With the availability of more oral and topical drugs for the treatment of cancer, it’s surprising to learn that adherence to cancer medication is a common problem among patients. “One of the thoughts that a lot of people had was that because cancer medicines are treating a life-threatening disease, patients would be much more certain to take medications as instructed,” said J. Leonard Lichtenfeld, MD, MACP, Deputy Chief Medical Officer, American Cancer Society, in an interview with Pharmacy Today.
But research has shown otherwise, according to Lichtenfeld. Adherence is a problem even though oral cancer drugs—such as the older and widely used tamoxifen, as well as newer oral drugs including aromatise inhibitors, imatinib mesylate, erlotinib, and capcetabine—have fewer adverse effects and are better tolerated than I.V. chemotherapy drugs.
There is no “one size fits all” explanation for lack of adherence to medications that treat a life-threatening disease like cancer. Reasons cited include adverse effects that exist even with oral and topical drugs that are better tolerated, the cost of medications, a sense of fatalism about the disease, lack of support from family members and caregivers, and, especially among older adults who often take many medications, the difficulty in remembering to take their meds or in understanding how to take them correctly.
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