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To test my theory I searched for academic studies about chemotherapy non-adherence in general. A practice that is common in oncology. The study that proves my theory is linked and excerpted below.
My interpretation of the studies linked below is that it is physicians who cause more problems with sticking to chemotherapy regimens than patients. Maybe they are the ones who need “education.”
I am a cancer survivor and cancer coach. Breast cancer patients must think beyond conventional oncology in order to beat their cancer. Scroll down the page to ask a question or make a comment. I will reply to you ASAP.
“Women who are at high risk of developing breast cancer may be failing to take the preventive anti-cancer drug tamoxifen because they are confusing naturally-occurring symptoms with side effects from the medicine, according to a study…
Tamoxifen, which is used to treat women with breast cancer driven by the oestrogen hormone, has been shown to reduce the incidence of breast cancer by at least 30 per cent if it is given before disease develops in women who are at high risk of developing it due to factors such as a family history of breast cancer…
Overall, 69.7 per cent of women managed to adhere to their treatment for at least 4.5 years (74 per cent taking placebo and 65.2 per cent taking tamoxifen). Symptoms that were reported included nausea or vomiting, headaches, hot flushes and gynaecological symptoms, such as irregular bleeding, vaginal dryness and vaginal discharge. Drop-out rates were highest in the first 12-18 months of follow-up (7.4 per cent on placebo versus 12.2 per cent on tamoxifen).
At six months among women who reported symptoms of nausea or vomiting, just over 40 per cent failed to adhere to their treatment, regardless of whether they were receiving placebo or tamoxifen…
This is particularly important for women who are expected to experience the menopause while taking preventive therapy,” said Dr Sestak. “These discussions may encourage more realistic expectations of the likelihood of experiencing side effects…””
“Physician nonadherence to cancer treatment regimens may diminish treatment efficacy and compromise clinical research. The influence of clinical, demographic, and psychosocial patient characteristics on physician adherence to breast cancer chemotherapy was investigated, as was the role of the clinician’s attitudes concerning the chemotherapy.
One hundred seven women recently diagnosed with breast cancer were followed for 26 weeks of treatment. Fifty-six (52%) of the patients experienced unjustified modification for at least one chemotherapeutic agent. Stepwise multiple regression revealed independent contributions of increased patient age, treatment setting (clinic versus academic or community private practice), and stage of disease to physician nonadherence.
Regimen complexity, delay in seeking treatment, and presence of psychiatric disorder did not contribute, in general, to unjustified regimen modifications. Patient psychological and psychiatric factors, however, did influence prescribing behavior for vincristine. Physician awareness of factors contributing to unnecessary treatment modifications may reduce the frequency of such behaviors…”