University of Miami, Coral Gables, Florida, USA.
Massachusetts General Hospital, Boston, Massachusetts, USA.
Eur J Cancer Care (Engl). 2022 Nov;31(6):e13723. doi: 10.1111/ecc.13723. Epub 2022 Oct 4.
Most patients report pain while taking adjuvant endocrine therapy (AET) for the treatment of breast cancer. While studies have examined patients' experiences with side effects, none solely capture patients' experiences with AET-related pain, a troubling symptom that reduces quality of life and impairs treatment adherence. This study explored themes of AET-related pain to inform future intervention development.
Between November 2017 and November 2018, female patients (n = 30) with early-stage breast cancer enrolled between 3 and 36 months post-initiation of AET. Purposeful sampling was stratified by adherence level, age, distress level and time taking AET. Study staff conducted, transcribed and coded semi-structured interviews via inductive thematic coding to identify pain-related themes and achieved high inter-coded reliability (Kappa = 0.96).
Several pain-related themes were observed. Attitudes around pain are generally negative, and management needs are largely unmet. Patients reported preferences for non-pharmacological management strategies and cited AET pain as a reason for medication breaks but not discontinuation. Patients within 19 months of starting AET and low adherers reported more intense and disruptive pain.
Patients' experiences varied by patient attributes and revealed modifiable factors that may be targeted through behavioural interventions. AET-related pain is a complex side effect for which psychosocial support may be beneficial.
大多数接受辅助内分泌治疗（AET）治疗乳腺癌的患者在治疗过程中会报告疼痛。虽然有研究检查了患者对副作用的体验，但没有一项研究专门针对与 AET 相关的疼痛，这种令人困扰的症状会降低生活质量并影响治疗依从性。本研究探讨了与 AET 相关的疼痛主题，以为未来的干预措施开发提供信息。
2017 年 11 月至 2018 年 11 月，在开始 AET 后 3 至 36 个月期间，招募了 30 名患有早期乳腺癌的女性患者。根据依从水平、年龄、困扰程度和接受 AET 的时间，进行了有针对性的抽样。研究人员通过归纳主题编码对半结构化访谈进行了转录和编码，以确定与疼痛相关的主题，并实现了高编码可靠性（Kappa=0.96）。
观察到了几个与疼痛相关的主题。人们对疼痛的态度普遍较为消极，而对疼痛的管理需求基本得不到满足。患者报告了对非药物管理策略的偏好，并指出 AET 疼痛是药物中断的原因之一，但不是停药的原因。开始接受 AET 治疗 19 个月内和低依从性的患者报告了更强烈和更具破坏性的疼痛。
患者的体验因患者的属性而异，揭示了一些可能通过行为干预来靶向的可改变因素。与 AET 相关的疼痛是一种复杂的副作用，可能需要提供社会心理支持。
