According to a study released last week in the journal Cancer, almost 25% of women taking tamoxifen stopped within one year, a much higher rate than has been suggested. By 3.5 years, more than one-third of the women had discontinued the drug, said the authors of the study, from Trinity College Dublin in Ireland.
Like the aromatase inhibitors, tamoxifen should be taken for at least five years, according to current research. Taking the drug for fewer than five years leads to higher rates of cancer recurrence and death.
For The Record
Los Angeles Times Wednesday January 31, 2007 Home Edition Main News Part A Page 2 National Desk 1 inches; 37 words Type of Material: Correction
Breast cancer: An article on breast cancer drugs in Monday's Health section said Dr. Cary Presant is past president of the American Cancer Society. He is past president of the California division of the American Cancer Society.
For The Record
Los Angeles Times Monday February 05, 2007 Home Edition Health Part F Page 6 Features Desk 1 inches; 32 words Type of Material: Correction
Breast cancer: A Jan. 29 article on breast cancer drugs misstated Dr. Cary Presant's title. He is past president of the California division of the American Cancer Society, not the national organization.
The recent studies have ignited a call for more long-term research on patients taking antihormonal drugs for breast cancer.
"We're becoming much more aware about what patients are experiencing," says Dr. Jennifer Garreau, chief surgical resident at Oregon Health & Science University and coauthor of the side-effects study in the American Journal of Surgery. "We need to not just focus on the effects of the treatment; we need to focus on patients' quality of life."
Sometimes, switching to another aromatase inhibitor (three are available) or switching from tamoxifen to an aromatase inhibitor or vice versa can correct, or limit, a problem. Other drugs can be used to treat specific symptoms, such as pain relievers for muscle aches and bone pain; antidepressants for hot flashes; and calcium, vitamin D and bisphosphonates for bone thinning. Women should consider having a bone density scan before beginning an aromatase inhibitor regimen, Presant says.
"At least 80% of side effects can be treated effectively, and 90% of women can stay on the drugs," he says.
Many of the side effects are thought to persist, however. Because aromatase inhibitors are expensive medications, doctors and patients should also consider the cost of medications used to treat side effects, Garreau says.
Although many doctors worry that women will reduce their chance of survival if they stop taking the drugs, quality of life must be factored into the equation, says Barbara Brenner, executive director of Breast Cancer Action.
Women who are still suffering from side effects despite efforts to resolve them should consider whether the therapy is worth it, Brenner says. "The first question is, what is your risk of recurrence," she says. "If your risk is low -- and you see it as low -- then maybe it isn't worth the risks of the drug. However, another patient may see risk in a very different way. She may say, 'I'm going to do whatever I can to prevent a recurrence.' "
shari.roan@latimes.com
