Supportive care underutilized by breast cancer survivors

July 29, 2020

New research shows that, when seeking treatment for cancer-related fatigue, breast cancer survivors underutilize recommendations.

Cancer-related fatigue (CF) can significantly impact breast cancer survivors and limit their ability to return to a normal life. Although research proves that physical activity and psychosocial interventions are successful in alleviating CF, many breast cancer survivors struggle to adhere to them.1

A new study from the European Society for Medical Oncology (ESMO) analyzed the real-world uptake of physical activity and supportive care recommendations among early breast cancer survivors.

The findings, presented at the ESMO Breast Cancer Virtual Meeting, highlighted a need for more personalized recommendations tailored to unique needs of the patient. They also found that the use of supportive care seemed to be overshadowed by an emphasis on physical activity as the primary recommendation.

Using data from a CANTO study that analyzed long-term toxicities in early breast cancer patients from 26 French cancer centers for at least 5 years from the time of diagnosis, researchers investigated data from more than 7,000 patients, all of whom had completed primary treatment and were free of disease.2

Patients reported the use of the recommended fatigue treatment strategies—physical activity and supportive care—once at baseline and 12 months thereafter. While 64% of patients compied with physical activity recommendations during that year, 36% reported severe fatigue at 3 to 6 months after treatment.

Patients who reported severe levels of fatigue immediately after completing treatment were less likely than those with non-severe symptoms to adhere to physical activity recommendations (59% versus 67%) in the year after treatment.

According to researchers, only one out of 10 women consulted a psychologist; one out of 12 saw an acupuncturist; and one of 14 sought treatment from a homeopath.1 Researchers note that cost may have had an impact, but it requires further research.

“The fact that the strategies patients adopt to manage side-effects are strongly correlated to the type of fatigue they are suffering from is particularly interesting,” Prof. Gabriella Pravettoni, Director of the Psycho-Oncology Division at the Eurpean Institute of Oncology (IEO) said in a recent press release. “Patients experiencing significant physical fatigue, for example, may actually benefit substantially from seeing a psychologist.”3

Patients with severe physical fatigue, according to the study, were less likely to adhere to physical activity recommendations, at 59% compared to 67% of those with non-severe physical fatigue. The study also found that women with severe overall fatigue were only 1.3 times more likely to seek help from a psychologist than patients with non-severe fatigue.

This study highlights the need for more emphasis on supportive care to improve patients’ motivation and resilience, and that CF relief recommendations should be personalized.

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References
  1. Abstract 183O ‘Use of physical activity (PA) and supportive care (SC) among patients (pts) with early breast cancer (BC) reporting cancer-related fatigue (CRF)‘ will be presented by Antonio Di Meglio during the Proffered Paper session 1 on Saturday, 23 May, 12:45 to 14:15 (CET) on Channel 1. Annals of Oncology, Volume 31, Supplement 2, May 2020
  2. Vaz-Luis I, Cottu P, Mesleard C, et al. UNICANCER: French prospective cohort study of treatment-related chronic toxicity in women with localised breast cancer (CANTO) ESMO Open 2019;4:e000562. doi: 10.1136/esmoopen-2019-000562
  3. “Supportive Care to Relieve Cancer-Related Fatigue Is Largely Underutilized by Breast Cancer Survivors.” ESMO.org, ESMO, 22 May 2020, www.esmo.org/newsroom/press-office/esmo-congress-breast-2020-breast-supportive-care-fatigue-dimeglio.