SAN ANTONIO, Dec. 9 /PRNewswire/ -- Hot flashes, some intense enough to severely affect quality of life, can be successfully treated with hormone replacement therapy (commonly referred to as HRT), but apparently not in women receiving tamoxifen to prevent recurrence of breast cancer. Nearly 60% of postmenopausal women develop hot flashes, and 10% to 20% report that they are nearly unbearable. Although losing weight, exercising, and changing drinking or smoking habits can help to some degree, HRT is the most effective treatment for hot flashes. HRT has recently been shown to cause a slight increase in the risk of breast cancer, but some physicians may continue to prescribe it for selected patients whose quality of life is severely impacted by hot flashes.
The growing number of breast cancer survivors who are undergoing long-term tamoxifen treatment represent a challenge. Patients taking tamoxifen frequently develop hot flashes as a result of tamoxifen treatment, and these may continue even long after treatment is completed. Although most patients report that the symptoms are mild, one third of women say that the hot flashes caused by tamoxifen are severe. The occurrence of vasomotor symptoms like hot flashes is a leading reason for women to decide against using tamoxifen, or to stop using it prematurely. Since proper long-term use of tamoxifen can reduce the risk of cancer recurrence by as much as 50%, this is a major clinical problem.
At the 28th Annual San Antonio Breast Cancer Symposium, Ivana Sestak, PhD, of Cancer Research UK, discussed whether HRT would effectively curb hot flashes in patients being treated with tamoxifen. Unfortunately, it appears to have only a slight effect. In Dr. Stestak’s study, HRT was given to patients 6 months after the beginning of treatment with either placebo or tamoxifen. For patients taking placebo, 23% of those taking HRT reported hot flashes, compared with 34% of those not taking HRT. In the tamoxifen group, 61% of patients taking HRT reported hot flashes, compared with 50% of patients not taking HRT. This latter difference was not significant, indicating that HRT was ineffective in preventing hot flashes in women taking tamoxifen
Because hot flashes can seriously affect quality of life in women taking tamoxifen, clinicians may wish to work with their patients in investigating alternative approaches to alleviating this vasomotor symptom. Various agents that have been investigated for relief of hot flashes include progestins, tibolone, clonidine, fluoxetine, and the herb black cohosh. Care should be taken, however, to determine if such agents might interfere with the therapeutic action of tamoxifen. Tamoxifen itself has only limited clinical value until it is metabolized into a more active form in the body. Some medications that might otherwise be considered for the relief of menopausal symptoms, including the antidepressants paroxetine and fluoxetine, may interfere with this activation, leading to increased risk of breast cancer recurrence.
San Antonio Breast Cancer Symposium
CONTACT: Marybeth Libonate, +1-201-433-9400, marybeth@m2usa.com, for theSan Antonio Breast Cancer Symposium
Web site: http://www.sabcs.org/
