eighty percent of the women in the study said they were worried about the drug's side effects, which can include hot flashes, sexual problems and, in rare cases, blood clots, cataracts or endometrial cancer, the study authors noted.

"Experts have bemoaned the dearth of women taking these pills, worried that word has not gotten out about tamoxifen's ability to prevent breast cancer in high-risk women. Our study shows that even when the word does get out, most women are too concerned about the pills' side effects to want to take it," senior author Dr. Peter Ubel, a professor of internal medicine and director of the University of Michigan's Center for Behavioral and Decision Sciences in Medicine, said in the news release.

The study was released online in advance of publication in an upcoming print issue of the journal Breast Cancer Research and Treatment.

More information

The U.S. National Cancer Institute has more about tamoxifen.

Posted: December 2009


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