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

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.