Dr Meisel on AE Communication Challenges in Metastatic Breast Cancer Treatment

Jane L. Meisel, MD, associate professor, Department of Hematology and Medical Oncology, associate professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, discusses findings from a study of communication challenges that exist between health care providers and patients with metastatic breast cancer regarding treatment-related adverse effects (TRAEs).

Meisel and colleagues surveyed patients with estrogen receptor–positive, HER2-negative metastatic breast cancer to gather perspectives regarding the AEs patients experienced during cancer treatment; the level and quality of communication patients received about AEs from their oncologists and medical teams; and the types of AE information patients preferred to receive.

This survey found that 49% of participating patients felt extremely comfortable or very comfortable discussing treatment AEs and toxicities with their medical team, 36% of patients felt somewhat comfortable, and 14% of patients felt not so comfortable or not comfortable at all. When patients were asked how informed they felt about treatment-related toxicities, 86% reported feeling well informed, and 25% indicated that their health care providers did not ask them which AEs they would find tolerable or intolerable. Meisel notes that when she explains chemotherapy or endocrine therapy regimens to patients, she prioritizes asking them which TRAEs they are most concerned about and works to avoid or mitigate those TRAEs as much as possible. For instance, if patients are worried about hair loss, Meisel chooses treatment regimens that are not associated with that AE when possible. If a patient is not eligible for therapies that are not associated with hair loss, Meisel suggests exploring alternative avenues to alleviate that AE, such as cold caps and wigs.

Talking to patients about the AEs of concern and considering those preferences when selecting a treatment regimen can improve patient quality of life, as patients may be able to avoid experiencing certain AEs, Meisel explains. These discussions also help build trust between patients and their care teams, according to Meisel. When patients feel that their oncology care team has their best interests in mind, they may feel less anxious or depressed about their disease and often feel a greater sense of empowerment, Meisel concludes.