Adjuvant Hormonal Therapy
Hormonal or anti-endocrine treatments are a primary part of adjuvant breast cancer treatment for women with ER positive tumors. Tamoxifen, the first such medication, has been approved for early breast cancer treatment since the early 1980s; the Ais are a most recent option for post-menopausal women. To make a sweeping generalization, these drugs generally reduce the recurrence risk by 50%. That is, if the risk is 20%, a hormonal agent will reduce it to 10%. This is comparable to the benefit from chemotherapy, so clearly a powerful and important contribution. And, as opposed to chemotherapy, these medications are easy to take.
Yes, there are side effects, and there are a few very serious ones: the small risk of pulmonary emboli or endometrial cancer from tamoxifen. The more common and not dangerous side effects include weight gain (usually in the 5-10 pound range), joint and/or muscle aches and pains, hot flashes. The aromatase inhibitors may cause bone weakening, so annual or bi-annual bone density exams are generally recommended.
Women seem to be staying on these drugs for increasingly long periods of time. In the beginning, the standard treatment was five years, but now it is often ten years, and there are hints that it may become longer and longer.
Here is a good summary from MedScape about this kind of treatment and then another link if you want to read even more:
Adjuvant Hormone Therapy for Breast Cancer
Author: Rachel Swart, MD, PhD; Chief Editor: Jules E Harris, MD more...
Updated: Sep 17, 2012
Adjuvant Hormone Therapy In ER positive earlystage breast cancer, hormone therapy plays a main role in adjuvant treatment, either alone or in combination with chemotherapy. Hormone treatments function to decrease estrogen's ability to stimulate existing micrometastases or dormant cancer cells.
Adjuvant hormone therapy can reduce the relative risk of distant, ipsilateral, and contralateral breast cancer recurrence by up to 50% in tumors with high ER expression.
FDAapproved endocrine therapies for adjuvant treatment of breast cancer include tamoxifen and the aromatase inhibitors (anastrozole, letrozole [Estroblock], exemestane [Aromasin] ).
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