Perceptions of breast cancer survivors participating in a Chinese herbal medicine study : an exploratory narrative study

Objective: Survivors report Hot Flushes/Night Sweats (HF/NS) as the most debilitating side-effect of breast cancer endocrine therapy with limited treatment options. The aim of the investigation was to gather information, not available in quantitative outcome measures, including narrative data of women's experiences of HF/NS and personal experience of participating in a Chinese Herbal Medicine (CHM) trial to alleviate this bothersome side-effect. This is an import¬ant pilot feasibility study to evaluate the potential benefit of trialling a novel Chinese medicinal product for a symptom of HF/NS identified as an unmet need for breast cancer survivors and may help inform future studies. Participants and Methods: Semi-structured focus groups were conducted with 8 breast cancer survivors with hot flush symptoms. All women had been randomised to participate in a CHM clinical trial for alleviation of HF/NS. A discussion guide was employed to provide insights regarding symptom experience, hot flush impact on quality of life, and qualitative data related to the acceptability and feasibility of CHM as a management option for HF/NS. Digitally recorded nar¬ratives were analysed using thematic analysis. Results: Our analysis confirms CHM acceptability is complex. The taste was deemed "not pleasant", however, the driver of hot flush reduction helped maintain adherence. Additionally, after completing their primary care participants reported a feeling of insecurity and not knowing where to turn for help with side-effects of treatment. These findings reveal that survivorship has its challenges and can impact quality-of-life with psychosocial and physiological implications long-term. Categories identified included 'give it a go', 'avoidance and acceptance', 'routine and reward', 'transitioning to survivorship'. Conclusion: Focus group findings report CHM through the hospital setting provided an additional safety measure. Drivers for acceptabil¬ity of CHM included commitment to the trial, the belief that it would work, taking a more active role in their well-being and feeling valued as a participant in the trial. Other themes include opportunities for better transition to survivorship and management of adverse effects.