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Expecting the Worst Increases Side-Effects in Breast Cancer Patients on Hormone Therapies

A study of women receiving hormone therapies such as tamoxifen as part of their treatment for breast cancer has found that the number and seriousness of side-effects they experienced were influenced by their expectations.

The study, which is published in the journal Annals of Oncology, found that women who had higher expectations of suffering more and worse side-effects before their treatment began did, in fact, experience more after two years of adjuvant hormone therapy. They experienced nearly twice the number of side-effects than did women with positive expectations or who thought the effects would not be too bad.

The researchers say that their findings are important because women may stop taking their adjuvant hormone treatment if they experience too many side-effects and worse health-related quality of life; this, in turn, can affect the success of treatment and survival. However, if expectations can predict the risk of experiencing side-effects, then interventions such as counseling could lower the risk and, therefore, improve adherence to medication.

Professor Yvonne Nestoriuc, of the Department of Psychosomatic Medicine and Psychotherapy at the University Medical Centre, Hamburg, Germany, who led the study, said: "Our results show that expectations constitute a clinically relevant factor that influences the long-term outcome of hormone therapy. Expectations can be modified so as to decrease the burden of long-term side-effects and optimize adherence to preventive anti-cancer treatments in breast cancer survivors."

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