ASUHAN KEPERAWATAN

Early menopause is often a side effect for women treated with chemotherapy for breast cancer, but a new study reveals some guarded promise for preventing early menopause breast cancer patients. The results are published in the Journal of the American Medical Association.

While most breast cancer is diagnosed at later ages, about 6% of women learn that they're ill before age 40 - when they are still of childbearing age. Breast cancer treatments that have shown the best results for for disease free survival include chemotherapy, hormonal therapy, or both. For younger women still hoping for children, these treatments can cause devastating short-term or long-term loss of menstrual periods, and loss of fertility. While many women choose to preserve the option of having children by storing eggs before cancer treatment, the process can be costly and difficult.

Italian researchers conducted a phase three study that included 281 women with breast cancer, aged 18 to 45 years and who had not experienced menopause. Patients were randomly selected to be treated with chemotherapy alone or with chemotherapy and triptorelin, a drug, called a GnRH analogue, that prevents the ovaries from releasing eggs. The researchers followed the women for one year after they had finished chemotherapy.

Among the women who had not received triptorelin, the rate of early menopause was 25.9%. Among the women who had received triptorelin, the rate of early menoapuse was 8.9%, which is 17% lower.

An accompanying editorial by Dr. Hope S. Rugo and Dr. Mitchell P. Rosen of the University of California-San Francisco says that trptorelin therapy should not be recommended as a standard treatment and should be approached with caution in women with hormone-sensitive disease. They also stress that women resuming their menstrual cycles does not mean the same thing as women preserving their fertility. They conclude that using assisted reproductive technology – such as storing eggs before chemo, is “the most effective option for fertility preservation.”
(cnn)

Cancer Patients Struggle as Drug Costs Soar: Study TUESDAY, June 7 (HealthDay News) --Increasing out-of-pocket expenses forcesmany cancer patients in the United States toforgo drugs and doctor appointments andto cut back on food and other necessities, anew study reveals.The researchers looked at 216 cancerpatients who sought help from the nationalnonprofit HealthWell Foundation, whichhelps underinsured patients affordexpensive medications. All but one patienthad insurance, two-thirds were covered byMedicare and 83 percent had prescriptiondrug coverage. Most of the patients werewomen (88 percent) with breast cancer (76percent).The patients' out-of-pocket expensesaveraged $712 a month for things such asprescription drugs, doctor visit copays, lostwages and travel to medical appointments.These expenses were a significant problemfor 30 percent of the patients and acatastrophic problem for 11 percent,according to the researchers at DukeUniversity Medical Center and the Dana-Farber Cancer Institute.The study didn't examine whether patientssuffered worse outcomes because oftreatment choices they were forced to makedue to financial problems. However, theresearchers did find that patients took fewermedications due to costs and were lesssatisfied with their care when out-of-pocketexpenses caused hardship.The data and conclusions of this study,which was scheduled for presentationMonday at the annual meeting of theAmerican Society of Clinical Oncology inChicago, should be viewed as preliminaryuntil published in a peer-reviewed journal."Overall, this study provides a patient-centered view of a reality of modern daycancer care -- something that we call'financial toxicity,'" senior author Dr. AmyAbernethy, an associate professor in Duke'smedical oncology division, said in a Dukenews release."We used to think about chemotherapytoxicity in terms of bad side effects likevomiting, nerve pain, confusion and risk offatal infection. Now we are starting to thinkin terms of how treatment choices impactreal aspects of daily living such as the abilityto buy groceries or not," she added. Cancer Patients Struggle as Drug Costs Soar: Study