GPs urged to help cancer therapy compliance

Women's health GPs should encourage their patients to complete the full course of tamoxifen treatment.

GPs should encourage breast cancer patients to continue taking tamoxifen, after research found that half of women fail to complete the full course of the drug.

A five-year course of tamoxifen, 20mg once daily, is recommended for women diagnosed with estrogen receptor-positive breast cancers.

For this latest study, researchers from the University of Dundee analysed prescription records of 2,080 women to see how many did not complete their full course of tamoxifen.

They found that 51 per cent of women had stopped taking the drug before the five-year course had finished.

Ten per cent of women who were followed up for one year stopped taking the drug and 19 per cent of women who were followed up for two years had also stopped taking tamoxifen.

Almost a third of women, 32 per cent, who were followed up for three-and-a-half years were found to be no longer taking the drug.

Lead researcher Professor Alastair Thompson, from Ninewells Hospital in Dundee, said that the findings painted a 'worrying picture'.

'Tamoxifen is prescribed for five years to offer the best chance of surviving breast cancer, and not taking the tablets means that many women could be disadvantaged,' he said.

'Doctors should encourage patients to keep taking their prescribed medications, ensure side-effects are managed as well as possible and get the maximum benefit from the medication.'

Dr Rob Bailey, a GP in Peterborough and a hospital practitioner in breast cancer, said: 'GPs should encourage women who have a high risk of breast cancer, such as those with large or high grade tumours, to complete the full course of tamoxifen.

'But if a patient is suffering side-effects caused by tamoxifen use and is in a low-risk group then they should stop the drug or switch to an alternative.'

If GPs encounter patients who have discontinued treatment they should discuss the situation with the patient's oncologist or breast surgeon, he advised.

BJC Online 2008.

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