¶ … treatment using the drug, tamoxifen, and higher mortality rates in females aged over forty years. The peer-reviewed papers employed for this study reveal a dynamic scrutiny of the aforementioned link. Quantitative as well as qualitative research works have been utilized, with a comparison and contrast made of the most apt methodology employed by the researchers. The end goal is ascertaining whether or not it is a risky decision to not adhere to tamoxifen treatment and how much information patients possess with regard to the drug and its effects.
The Research Question and its Importance
After the diagnosis of her health condition, Ms. Jones is prescribed tamoxifen as medication. For an entire year, Ms. Jones fails to consume this prescribed drug. Upon revisiting the hospital after a year of not complying with this recommended treatment plan, she is told that her cancer has reappeared and is much more lethal than before. She is told that she has only 6 months to live. Further, Ms. Jones claims a number of her relatives have also succumbed to this disease in the past, indicating a family history of cancer. Thus, she is worried that this disease will be the chief causative factor of her looming death. The sections that follow aim at ascertaining whether or not mortality due to breast cancer is accelerated if the patient fails to adhere to the medication prescribed.
Research Question
Does non-compliance with 'taxomifen' treatment lead to increased risk of mortality in elderly females diagnosed with breast cancer?
PICO Framework and Description of Each Element of the Research Question using the PICO Framework
P (Population): breast cancer patients
I (Intervention): Tamoxifen
C (Comparison): non-compliance
O (Outcome): heightened mortality risks
According to the ACS (American Cancer Society), breast cancer is one of the most frequently witnessed forms of cancer to be diagnosed, and is also the second greatest cause of death. Roughly two hundred thousand females receive breast cancer diagnoses per annum, with 40,000 succumbing to it (averagely), according to 2010 estimates (ACS, 2010). While progress has been achieved with respect to eliminating the disease, in the form of timely ailment predictions/diagnoses and therapeutic interventions, this form of cancer apparently reappears in 30% of patients, largely on account of their non-compliance with the prescribed tamoxifen chemotherapy. As it is an estrogen hormone-dependent growth, it commences and develops swiftly (Banerjee et al., 2003).
In the opinion of Chang (2012), tamoxifen is a major component of estrogen receptor positive (ER+) breast cancer therapy. Besides being employed for more than three decades, the drug is currently utilized in the form of chemo-preventer for females highly vulnerable to developing breast cancer. This triphenylethylene derivative is pharmacologically grouped among SERMs (selective estrogen receptor modulators) which is a uterine agonist but an antagonist when it comes to the breast. The drug is most frequently utilized as a chemotherapeutic agent to treat individuals suffering from ER+ breast cancer that accounts for nearly 70% of all surfacing cases. Tamoxifen functions in the form of a partial antagonist in the breasts (which are hormonesensitive), hampering estrogen receptor function by vying with the hormone to bind to the receptor (Banerjee et al., 2003). The bound estrogen receptor complex disallows gene activation by estrogen, resulting in estrogenic impact inhibition; estrogenic impacts are responsible for the development and spread of cancer cells (Chang et al., 2007). A number of ER+ cancer patients are intrinsically resistant to hormone treatment, irrespective of high estrogen receptor levels. A large number of patients suffering from localized cancer and almost every patient suffering from advanced forms of the disease and display initial positive response to tamoxife treatment gradually develop acquired (de novo) resistance to the drug (EBCTCG, 2005). Intriguingly, a number of patients who suffer relapse when on tamoxifen medication will display response to diverse kinds of hormonal manipulations. These include aromatase inhibitors or estrogen receptor antagonists/downregulators. This indicates that estrogen receptor is still a critical contributor to the advancement of breast cancer (Pike et al., 1993; Forbes et al.,2008; Mouridsenet al., 2009)
While the molecular processes which underlie tamoxifen medication resistance are still...
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