Adherence and Treatment Tolerability in Breast Cancer: A Patient-Centered Approach to Improving Outcomes With Erica Fortune, PhD

At the 2024 San Antonio Breast Cancer Symposium (SABCS), Dr. Erica Fortune, Vice President of Research at Cancer Support Community, presented their abstract on the relationship between treatment adherence, tolerability, and patient experiences in breast cancer. These findings underscore the importance of understanding patients’ needs and preferences to maximize treatment success.

Why Treatment Adherence Matters

“Adherence is critical when it comes to achieving optimal outcomes,” Dr. Fortune explained. Treatment adherence directly impacts therapy effectiveness, influencing disease management and recurrence prevention. Poor adherence can lead to worse outcomes, including disease progression and, unfortunately, mortality. However, adherence is not simply a patient decision, it is shaped by a variety of personal, emotional, and practical factors.

Key Findings From the Research

Cancer Support Community’s study, derived from their Cancer Experience Registry, explored factors that influence treatment tolerability and adherence in breast cancer. The registry collects patient-reported data on physical, emotional, and practical aspects of cancer care. Among the 244 surveyed individuals, several striking results emerged:

1. Top Factors for Tolerability: The top three factors influencing treatment tolerability were the ability to slow disease progression, symptom relief, and treatment side effects. For nonmetastatic patients, the potential for a cure was even more critical than side effects
2. Adherence Levels: Encouragingly, only 23% of respondents reported treatment non-adherence. Reasons cited included a desire to avoid side effects, interference with daily activities, and impact on personal life
3. The Role of Emotional Wellbeing: Dr. Fortune highlighted the emotional toll of treatment as a significant factor. “Support of wellbeing should be part of the standard of care process,” she stated, stressing the importance of addressing emotional health alongside physical treatment.

Additionally, cost and affordability of treatment emerged as major barriers, linking the findings to ongoing health equity concerns. As Dr. Fortune explained, “Tolerability and adherence are health equity issues that need to be continually discussed.”

Key Takeaways

• For patients: Cancer Support Community is here for you. Dr. Fortune encourages patients to share their experiences, emphasizing that their voices are vital to shaping programs, policies, and research priorities
• For clinicians: Patient preferences, emotional wellbeing, and tolerability must be central to care discussions. Asking these questions and understanding the factors that impact tolerability can improve adherence and, ultimately, outcomes

Conclusion

Improving breast cancer treatment outcomes requires a patient-centered approach that prioritizes emotional health, accessibility, and personal preferences. Addressing these factors will not only support adherence but also ensure that patients feel heard and supported throughout their cancer journey.

About Dr. Fortune

Erica Fortune, PhD, is the Vice President of Research at Cancer Support Community. She holds a PhD in Cognitive and Experimental Psychology from the University of Georgia and previously served as an Associate Professor of Psychology at Arcadia University. Dr. Fortune’s research focuses on cognition, decision-making, and risk-taking as part of the patient experience, as well as outcomes, disparities, and communication within healthcare settings. She has experience working with patients with cancer, HIV, and addictive disorders. At Cancer Support Community, she leads efforts in program evaluation and assesses the impact of their programming and support on individuals and communities.