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Women With Certain Breast Cancer Type Can Safely Skip Chemotherapy: What Are The Side Effects Of Endocrine Therapy?

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Many women with an early-stage breast cancer can safely skip chemotherapy and focus on another type of treatment. Experts said this is a game-changer in the field of cancer since patients need not undergo a toxic treatment that is unlikely to yield long-term health benefits.

Researchers from participating hospitals and cancer care centers conducted gene tests on tumors from women with early-stage breast cancer. They found that the patients can safely forego chemotherapy if they take a drug that blocks the production of estrogen.

The study was published June 3 in the New England Journal of Medicine.

Outcomes Of The 12-Year TAILORx Study

The drug called tamoxifen is the primary component of the endocrine or hormonal therapy. Results of the TAILORx trial showed that women who took tamoxifen had lower risks of relapse, new tumor formation, and cancer death.

"The new results from TAILORx give clinicians high-quality data to inform personalized treatment recommendations for women," said lead author Dr. Joseph Sparano, the associate director of clinical research at Montefiore Einstein Center for Cancer Care in New York City.

"These data confirm that using a 21-gene expression test to assess the risk of cancer recurrence can spare women unnecessary treatment if the test indicates that chemotherapy is not likely to provide benefit," Dr. Sparano said.

Other medical professionals, who are not part of the 12-year study, said the results present new hope for breast cancer patients with good prognosis, especially that there is an alternative treatment aside from chemotherapy.

Side Effects Of Endocrine Therapy

The National Cancer Institute at the National Institutes of Health defines endocrine therapy as a treatment that adds, blocks, or removes hormones. In certain cancer types such as prostate or breast, hormones could cause the growth of tumors. In some cases, a surgery is required to remove the gland that produces the hormone.

Endocrine or hormonal therapy has been recognized as a viable alternative to chemotherapy. In a study published in the October 2010 issue of Annals of Oncology, study authors noted that women with responsive tumors who undergo endocrine therapy experience severe sexual dysfunction.

Other side effects include suppressed ovarian function such as pregnancy, bone loss, lipid disorders, and decreased cognitive function. A 15-year follow-up study of the Scottish Adjuvant Tamoxifen trial published in 2001 showed that tamoxifen treatment in premenopausal women with breast cancer was discontinued due to adverse effects such as hot flushes, vaginal discharge, irregular menstruation, ovarian cysts, and endometrial polyps, among others.

"Although an advantage from the use of tamoxifen can be demonstrated for patients with lower risk disease, the question of whether or not to treat with tamoxifen depends on a risk-benefit analysis," reported Dr. Marco Colleoni, the director of the Division of Medical Senology at the European Institute of Oncology in Milan, Italy.

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