Priorities for alleviating menopausal symptoms after cancer.

Objective: To determine treatment priorities in women cancer patients attending a dedicated Menopausal Symptoms After Cancer service.
Methods: Cancer type and stage were abstracted from medical records. Women ranked up to three symptoms as treatment priorities from the list "hot flushes/night sweats," "mood changes," "vaginal dryness or soreness," "sleep disturbances," "feeling tired or worn out (fatigue)," "sexual problems and/or pain with intercourse," "joint pain," and "something else" with free-text response. For each prioritized symptom, patients completed standardized patient-reported outcome measures to determine symptom severity and impact.
Results: Of 189 patients, most had breast cancer (48.7%, n = 92), followed by hematological (25.8%, n = 49), gynecological (18.0%, n = 34), or colorectal (2.6%, n = 5). The highest (first-ranked) treatment priority was vasomotor symptoms (33.9%, n = 64), followed by fatigue (18.0%, n = 34), vaginal dryness/soreness (9.5%, n = 18), and sexual problems/pain with intercourse (9.5%, n = 18). Symptoms most often selected in the top three ("prioritized") were fatigue (57.7%, n = 109), vasomotor symptoms (57.1%, n = 108), and sleep disturbance (49.2%, n = 93). In patients who prioritized vasomotor symptoms, medians on the "problem," "distress," and "interference" dimensions of the Hot Flash Related Daily Interference Scale were, respectively, 6.0 (interquartile range [IQR], 5.0-8.0), 5.5 (IQR, 3.0-8.0), and 5.0 (IQR, 3.-7.0), indicating moderate severity. In patients who prioritized fatigue, the median Fatigue Scale score was 28 (IQR, 19-36), 37% worse than general population.
Conclusions: Vasomotor symptoms, fatigue, sexual problems, and vaginal dryness/soreness were the leading priorities for treatment. Understanding symptom severity and patient priorities will inform better care for this growing population.
Competing Interests: Financial disclosure/conflicts of interest: M.P. currently receives institutional funding from AE Rowden White and Edward R. White Foundation Trust “People and People Support” Grant, Cancer Council NSW Project Grant RG 21-06, and NHMRC (APP1163202). She has received past funding from Centre for Research Excellence in Women's Health in Reproductive Life (CREWHiRL) Seed Funding and Project Support Grant, Department of Obstetrics and Gynaecology Innovation Grants, Melbourne Medical School Minor Infrastructure Funding Scheme 2020, Department of Obstetrics and Gynecology MCR Fellowship, and Royal Children's Hospital Foundation. The other authors have nothing to disclose.
(Copyright © 2022 by The North American Menopause Society.)