Re: [MOL] NY Times re: Tamoxifen/Evista [01161] Medicine On Line


[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index]

Re: [MOL] NY Times re: Tamoxifen/Evista



I just wanted to say that when I stumbled upon this sight I had no idea
what a lucky person I had become. Really wish I had mol right after dx.
Thank you so much for all of your help and information.
Your friend
Debby G.

Lillian wrote:
> 
> Your doctor will send you to a bone specialist for the bone density testing.
> Just ask him.  Your friend, lillian
> 
> -----Original Message-----
> From: deb grodin <debg@home.com>
> To: mol-cancer@lists.meds.com <mol-cancer@lists.meds.com>
> Date: Thursday, May 13, 1999 12:27 PM
> Subject: Re: [MOL] NY Times re: Tamoxifen/Evista
> 
> >Too easy for me to see.Thank you that was brilliant. My next question
> >what doctor would I go to for the bone density test?
> >Thank you
> >Debby G.
> >
> >Martin Auslander wrote:
> >>
> >> DEar Deb,
> >>
> >> You may wish to take a bone density test first. If your bones are low in
> >> density,
> >> Tamoxifen is another form of bone strengthening or may help you make
> >> your decision. The test is quite simple its like a cat scan.
> >>
> >> God Bless
> >> marty auslander
> >>
> >> deb grodin wrote:
> >> >
> >> > And I wonder why I can't decide to take tamoxifen or not.
> >> > Finally finished 28 regular radiation treatments!!! Begin first of 5
> >> > boosts tomorrow and then I am done!!!!!! Wanted to celebrate today and
> >> > did - fell asleep outside under a tree. Do I know how to party or
> >> > what!!! Next week for a real celebration my husband is going with me
> and
> >> > then it's lunch in Princeton.
> >> > As for the channel 7 special report on Stacey Sagers breast cancer,
> part
> >> > two is on tonight. I did not watch it yet, however if you wish to view
> >> > it just go to the web site - www.7online.com. Tonight at 7:00 she will
> >> > be on line -  www.7online.com  to answer questions as to how she made
> >> > her decisions, and to answer questions. I think it runs for one hour.
> >> > I need to revisit my tree, I am so tired.
> >> > Debby G.
> >> > Becker, Joyce wrote:
> >> > >
> >> > > Round 3 in Cancer Battle: A 5-Year Drug Regimen
> >> > >     [05/11/99; New York Times (Free Registration Required)]
> >> > >
> >> > >                     Having completed the first two phases of
> treatment for an
> >> > > early breast cancer -- a
> >> > >                     lumpectomy and six weeks of radiation therapy --
> I have
> >> > > now begun the third and, in
> >> > >                     a way, the most exciting phase: five years of
> daily
> >> > > treatment with the drug
> >> > >               tamoxifen.
> >> > >
> >> > >               Unlike traditional cancer chemotherapy, tamoxifen does
> not kill
> >> > > cells and does not cause
> >> > >               nausea and hair loss. Tamoxifen is more like a growth
> >> > > regulator. It is an estrogen-like
> >> > >               compound that acts in the breast as an antiestrogen,
> preventing
> >> > > the natural hormone from
> >> > >               stimulating the growth of breast cancer cells.
> >> > >
> >> > >               Tamoxifen has been around for about 20 years. It was
> first used
> >> > > to treat advanced breast
> >> > >               cancer, then to prevent recurrence of less advanced
> disease.
> >> > > Now it is being used to prevent
> >> > >               breast cancer from occurring in the first place in
> women at
> >> > > high risk of developing the
> >> > >               disease.
> >> > >
> >> > >               Factors that contribute to a woman's risk of developing
> breast
> >> > > cancer include being over 60,
> >> > >               having a family history of breast cancer, having had a
> >> > > noninvasive breast cancer or
> >> > >               precancerous breast abnormalities, having begun to
> menstruate
> >> > > before the age of 12 and
> >> > >               having had no children or a first child after age 30.
> >> > >
> >> > >               The First Cancer Preventive
> >> > >
> >> > >               I admit to being confused and disappointed when my
> surgeon
> >> > > announced gleefully that my
> >> > >               cancer was highly sensitive to hormone stimulation, as
> >> > > indicated by a test for estrogen and
> >> > >               progesterone receptors on the cancer cells. To me that
> meant I
> >> > > would probably never again be
> >> > >               able to take postmenopausal hormones, which could
> protect my
> >> > > heart, bones and brain from
> >> > >               premature deterioration and which prevented hot flashes
> and
> >> > > vaginal dryness.
> >> > >
> >> > >               The surgeon was pleased because being
> >> > > estrogen-receptor-positive meant that my tumor was
> >> > >               slower growing, and that I could reap the maximum
> protection
> >> > > from tamoxifen, which has
> >> > >               been shown to cut in half the risk of recurrence of the
> >> > > original breast cancer as well as the
> >> > >               development of a second cancer in the opposite breast.
> >> > >
> >> > >               Estrogen receptors are found in about 65 percent to 80
> percent
> >> > > of breast cancers in
> >> > >               postmenopausal women and 45 percent to 60 percent of
> cancers in
> >> > > premenopausal women.
> >> > >
> >> > >               The higher the level of estrogen receptors in a woman's
> tumor,
> >> > > the greater the survival
> >> > >               benefit associated with taking the drug. Women whose
> cancers
> >> > > are
> >> > >               estrogen-receptor-negative reap some benefit from
> tamoxifen as
> >> > > well, suggesting that the
> >> > >               drug has other as-yet undiscovered actions.
> >> > >
> >> > >               Studies have indicated that five years of daily
> tamoxifen is
> >> > > more protective than one or two
> >> > >               years and as good or better than taking the drug for 10
> years.
> >> > > Its protective effects have been
> >> > >               shown to persist for at least five years after the drug
> is
> >> > > stopped.
> >> > >
> >> > >               Most exciting, last year tamoxifen was shown in a study
> of more
> >> > > than 13,000 women to
> >> > >               reduce by 50 percent the development of a first cancer
> in women
> >> > > considered at high risk for
> >> > >               the disease. This made tamoxifen the first drug found
> to
> >> > > prevent cancer, although it is still
> >> > >               not known for sure whether the protection is permanent.
> But
> >> > > tamoxifen may not be helpful in
> >> > >               women who carry cancer-promoting mutations of the genes
> BrCa1
> >> > > and BrCa2.
> >> > >
> >> > >               Dr. D. Lawrence Wickerham, an oncologist at Allegheny
> >> > > University in Pittsburgh and a
> >> > >               co-leader of national tamoxifen studies, said, "The
> cancers
> >> > > that developed in
> >> > >               tamoxifen-treated women tended to be smaller and were
> found at
> >> > > an earlier stage," meaning
> >> > >               they were more readily cured. Describing other benefits
> found
> >> > > in the studies, Dr. Wickerham
> >> > >               said: "Women taking tamoxifen suffered fewer bone
> fractures of
> >> > > the wrist, hip and spine and
> >> > >               their cholesterol level dropped by 12 to 20 percent.
> >> > > Furthermore, there is no evidence that
> >> > >               tamoxifen is associated with weight gain, depression,
> nausea or
> >> > > cancers of the ovary, liver
> >> > >               and gastrointestinal tract."
> >> > >
> >> > >               The effects of tamoxifen on the brain are unknown,
> though there
> >> > > is no evidence of any ill
> >> > >               effect, like memory impairment.
> >> > >
> >> > >               Unwanted Effects, Too
> >> > >
> >> > >               But for all the good tamoxifen does, it has certain
> major and
> >> > > minor disadvantages. Like
> >> > >               estrogen, it raises the risk of developing a relatively
> >> > > uncommon cancer of the uterus,
> >> > >               endometrial cancer, a disease that can be detected
> early
> >> > > through routine monitoring and cured
> >> > >               by surgery and, if needed, radiation therapy. Its other
> serious
> >> > > side effect -- one that is shared
> >> > >               by estrogen as well -- is an increased risk of blood
> clots,
> >> > > which are occasionally fatal.
> >> > >               Nonetheless, Dr. V. Craig Jordan of Northwestern
> University's
> >> > > cancer center, who did
> >> > >               pioneering research on tamoxifen, said the survival
> benefit
> >> > > from the drug for a woman like
> >> > >               me who has had breast cancer outweighs the risk of
> death from
> >> > > its effects on the uterus and
> >> > >               blood by about 30 times.
> >> > >
> >> > >               Stimulation of the growth of the endometrium, or
> uterine
> >> > > lining, which could increase the
> >> > >               risk of cancer, occurs in a small percentage of women
> who take
> >> > > tamoxifen. Nonetheless,
> >> > >               women may be advised to have a baseline uterine
> examination
> >> > > before starting tamoxifen,
> >> > >               followed by annual checkups to see if the drug is
> stimulating
> >> > > growth of the endometrium.
> >> > >               This examination can be done in a doctor's office as an
> >> > > endometrial biopsy or painlessly by
> >> > >               transvaginal ultrasound. A woman who experiences an
> unusual
> >> > > vaginal discharge or bleeding
> >> > >               while on tamoxifen should report that to her
> gynecologist
> >> > > without delay.
> >> > >
> >> > >               On a less serious note, tamoxifen also causes hot
> flashes in a
> >> > > quarter to a third of users and
> >> > >               an annoying vaginal discharge in about 5 percent to 10
> percent
> >> > > of women. The hot flashes
> >> > >               may seriously disrupt a woman's life. But they usually
> diminish
> >> > > with time, and their
> >> > >               intensity may be diminished by daily consumption of soy
> >> > > products like tofu and ground
> >> > >               flaxseed.
> >> > >
> >> > >               A New Class of Drugs
> >> > >
> >> > >               Tamoxifen, sold as Nolvadex, is the first of a new
> class of
> >> > > drugs called SERM's, for
> >> > >               selective estrogen receptor modulators. These compounds
> compete
> >> > > with natural estrogen for
> >> > >               a docking site on cells throughout the body. When these
> sites,
> >> > > called receptors, are occupied
> >> > >               by tamoxifen, estrogen cannot hook on properly and
> exert its
> >> > > usual effects.
> >> > >
> >> > >               A more recent addition to this class is raloxifene,
> sold as
> >> > > Evista, which seems to share most
> >> > >               of the characteristics, good and bad, of tamoxifen, and
> several
> >> > > other such drugs are in
> >> > >               various stages of development. The ultimate goal is to
> find a
> >> > > compound that does all the good
> >> > >               that estrogen does, including reducing the risk of
> heart
> >> > > disease and osteoporosis, stimulating
> >> > >               brain cells and preventing menopausal symptoms, but
> that has
> >> > > none of estrogen's bad
> >> > >               effects, especially raising the risk of cancers of the
> breast
> >> > > and uterus and causing blood clots.
> >> > >
> >> > >               Raloxifene, which is approved for the prevention of
> bone loss,
> >> > > also appears to protect the
> >> > >               breast and heart but without stimulating cell growth
> and cancer
> >> > > in the uterus. But like
> >> > >               tamoxifen, it can increase clotting and induce hot
> flashes, and
> >> > > it is not yet known whether it
> >> > >               is as good as or better than tamoxifen in preventing
> breast
> >> > > cancer.
> >> > >
> >> > >               A study to determine this, called STAR (for Study of
> Tamoxifen
> >> > > and Raloxifene), is just
> >> > >               getting under way. The study, sponsored by the National
> Cancer
> >> > > Institute, will involve
> >> > >               22,000 women and is expected to last 5 to 10 years.
> >> > >
> >> > >               "At the moment, it's too early to use raloxifene to
> prevent
> >> > > breast cancer outside of a clinical
> >> > >               trial," Dr. Wickerham said during a teleconference
> sponsored by
> >> > > Cancer Care Inc.
> >> > >
> >> > >               "We don't yet know raloxifene's long-term benefits or
> risks."
> >> > >
> >> > >               He suggested that women interested in possibly
> participating in
> >> > > the STAR trial call the
> >> > >               National Cancer Institute's hot line, (800) 4-CANCER,
> or sign
> >> > > on to the Web site of the
> >> > >               National Surgical Adjuvant Breast and Bowel Project.
> >> > >
> >> > >               More information on tamoxifen can be found in a new
> paperback
> >> > > book, "Tamoxifen," by Dr.
> >> > >               John F. Kessler and Greg A. Annussek (Avon, $5.99).
> >> >
> > ------------------------------------------------------------------------
> >> > > This is an automatically-generated notice.  If you'd like to be
> removed
> >> > > from the mailing list, please visit the Medicine-On-Line Discussion
> Forum
> >> > > at <http://www.meds.com/con_faq.html>, or send an email message to:
> >> > > majordomo@lists.meds.com
> >> > > with the subject line blank and the body of the message containing
> the line:
> >> > > unsubscribe mol-cancer your-email-address
> >> > > where the phrase your-email-address is replaced with your actual
> email
> >> > > address.
> >> >
> > ------------------------------------------------------------------------
> >>
> > ------------------------------------------------------------------------
> >> > This is an automatically-generated notice.  If you'd like to be removed
> >> > from the mailing list, please visit the Medicine-On-Line Discussion
> Forum
> >> > at <http://www.meds.com/con_faq.html>, or send an email message to:
> >> > majordomo@lists.meds.com
> >> > with the subject line blank and the body of the message containing the
> line:
> >> > unsubscribe mol-cancer your-email-address
> >> > where the phrase your-email-address is replaced with your actual email
> >> > address.
> >>
> > ------------------------------------------------------------------------
> >> ------------------------------------------------------------------------
> >> This is an automatically-generated notice.  If you'd like to be removed
> >> from the mailing list, please visit the Medicine-On-Line Discussion Forum
> >> at <http://www.meds.com/con_faq.html>, or send an email message to:
> >> majordomo@lists.meds.com
> >> with the subject line blank and the body of the message containing the
> line:
> >> unsubscribe mol-cancer your-email-address
> >> where the phrase your-email-address is replaced with your actual email
> >> address.
> >> ------------------------------------------------------------------------
> >------------------------------------------------------------------------
> >This is an automatically-generated notice.  If you'd like to be removed
> >from the mailing list, please visit the Medicine-On-Line Discussion Forum
> >at <http://www.meds.com/con_faq.html>, or send an email message to:
> >majordomo@lists.meds.com
> >with the subject line blank and the body of the message containing the
> line:
> >unsubscribe mol-cancer your-email-address
> >where the phrase your-email-address is replaced with your actual email
> >address.
> >------------------------------------------------------------------------
> >
> 
> ------------------------------------------------------------------------
> This is an automatically-generated notice.  If you'd like to be removed
> from the mailing list, please visit the Medicine-On-Line Discussion Forum
> at <http://www.meds.com/con_faq.html>, or send an email message to:
> majordomo@lists.meds.com
> with the subject line blank and the body of the message containing the line:
> unsubscribe mol-cancer your-email-address
> where the phrase your-email-address is replaced with your actual email
> address.
> ------------------------------------------------------------------------
------------------------------------------------------------------------
This is an automatically-generated notice.  If you'd like to be removed
from the mailing list, please visit the Medicine-On-Line Discussion Forum
at <http://www.meds.com/con_faq.html>, or send an email message to:
majordomo@lists.meds.com
with the subject line blank and the body of the message containing the line:
unsubscribe mol-cancer your-email-address
where the phrase your-email-address is replaced with your actual email
address.
------------------------------------------------------------------------