[MOL] Luckier then you think [01164] Medicine On Line


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[MOL] Luckier then you think




I think that you have already met me,but if you haven,t this is your lucky
night.My name is Frank,and I have been called the best looking of the
group.You see,I have experienced four major attacks of cancer.This past
summer I lost my right kidney and prostate.Now I have spots on my left
kidney,and liver.So I act this way because I am scared to death.But
anyway,I,m good looking,I have a good sense of humor,and I am very
rich,because I have so many friends on this chat line.Your loving friend,the
best of them all.."Lone Wolf Frank"










----- Original Message -----
From: deb grodin <debg@home.com>
To: <mol-cancer@lists.meds.com>
Sent: Thursday, May 13, 1999 7:28 PM
Subject: 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).
> > >> >
> >
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