Endocrine Treatment Toxicity in Breast cancer: A Good Thing?

smiling senior woman with husband in brackground white

We have additional evidence that post-menopausal women who get side effects from anti-estrogen treatment for breast cancer do better than those who don’t experience toxicity! A study of nearly 10,000 women received some anti-estrogen treatment for breast cancer. Patients received either the anti-estrogen drug exemestane for 5 years, or tamoxifen for 2.5-3 years, followed by exemestane (for 2.5-2 years).

Results: Patients who reported vasomotor symptoms (for example, hot flashes) during the first year of treatment had a longer disease-free survival (DFS) and loger overall survival (OS) when compared to those who did not have such side effects. Women who had discomfort in their muscles, bones, or joints also achieved superior DFS (but not OS). These results helpd true regardless of the type of anti-estrogen therapy.

My take: The link between toxicity and treatment benefit is intriguing. Still, we need better studies, as the  available ones have mixed results. The researchers need to do a better job of controlling for symptoms at baseline, other medications used at the same time as the anti-estrogen therapy, and capturing side effects with a validated tool.

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Caveat: This material is for general use only, and should not be regarded as personal, individualized medical advice. Please check with a valued health care provider with any questions or concerns. Today’s material is based on an article in the Journal of Clinical Oncology, published 22 April 2013.

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Harvard AB Yale MD UPenn Radiation Oncology Radiation Oncologist, Seattle area

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