At the symposium at the ESMO 2025 Congress, we have addressed, I would say, a neglected but very important topic, which is adherence to adjuvant endocrine therapy, which is something that as oncologists we will probably not have been so careful about over the past years. However, we do know now, way better than in the past, the major negative impact that endocrine therapy may have on the quality of life of our patients, even in the long term, and this negative effect on their quality of life may have a critical influence on adherence to the treatment itself...
At the symposium at the ESMO 2025 Congress, we have addressed, I would say, a neglected but very important topic, which is adherence to adjuvant endocrine therapy, which is something that as oncologists we will probably not have been so careful about over the past years. However, we do know now, way better than in the past, the major negative impact that endocrine therapy may have on the quality of life of our patients, even in the long term, and this negative effect on their quality of life may have a critical influence on adherence to the treatment itself. And we do have now accumulating data, particularly published in the last couple of years, clearly showing that if a patient, as we could expect, but we now have proof and evidence that if a patient does not take a drug, of course, there could be potential negative consequences also on her prognosis. So it’s what we say, that we need to address survivorship-related issues, also to avoid having survival issues. There are a lot of potential reasons for non-adherence to endocrine therapy. One of the critical reasons is the toxicity of the therapy. We do have different types of endocrine agents, tamoxifen, aromatase inhibitors, ovarian function suppression in premenopausal women. Each of these treatments has its own toxicity profile, and these side effects may again lead to a potential treatment interruption if we do not properly address this toxicity. So what we have discussed also in this symposium, the need for a proactive management of these side effects. We do have different ways to help patients try to stick to the therapy. One of them is, again, addressing the toxicity and the side effects of the treatment. We do have many pharmacological and non-pharmacological strategies that we can offer. Some of them, very simple measures, physical exercise, maybe acupuncture, cognitive behavioral therapy, before moving maybe to other pharmacological strategies, anti-depressive agents, some treatments that may work on musculoskeletal symptoms or on flashes. The main point from this session is really to help proactively patients to prevent, if possible, or to counteract if the side effects appear, to really help them to adhere to the treatment.
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