Managing Side Effects

For postmenopausal women with hormone receptor–positive breast cancer, aromatase inhibitors (AIs) are an essential therapy to extend survival and reduce recurrence risk. They are usually prescribed for at least five years. However, the most common side effect—arthralgia—should not be underestimated, as it can severely affect treatment adherence. Discontinuation rates are reported to be as high as 13–22%. Without proper understanding and management, patients may miss the full therapeutic benefit.

In Hong Kong, breast cancer is the most common cancer among women, and head and neck cancers are also relatively prevalent. Radiotherapy plays a critical role in the treatment of both.

Cancer treatments—particularly chemotherapy drugs such as docetaxel, carboplatin, anthracycline, paclitaxel, or vinorelbine, as well as head and neck radiotherapy—cause taste alterations in about 86% of patients. These changes may include a metallic taste, bitterness, diminished taste sensitivity, or even complete loss of taste. Symptoms can last from several weeks to months (SpringerLink).

EGFR-targeted therapies (including EGFR-TKIs and EGFR antibodies) have significantly prolonged survival in various solid tumors such as lung cancer, head and neck cancer, and colorectal cancer. Their efficacy is well established. However, side effects—particularly cutaneous toxicities—pose a major threat to patients’ quality of life, sometimes forcing dose reductions or even treatment discontinuation.
This article has been revised from the perspective of Hong Kong patients, emphasizing “prevention first, response second”, and provides practical answers to common patient concerns and management strategies.