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Focus: Recent Findings about Breast Cancer Treatment

separator As women live longer and longer after being diagnosed with breast cancer, researchers have had the opportunity to study the long-term effects of medications and chemotherapy regimens. There have been important findings about how often women with certain types of cancer should have chemotherapy, and also about two common breast cancer medications, Arimidex and Tamoxifen.

Decreasing cancer recurrence through new chemo regimen
One area of breast cancer treatment that’s undergoing some change is the frequency of chemotherapy. Instead of having chemotherapy every three weeks, which has become fairly standard, women who have breast cancer that’s spread to the lymph nodes, or women who are in a high risk category, may benefit from having what’s called “dose-dense chemotherapy.” In these cases, patients have their chemo treatments every two weeks instead of every three weeks.

Studies are finding that this schedule reduces the risk of breast cancer recurrence. For patients, the schedule has good points and bad ones. The good thing is that the overall chemotherapy treatment lasts for 4 months instead of 6. The difficult aspect is that you don’t have as much time to recover in between treatments. On the other hand, your hair begins to grow back 4 months after starting chemo instead of 6, and that’s a big plus for lots of women.

Additionally, people on dose-dense chemotherapy used to have to inject themselves every day with a drug that kept helped their bone marrow produce white blood cells. This, in turn, helped prevent infections, which are a common complication of chemotherapy. Now, however, there’s a medication that requires just one injection within 24 hours after a chemotherapy treatment. This is a big improvement in quality of life for patients.

Another issue that’s evolving is that researchers are learning that more and more people with early stage cancer benefit from chemotherapy, whereas before, many thought that chemo wasn’t necessary for early stage cancer. But a large study has shown that sometimes, people who had early stage cancer and did not receive chemotherapy may experience a recurrence of the cancer, even as long as 10 years later. To avoid this, many doctors are explaining to their patients that having chemotherapy may be the safest way to prevent a recurrence, even if the cancer is in an early stage.

Chemo drug that lowers rate of recurrence
Currently, there’s an ongoing research project called the ATAC Trial (Arimidex or Tamoxifen Alone or in Combination) that has provided information about two breast cancer drugs—Tamoxifen and Arimidex. The trial has more than 9,300 women participating from all over the world. The latest information from the ATAC trial shows that for women who received either Tamoxifen, Arimidex or a combination of both, Arimidex was better than Tamoxifen at preventing recurrence.

There have been about 70 months of follow-up data from the ATAC trial. Results indicate that compared to Tamoxifen, Arimidex produces

  • Higher disease-free survival rate
  • Decreased rate of recurrence
  • Decreased rate of recurrence of new breast cancer

Additionally, women on Arimidex had fewer hot flashes than women on Tamoxifen, a smaller chance of uterine cancer and reduced risk of blood clots. One problem with Arimidex is that it increases the risk of osteoporosis. So if you’re taking Arimidex, you’ll need to have your bone density monitored on a regular basis.

These new findings are important, but not every woman who has breast cancer should  necessarily have dose-dense chemotherapy or Arimidex instead of Tamoxifen. These are things you should discuss with your doctor, so that you understand the pros and cons of your treatment and which treatments are most appropriate for you.

The National Cancer Institute; Presentations from the 25th Annual San Antonio Breast Cancer Symposium, December 2004.
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