In a groundbreaking study presented at the 17th AACR Conference on the Science of Cancer Health Disparities, researchers revealed a troubling connection between sexual health issues and reduced adherence to adjuvant endocrine therapy (AET) among Black women diagnosed with early-stage breast cancer. The findings were shared during the conference held from September 21-24, 2024, in Los Angeles.

Adjuvant endocrine therapy is commonly prescribed for patients with hormone receptor-positive breast cancer following surgery, radiation, or chemotherapy. This treatment, which can extend between five to ten years, aims to suppress estrogen signaling in the breast and significantly lower the chance of cancer recurrence.

However, many women undergoing AET report severe side effects, including anxiety, depression, hot flashes, and joint pain. Alarmingly, these effects often lead to treatment nonadherence—characterized by skipping doses or discontinuing treatment altogether. Previous studies have indicated that Black women are at a higher risk of experiencing these side effects and are more prone to nonadherence compared to their white counterparts. Yet, the impact of sexual health symptoms has remained underexplored.

Dr. Janeane N. Anderson, a researcher and assistant professor at the University of Tennessee Health Science Center, emphasized the need to focus on sexual health symptoms in her analysis. “In interviews and informal conversations with over 100 women over seven years, I repeatedly heard that sexual health is one of the greatest unmet needs,” she explained.

The study analyzed data from the THRIVE clinical trial, which tracked AET adherence among patients at the West Cancer Center & Research Institute. With a combined group of 102 Black women and 173 white women, the researchers closely monitored treatment adherence using an electronic pillbox and collected data through surveys assessing both physical and emotional symptoms associated with sexual health.

Findings revealed that for both Black and white women, symptoms like vaginal dryness, painful intercourse, and diminished libido correlated with lower mental quality of life. However, Black women were uniquely affected, as loss of interest in sex specifically linked to reduced physical quality of life. More concerning was the finding that sexual health symptoms, such as dryness and decreased libido, were directly associated with lower adherence to AET among Black participants.

Anderson noted, “Women are significantly affected by these symptoms,” stressing that the experience of these side effects varies between Black and white patients. She advocates for the importance of open communication regarding sexual health between patients and oncologists to effectively manage these issues and foster lasting adherence to treatment.

There are both hormonal and nonhormonal strategies available to alleviate these symptoms. Options such as vaginal moisturizers, topical estrogen treatment, and counseling can be highly effective. Anderson implores medical professionals to routinely address sexual health, emphasizing, “By focusing on these symptoms, we can potentially achieve similar AET adherence rates between Black and white women.

While the study offered compelling insights, its limitations include reliance on data from a single cancer center, which may restrict the application of the findings to broader populations and various geographic locales. Additionally, the research faced challenges with a limited representation of other minority women, further highlighting an urgent need for inclusive studies that assess sexual health symptoms across diverse populations.

This study, funded by the National Cancer Institute, underscores an imperative shift towards comprehensive care that acknowledges and addresses the sexual health needs of all women battling breast cancer, making a critical impact on treatment adherence and overall quality of life.