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Study Examines Side Effects of Breast Cancer Prevention Drugs

Posted on: Monday, 5 June 2006, 21:00 CDT

ATLANTA _ Though two breast cancer prevention drugs are equally effective at lowering a woman's chance to develop the disease, experts say deciding which drug to take may be difficult.

At a meeting of cancer specialists on Monday, researchers released data showing that women taking the standard treatment drug tamoxifen reported more gynecological problems, hot flashes, leg cramps and bladder-control problems than those taking the osteoporosis treatment drug raloxifene. The women on tamoxifen also reported better sexual function.

Women taking raloxifene had more musculoskeletal problems, pain during intercourse and weight gain, the study showed.

"It does us no good if a woman doesn't take the drug, so the effects on quality of life are important," said Patricia A. Ganz, the director for cancer prevention and control research at Jonsson Comprehensive Cancer Center at UCLA, who presented the findings.

Thus, women should take one of the drugs and discuss quality of life with their physician after three months to decide if a switch is needed, she said.

The quality-of-life differences are the latest finding in the STAR (Study of Tamoxifen and Raloxifene) trial, which included nearly 20,000 participants; the quality-of-life study subset had 1,983 participants. Researchers released results in April that found raloxifene worked just as well as standard treatment using tamoxifen in preventing breast cancer.

Tamoxifen is taken for five years. It blocks the effects of estrogen, a hormone that can fuel rapid cell growth and certain cancers. However, it increases the risk of developing uterine cancer or a life-threatening blood clot.

Raloxifene has the same side effects as tamoxifen, but those taking the drug had 36 percent fewer uterine cancers and 29 percent fewer blood clots, that study showed.

Both studies were presented at the American Society of Clinical Oncology meeting and are published this week in the Journal of the American Medical Association.

"These studies give physicians and patients options about which drugs are best to use for particular indications," said Robert F. Ozols, senior vice president of the medical science division at Fox Chase Cancer Center in Philadelphia. Still, it's up to primary care physicians to prescribe the medication, said D. Lawrence Wickerham, an author of the STAR trial.

He expects that most will prescribe raloxifene because of their familiarity with the drug.

Another study presented Monday found that women at high risk for breast and ovarian cancer could lower their disease risk by having their ovaries and fallopian tubes removed.

The study found that surgery reduced ovarian cancer risk best in patients with the BRCA1 gene mutation, whereas those with the BRCA2 gene mutation had more benefit in their breast cancer risk. After about three years of follow-up, surgery reduced breast cancer risk by 72 percent in women with the BRCA2 mutation, compared with 39 percent in those with the BRCA1 mutation.

The surgery reduced ovarian cancer risk in women with the BRCA1 mutation by 87 percent. So far no ovarian cancer has been observed in those with the BRCA2 mutation.

About 5 percent to 10 percent of breast cancers are caused by inherited mutations in a single gene. Women with mutations in BRCA1 or BRCA2 have about an 80 percent chance of getting breast cancer in their lifetimes.

"Although these are healthy women without disease, their lifetime risk is 10 to 60 times greater than what's seen in the general population," said Noah Kauff, author of the study and an assistant attending physician at Memorial Sloan-Kettering Cancer Center.

And since many of the women have watched their loved ones die from cancer, that option, while drastic, is a good one, he said.

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(c) 2006, Milwaukee Journal Sentinel.

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Source: The Milwaukee Journal Sentinel

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