Helping Patients Weigh Extended Endocrine Therapy With the BCI

Helping patients understand when and how to use tools such as the Breast Cancer Index (BCI) is an important part of shared decision-making regarding whether to continue endocrine therapy beyond 5 years, according to Michelle Kirschner, MSN, RN, ACNP, APRN-BC, director of program development at the Cancer Survivorship and Supportive Care Professionals Network.

Kirschner explained that patients are often unaware that resources like the BCI are available and that the first step is education, including clearly explaining what the test is, why it matters, and how it can be useful. She noted that patients should decide for themselves whether they wish to use the BCI, but oncology nurses and advanced practice providers should feel comfortable initiating and guiding these conversations.

According to Kirschner, discussing the potential value of the BCI can help patients with different stances on continuing treatment. It may encourage individuals who are struggling with adverse effects (AEs) to continue treatment by providing a clearer understanding of the benefits, or it may give others the confidence to stop therapy when it is not needed, easing anxiety about recurrence. Presenting the pros and cons, she emphasized, enables patients to make more informed choices that align with their personal goals.

Transcript

What’s most important is to let patients know when we have these types of tools to use in decision making, because there are so many times that patients don’t even know these resources are available. It’s also a part of the patient’s decision if they want to use BCI.

The first step is that education: “What is this? Why is it important? How is it useful?” Then they need to decide, “Is that something that I want to do?” If you’re new to the space, you must feel comfortable with having that discussion. That’s what’s really important: being able to fully educate the patient as to why [the BCI] could be helpful in their decision making on both ends [of the spectrum]. Maybe it’s convincing someone who’s having a little bit of a hard time on these medications to continue, giving them that motivation factor, but it also may be allowing individuals who don’t need to continue treatment to feel confident stopping treatment and relieving some of their anxiety. Having that discussion and being able to do the pros and cons [is helpful for patients.]

This transcript has been edited for clarity and conciseness.