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Cancer treatment–specific medication beliefs among metastatic breast cancer patients: a qualitative study

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Abstract

Background/significance

Over 168,000 women are living with metastatic breast cancer (MBC) in the USA. More efficacious treatments have lengthened overall survival, but these treatments often result in a myriad of symptoms and financial burden that may negatively impact perceptions of cancer treatment and medication-taking behavior.

Purpose

To explore cancer treatment–specific medication beliefs among women undergoing cancer treatment for MBC.

Methods

A qualitative study was conducted using semi-structured interviews that were audio recorded and transcribed verbatim. A thematic analysis was conducted using ATLAS.ti 8.0 software. Inter-rater reliability was set at a threshold of 0.80. Participants were recruited from a National Cancer Institute–designated comprehensive care center. Eligibility included ≥18 years old, English speaking, confirmed MBC diagnosis, and able/willing to complete interviews via telephone or Zoom.

Results

Participants (n = 16) were largely Caucasian (86.7%) and non-Hispanic (93.3%). Mean age was 55.62 years. Three major themes were revealed, with corresponding subthemes: (1) positive cancer treatment–specific medication beliefs highlighting the benefit of treatment (relief of cancer-related symptoms and medication efficacy: delayed disease progression/extended survival); (2) negative cancer treatment–specific medication beliefs that caused concern for cancer treatment (medication symptoms, side effects and drug-drug interactions, financial toxicity, lack of guarantee medication would work); and (3) dialectical cancer treatment–specific medication beliefs indicating the benefits of cancer treatment outweigh the risks.

Conclusion

Overall, participants noted that the benefits of cancer treatment outweighed the risks in the context of metastatic disease. Participants understood their prognosis and that they depended on their cancer treatment for survival. Oncology providers should continue to assess and address medication beliefs over the treatment trajectory and assist MBC patients with the decisional balance between the risk and benefit of continued cancer treatment.

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Availability of data and materials

All data specific to this research article have been stored on a secure database and are available by making a formal request to the primary author, Dr. Victoria K. Marshall, Assistant Professor, University of South Florida, College of Nursing, at vkmarshall@usf.edu.

Code availability

All data, associated codes, and codebooks included in this article are available upon formal request to the primary author, Dr. Victoria K. Marshall, Assistant Professor, University of South Florida, College of Nursing, at vkmarshall@usf.edu.

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Authors and Affiliations

  1. College of Nursing, University of South Florida, Tampa, FL, USA

    Victoria K. Marshall & Constance Visovsky

  2. Mayo Clinic, Jacksonville, FL, USA

    Pooja Advani, Dawn Mussallem & Cindy Tofthagen

Authors
  1. Victoria K. Marshall
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  2. Constance Visovsky
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  3. Pooja Advani
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  4. Dawn Mussallem
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  5. Cindy Tofthagen
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Contributions

All the authors contributed to the study conception and design. Dr. Pooja Advani, Dr. Dawn Mussallem, and Dr. Cindy Tofthagen contributed to the IRB submission and recruitment of participants. Material preparation, and data collection and analysis were performed by Victoria K. Marshall, Constance Visovsky, and Cindy Tofthagen. The first draft of the manuscript was written by Victoria K. Marshall, and all the authors commented on, contributed to, and approved the final versions of the manuscript.

Corresponding author

Correspondence to Victoria K. Marshall.

Ethics declarations

Ethics approval

The Institutional Review Board from Mayo Clinic, Jacksonville, Florida, approved this study, IRB# 19-006784.

Consent to participate and publish results

Informed consent was obtained from all individual participants included in the study. Additionally, participants consented to having their data published.

Competing interests

The authors declare no competing interests.

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Marshall, V.K., Visovsky, C., Advani, P. et al. Cancer treatment–specific medication beliefs among metastatic breast cancer patients: a qualitative study. Support Care Cancer 30, 6807–6815 (2022). https://doi.org/10.1007/s00520-022-07101-7

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  • DOI: https://doi.org/10.1007/s00520-022-07101-7

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