|
E-mail this page to a friend!
Senior Citizen Health & Medicine
Tamoxifen and Raloxifene Both Guard Against Invasive
Breast Cancer, But
Raloxifene the rising star says editorial in JAMA
 June 5, 2006 - Raloxifene and tamoxifen are both
effective in reducing the risk of invasive breast cancer, but each has
potential disease and quality of life side effects that women and their
physicians will need to consider, according to two reports and an
editorial published online June 5 by JAMA.
The papers are being published online to coincide
with the scientific presentation of this information at the annual
American Society of Clinical Oncology meeting in Atlanta. The papers
will be published in the June 21 issue of JAMA.
| |
Related Stories |
|
| |
Success of Raloxifene to Prevent Breast Cancer is
Encouraging for Senior Women
Osteoporosis drug
Raloxifene as effective as Tamoxifen without side effects
April 19, 2006 The study released Monday showing
the drug raloxifene, currently used to prevent and treat osteoporosis in
postmenopausal women, works as well as tamoxifen in reducing breast
cancer risk, without some of the side effects, is encouraging news for
female senior citizens, who are at the highest risk of breast cancer.
The disease is expected to strike 213,000 American women this year, with
the majority being over 50 years of age. The results show less uterine
cancer and blood clots from raloxifene.
Read more...
Older Women with Early Breast Cancer have Better
Survival with Aromasin
Company says 17% less deaths when
switched from tamoxifen
June 3, 2006 - New data from the Intergroup
Exemestane Study (IES) showed for the first time today that hormone
sensitive postmenopausal early breast cancer patients who switched to
Aromasin after 2 to 3 years of tamoxifen were 17% more likely to be
alive and were 25% less likely to have their cancer return than patients
who continued on tamoxifen for a full 5 years of therapy. The news was
issued by the company.
Read more...
Obesity Linked to All Types of Breast Cancer in
Older Women
Risk for spread of disease increased for all women
who gained weight
May 22, 2006 - According to a new study, women who
gain weight in adulthood face a higher lifetime risk of all types of
breast cancer even if they do not take hormone replacement therapy after
menopause. The study of postmenopausal women is the first to investigate
the relationship between weight gain and type of breast cancer.
Read more...
Breast Cancer Risk Assessment Information Updated by
Cancer Institute
Breast Cancer Risk
Assessment Tool available online
May 8, 2006 The National Cancer Institute has
recently updated its Web page on "Estimating Breast Cancer Risk," which
is a question-and-answer dialogue about the risk of most frequently
diagnosed non-skin cancer in American women and also promotes the use of
their online Breast Cancer Risk Assessment Tool. An estimated 213,000
American women will be diagnosed with breast cancer in 2006, many of
them senior citizens, since the risk of breast cancer increases as women
get older. Read
more...
Women Have High Expectations of Mammography
Screening
May 4, 2006 A study that included women up to 83
years old found a substantial proportion of women have beliefs about
their personal risk of breast cancer, and expectations about the
performance of mammography that are abnormally high or unrealistic.
The survey was conducted at University of Michigan Health Systems
in Ann Arbor, Michigan. Read
more...
Older Women Breast Cancer Survivors Not Continuing
Mammograms
April 24, 2006 - A new study finds use of annual
mammography among older female breast cancer survivors, who are at
increased risk of a recurrence or a new malignancy in the other breast,
dropped off after a few years. During the five year study period, only
one in three women in this high-risk group had received regular annual
mammograms. Read
more...
Read more
on
Health & Medicine |
|
Tamoxifen is a selective estrogen receptor
modulator (SERM) that has been used to treat both early and advanced
breast cancer for more than three decades, according to background
information in the article. Raloxifene is a second-generation SERM
currently used as a medication for the prevention and treatment of
osteoporosis. But clinical trials have shown it may have a role in
reducing the risk of invasive breast cancer in postmenopausal women.
Victor G. Vogel, M.D., M.H.S., from Magee-Womens
Hospital, University of Pittsburgh School of Medicine, and colleagues
from The National Surgical Adjuvant Breast and Bowel Project (NSABP),
conducted a randomized clinical trial (Study of Tamoxifen and Raloxifene
or STAR trial) at nearly 200 clinical centers throughout North America.
Patients were 19,747 postmenopausal women with an
average age of 58.5 years with an increased five-year breast cancer
risk. The study patients were randomized to receive oral tamoxifen (20
mg/day) or raloxifene (60 mg/day) over five years.
There were 163 cases of invasive breast cancer in
women assigned to tamoxifen and 168 in those assigned to raloxifene
(incidence, 4.30 per 1,000 vs. 4.41 per 1,000), according to the study
authors.
There were fewer cases of noninvasive breast cancer
in the tamoxifen group (57 cases) than in the raloxifene group (80
cases), while there were 36 cases of uterine cancer with tamoxifen and
23 with raloxifene; however, neither of these differences were
statistically significant.
No differences were found for other invasive cancer
sites, for ischemic heart disease events, or for stroke. Thromboembolic
events (such as blood clots in the lung or deep veins) occurred less
often in the raloxifene group and there were fewer cataracts and
cataracts surgeries in that group. The number of osteoporotic fractures
in the two groups was similar. There were no differences in the total
number of deaths or in causes of death.
The authors suggest that primary care physicians,
who are the most involved in preventive care, have not prescribed
tamoxifen because it is viewed as a toxic cancer drug. In contrast,
raloxifene is well known to the primary care community and is widely
prescribed for the prevention and treatment of osteoporosis in
postmenopausal women. More than 500,000 women in the United States are
currently taking raloxifene, the majority of whom are older and at lower
risk of breast cancer than are the women in the STAR trial.
In conclusion, the researchers write: This trial
confirms the previously reported benefit of raloxifene in reducing the
risk of invasive breast cancer and indicates that raloxifene is as
active as tamoxifen in this regard. If raloxifene is approved by the
Food and Drug Administration for the prevention of breast cancer,
primary care physicians may be more willing, given their experience with
raloxifene, to prescribe it for breast cancer chemoprevention than they
have been to prescribe tamoxifen.
The study was supported by Public Health Service
grants from the National Cancer Institute, National Institutes of
Health, Department of Health and Human Services, and by AstraZeneca
Pharmaceuticals and Eli Lilly and Co.
Patient-Reported Symptoms and Quality Of Life
In a related paper, Stephanie R. Land, Ph.D., from
the University of Pittsburgh and colleagues from the NSABP STAR trial
compared differences in patient-reported outcomes focused on quality
of life, and symptoms in the STAR participants. The patient-reported
outcomes were evaluated with standardized surveys.
No significant differences existed between the
tamoxifen and raloxifene groups in patient-reported outcomes for
physical health, mental health, and depression, although the tamoxifen
group reported better sexual function, the authors found.
Although mean (average) symptom severity was low
among these postmenopausal women, those in the tamoxifen group reported
more gynecological problems, vasomotor symptoms, leg cramps, and bladder
control problems, whereas women in the raloxifene group reported more
musculoskeletal problems, dyspareunia (pain during sexual intercourse),
and weight gain.
The NSABPs STAR trial, with its large-scale
symptom evaluation and well-powered quality of life substudy, provides a
comprehensive, detailed view of the patient experience using raloxifene
and tamoxifen. Both of these agents are indicated for prevention in
large populations, so these results can be widely used as tools in
decision making or in helping a woman anticipate and cope with the
sequelae of her chosen agent, the authors conclude.
Editorial: Is Raloxifene the Rising Star?
This year, more than 200,000 women in the United
States will be diagnosed as having invasive breast cancer, William J.
Gradishar, M.D., from the Northwestern University Feinberg School of
Medicine, and David Cella, Ph.D., from the Robert H. Lurie Comprehensive
Cancer Center of Northwestern University, Chicago, write in an
accompanying editorial.
The past 20 years of research translating an
understanding of basic biology into therapeutics has led to major
improvements in the survival and quality of life of patients who carry a
diagnosis of breast cancer.
The results of the STAR trial offer a pragmatic
stepping stone to the next prevention trial in breast cancer.
Raloxifene, if not superior to tamoxifen, may be more acceptable to
clinicians presenting the option of a preventive drug.
The breast cancer chemoprevention sky now includes
2 shining STARs tamoxifen and raloxifene. Although neither is a
supernova, their benefits include prevention of breast cancer in
postmenopausal women at increased risk and, in the case of raloxifene,
reduction of fractures related to osteoporosis.
"Perhaps because the clear benefits are limited to
these end points, the relatively modest adverse event profiles and
minimally impaired quality of life experienced by these women still may
not be enough to convince primary care physicians to be more aggressive
than they have been to date in breast cancer chemoprevention.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
