Long Term Side Effects of Chemotherapy
This is a sobering article from the Annals of Oncology about the possible long-term consequences of adjuvant chemotherapy. Although we would agree that the most important goal is to treat the breast cancer so it does not recur, it is important to recognize that these are powerful drugs with other implications. Here is the abstract and then a link to read more:
Long-term toxic effects of adjuvant chemotherapy in breast cancer
- H. A. Azim Jr1,
- E. de Azambuja1,
- M. Colozza2,
- J. Bines3 and
- M. J. Piccart1,*
- 1Department of Medical Oncology, Jules Bordet Institute, Brussels, Belgium
- 2Department of Oncology, Terni Hospital, Terni, Italy
- 3Department of Clinical Oncology, University Hospital of Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence to: Dr M. J. Piccart, Department of Medical Oncology, Jules Bordet Institute, Boulevard De Waterloo, 125, 1000 Brussels, Belgium. Tel: +32-2-541-72-39; Fax: +32-2-538-08-58; E-mail: firstname.lastname@example.org
- Received August 25, 2010.
- Revision received October 19, 2010.
- Accepted October 25, 2010.
Breast cancer is the most common malignant tumor affecting women. Adjuvant systemic therapies have been shown to have a significant impact on reducing the risk for breast cancer recurrence and overall mortality. Chemotherapy remains an important and frequently used treatment option in the adjuvant setting, and the associated short-term adverse events are very well described. However, there is insufficient information regarding the long-term sequelae of most chemotherapeutic agents. In this review, we describe different potential long-term adverse events associated with adjuvant chemotherapy in breast cancer, with a particular focus on long-term cardiac toxicity, secondary leukemia, cognitive function, and neurotoxicity. In addition, we discuss the effect of adjuvant chemotherapy on fertility and sexual function of young breast cancer patients. These adverse events are frequently overshadowed by the well-demonstrated clinical efficacy and/or reassuring short-term safety profiles of the different chemotherapy regimens commonly used today. We believe that a proper understanding and appreciation of these adverse events will enable us to refine our strategies for managing breast cancer. The fact that adjuvant chemotherapy is often given to patients who might not really need it urges us to consider the whole spectrum of chemotherapy risks versus benefits to maximize benefit without compromising quality of life