Keep up with breast cancer information.

It's good to stay informed when it comes to breast cancer. These helpful articles have treatment facts, as well as tips for staying on track with your treatment plan.

By Lillie Shockney, RN, MAS

Going the Distance with Hormonal Therapy
Follow these tips to help you stick to your hormonal therapy.

Completing your breast cancer treatment is a huge milestone. But for some women, there's one more step they can take to help lower the odds they'll get breast cancer again: hormonal therapy. To reap that benefit, and the peace of mind that comes from taking action, it's important to take your medication exactly as prescribed.

I am a two-time breast cancer survivor whose second tumor was hormone-receptor positive. I know firsthand the challenges of adhering to hormonal therapy. Some days I had to remind myself why I would take something that didn't make me feel like myself. I placed a photograph of my husband and daughter next to my prescription bottle as a reminder.

If you're not sure about the benefits of hormonal therapy or how to overcome barriers that may be keeping you from taking it as prescribed, read on.

Know the benefits of hormonal therapy

Clinical trials involving thousands of women have shown the benefits of hormonal therapy. In one hormonal therapy study, the risk of a new cancer dropped a considerable percentage in women with node-negative tumors and also showed a measurable decrease in women with node-positive tumors. Even more important, those who took hormonal therapy were much more likely to live another 10 years.

Can a woman get the same benefit if she takes hormonal therapy every other day, or at a lower dosage than recommended? We simply don't know.

Figure out why you're not taking your meds

Despite the clear benefits of taking hormonal therapy as directed, some women still look for ways to adjust their medication dosage or schedule. One study showed that about one fourth of all women taking hormonal therapy in clinical trials chose to stop treatment ahead of schedule. In some studies, as much as 40 % of the participants quit early.

There are lots of valid reasons why some women may not take their hormonal therapy medication as directed. See if any of them apply to you:

You may be experiencing side effects from the medication. Potential side effects include hot flashes, night sweats, vaginal dryness, reduced libido, depression, sleep disorders, joint pain, and nausea. Any one of these is enough to make you feel miserable.

Hormonal therapy is a long-term commitment. Studies show that people who must take a medication for a short time to treat a serious but temporary condition are more likely to take it as directed. In contrast, hormonal therapy is usually taken for quite a long time, usually for 5 years. And breast cancer is always considered a chronic condition, even if you've finished treatment.

You can't feel the drug working. The benefits of hormonal therapy are "silent"—you can't really feel your risk of recurrence going down! But the side effects can be "loud"—you can definitely feel the uncomfortable symptoms. Some women get so discouraged that they want to stop or alter their therapy.

You may think of yourself as "cured" after surgery, chemotherapy, or radiation. Such a belief may keep you from recognizing the risk-reducing benefits of hormonal therapy.

You may not be aware of the drug's benefits. If a woman doesn't know or understand the purpose and benefit of the medication, she also may not grasp the importance of taking it daily.

You can't afford the medication. Some women may skip doses to try to make the medication last longer.

You and your doctor may communicate poorly. A woman may not feel free to ask questions or may feel dissatisfied with her care.

You may forget. This can happen if you are also taking multiple medications for other health conditions.

Be patient before changing your treatment

If side effects are a problem, it's not unusual for a woman to ask to modify her treatment after taking the medication for only a few weeks. Yet we don't really know the long-term effects of changing your medication schedule or jumping from one hormonal therapy to another. Talk to your doctor if you're having trouble sticking to your medication or to discuss other treatment options.

Hormonal therapy works but it takes time to see its full effects. Keep the benefits in mind and get help if you need it.

Doing the right thing

If you haven't been taking your medication as prescribed, here are tips to help you get back on track:

Be honest with your doctor. Tell your doctor if you aren't taking the medication as prescribed and why. If side effects are the reason, discuss your symptoms openly. Then, work with your doctor to address each one. Vaginal dryness got you down? One of several effective lubricants may take care of it. Not comfortable telling your (male) doctor? Ask to discuss your concern with a female nurse.

Focus on the drug's purpose. You're taking hormonal therapy to reduce your risk of getting cancer again. Ask for a clear explanation of how the drug works and the benefits you may get by faithfully taking it each day—you may find this information inspiring.

Ask about side effects before starting the drug. Each woman reacts differently to hormonal therapy. Knowing what to expect can help you notice and deal with symptoms right away. Hormonal therapy side effects are not trivial; if your doctor treats them as such, seek a second opinion. Most importantly, find out what can be done to relieve them.

Get your questions answered right away. Ask your doctor for a telephone number you can call with questions between scheduled visits.

Tell your doctor if you can't afford the medication. There are resources available to help you pay for your medicine.

Get support. Ask the doctor or nurse for a list of organizations and support groups in your town and on the Web. Many offer information and advice to patients taking hormonal therapy.

Tips to help you stick with your hormonal therapy

Keep meds in a convenient location. Place the bottle in a spot where you'll see it daily. Or use a daily pill dispenser so you can easily tell if you forgot to take your medicine on any given day.

Stick to a schedule. Every day, take your medication at the same time and place. If you take it with your morning coffee, place the bottle next to the coffee maker.

Remember to refill. Call in your refill before your prescription totally runs out. If you're going on a long trip, plan ahead so you won't run out while you're away.

Ask family and friends for friendly reminders. A note taped to the bathroom mirror by your partner that says, "I love you, so take your medicine," can do wonders!

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