ABSTRACT: Tamoxifen in Breast Cancer: Symptom Reporting
Clinical studies have traditionally identified treatment-specific
side effects by comparison of voiced side effects in treatment
and placebo arms of a study.
Highly motivated women in a clinical
trial may underreport drug-induced symptoms for medications which
may be considered lifesaving. Affective symptoms during treatment
of early breast cancer with tamoxifen (an estradiol receptor
antagonist) were reported as infrequent by the manufacturer.
However, reports suggest a higher rate of depression during general
use. The objective of the present study was to examine the frequency
of symptoms that might be side effects of tamoxifen and to relate
them to the way the women attributed such symptoms.
study involved semistructured telephone interviews of 25 women
who were taking tamoxifen. Textual analysis of the information
was used to examine the symptoms described by the women. They
were also asked whether any symptoms were related to the medication.
The symptoms and their attribution were evaluated against a background
of self-perceived stress.
The principal finding was a pattern
of ambivalence in attributing symptoms to the drug. Of all the
symptomatic changes noted, the women only attributed 51%
to tamoxifen. Flushes, fatigue, and depression were reported
most frequently during treatment; flushes were readily attributed
to tamoxifen but depression and fatigue were attributed to another
factor by half of the symptomatic women.
Women who reported moderate
to high levels of life stress were less likely to attribute symptoms
to drug therapy.
The results suggest that women taking tamoxifen
may not attribute known drug side effects to use of the medication.
[04/26/2001; The Breast]
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