Potential Benefits Of Risk
The USPSTF found convincing evidence that risk-reducing medications provide at least a moderate benefit in reducing risk for invasive estrogen receptorpositive breast cancer in postmenopausal women at increased risk for breast cancer .
Trials included women whose 5-year risk of breast cancer may have been lower than 3%.
Per 1000 women over 5 years of use.
§Results from the National Surgical Adjuvant Breast and Bowel Project Study of Tamoxifen and Raloxifene trial.
Both tamoxifen and raloxifene can reduce risk of some types of skeletal fractures, independent from the risk of breast cancer.
The USPSTF found that the benefits of taking tamoxifen, raloxifene, and aromatase inhibitors to reduce risk for breast cancer are no greater than small in women not at increased risk for the disease.
When Is Hormone Therapy Used
Hormone therapy is often used after surgery to help reduce the risk of the cancer coming back. Sometimes it is started before surgery . It is usually taken for at least 5 to 10 years.
Hormone therapy can also be used to treat cancer that has come back after treatment or that has spread to other parts of the body.
What Other Information Should I Know
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body’s response to anastrozole.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
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Can Arimidex Be Crushed Split Or Chewed
No, you shouldnt crush, split, or chew Arimidex tablets. Instead, you should swallow them whole. If you have trouble swallowing pills, talk with your doctor or pharmacist.
When you get Arimidex from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.
The expiration date helps guarantee that the medication is effective during this time. The of the Food and Drug Administration is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.
What Are Breast Cancer Chemotherapy Pills
Not all traditional chemotherapy drugs come in an oral form. Many chemotherapy medications, commonly prescribed to fight cancer are available as pills. Of these, capecitabine is approved in oral form for breast cancer.
Cyclophosphamide is another type of oral chemotherapy thats included as part of a combined treatment regimen called CMF .
Although most commonly administered intravenously for the treatment of breast cancer, methotrexate is another chemotherapy agent thats available in pill form.
Its important to know the difference between the various forms of oral medication prescribed to fight breast cancer, says Dr. Hannah Luu, California-based oncologist and CEO and founder of OncoGambit, an online service that creates personalized cancer treatment plans.
She outlines three categories of oral medications cancer patients may take as part of their treatment plan:
- chemotherapy pills
- antihormonal pills
- targeted therapy pills
Each therapy works differently and serves a different purpose, and not every medication will be right for everyone. Which therapy is right for you will depend on various factors including the type and stage of cancer youre fighting, and other health considerations.
In addition, many treatments known as targeted therapies may be prescribed orally.
Continue reading for an explanation of these medications and how they differ from oral chemotherapy.
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Common Breast Cancer Drugs
Doctors usually follow treatment protocols for cancer therapy. Protocols list the combination of drugs and how doctors should give them. Here are 10 drugs commonly prescribed for breast cancer:
Anastrozole is an aromatase inhibitor. It decreases estrogen levels in the body and can treat breast cancer that grows in the presence of estrogen. Anastrozole is a tablet you take once a day.
Cyclophosphamide is chemotherapy that comes as a tablet and an injection. You take the tablet once daily. Doctors give the injection intravenouslythrough a vein.
Everolimus is a targeted therapy. It interferes with signals telling cancer cells to grow and divide. This stops cancer cells from multiplying. It also decreases the blood supply to the cancer. It comes as a tablet and a dissolvable tablet you take once a day.
Exemestane is an aromatase inhibitor tablet you take once daily after a meal.
Fluorouracil is chemotherapy you receive intravenously.
Lapatinib is a . It blocks a protein that signals cancer cells to grow and divide. The dose consists of several tablets you take together once a day.
Letrozole is another aromatase inhibitor tablet you take once daily.
Methotrexate is that comes as a tablet and an injection. If you take the tablet, your doctor will give you specific instructions for when to take it.
Palbociclid is a targeted therapy. It works by blocking a protein that signals cancer cells to multiply. It is a capsule you take with food once a day.
How Could Oral Contraceptives Influence Cancer Risk
Naturally occurring estrogen and progesterone stimulate the development and growth of some cancers . Because birth control pills contain synthetic versions of these female hormones, they could potentially also increase cancer risk.
In addition, oral contraceptives might increase the risk of cervical cancer by changing the susceptibility of cervical cells to persistent infection with high-risk HPV types .
Researchers have proposed multiple ways that oral contraceptives may lower the risks of some cancers, including:
- suppressing endometrial cell proliferation
- reducing the number of ovulations a woman experiences in her lifetime, thereby reducing exposure to naturally occurring female hormones
- lowering the levels of bile acids in the blood for women taking oral conjugated estrogens
Burkman R, Schlesselman JJ, Zieman M. Safety concerns and health benefits associated with oral contraception. American Journal of Obstetrics and Gynecology 2004 190:S522.
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Follow Up Care After Breast Cancer Treatment
Many women are relieved or excited to be finished with breast cancer treatment. But it can also be a time of worry, being concerned about the cancer coming back, or feeling lost without seeing their cancer care team as often.
For some women with advanced breast cancer, the cancer may never go away completely. These women may continue to get treatments such as chemotherapy, hormone therapy, or other treatments to help keep the breast cancer under control and to help relieve symptoms from it. Learning to live with breast cancer that doesnt go away can have its own type of uncertainty.
Even if you have completed breast cancer treatment, your doctors will want to watch you closely. Its very important to go to all of your follow-up appointments. During these visits, your doctors will ask if you are having any problems, and will probably examine you. Lab tests and imaging tests aren’t typically needed after treatment for most early stage breast cancers, but they might be done in some women to look for signs of cancer or treatment side effects.
Can Other Drugs Interfere With Hormone Therapy
Certain drugs, including several commonly prescribed antidepressants , inhibit an enzyme called CYP2D6. This enzyme plays a critical role in the body’s use of tamoxifen because CYP2D6 metabolizes, or breaks down, tamoxifen into molecules, or metabolites, that are much more active than tamoxifen itself.
The possibility that SSRIs might, by inhibiting CYP2D6, slow the metabolism of tamoxifen and reduce its effectiveness is a concern given that as many as one-fourth of breast cancer patients experience clinical depression and may be treated with SSRIs. In addition, SSRIs are sometimes used to treat hot flashes caused by hormone therapy.
Many experts suggest that patients who are taking antidepressants along with tamoxifen should discuss treatment options with their doctors, such as switching from an SSRI that is a potent inhibitor of CYP2D6, such as paroxetine hydrochloride , to one that is a weaker inhibitor, such as sertraline or citalopram , or to an antidepressant that does not inhibit CYP2D6, such as venlafaxine . Or doctors may suggest that their postmenopausal patients take an aromatase inhibitor instead of tamoxifen.
Other medications that inhibit CYP2D6 include the following:
- Quinidine, which is used to treat abnormal heart rhythms
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How Long Will I Have To Take It
This will depend on your individual circumstances, but anastrozole is usually taken for five to ten years.
Some people start taking anastrozole after a number of years of taking the hormone therapy drug tamoxifen.
If youre taking anastrozole to treat breast cancer that has come back or spread to another part of the body, youll usually take it for as long as its keeping the cancer under control.
If youre taking anastrozole to reduce your risk of breast cancer developing because of your family history, youll usually take it for five years.
Does Taking The Combined Pill Increase The Risk Of Breast Cancer
Taking the combined pill will slightly increase the risk of breast cancer compared to people who are not taking it. But its important to remember that there are other things that have a bigger effect on breast cancer risk. For example, being overweight or obese increases the risk of breast cancer much more than taking the pill does.
When you stop taking the pill, your breast cancer risk stops increasing. About 10 years after stopping, a persons risk is no longer affected.
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Will I Have Any Permanent Damage After Using Arimidex
Its not likely that you will. In fact, side effects of Arimidex usually go away once youve stopped taking the drug.
However, Arimidex can weaken your bones while youre taking it. And some women can develop osteoporosis from this. You also have an increased risk of breaking a bone with Arimidex treatment. But one study found that after stopping Arimidex, the risk of breaking a bone was no longer increased.
If youre concerned about long-term side effects or permanent damage caused by Arimidex, talk with your doctor. They can discuss with you the risks and benefits of using this drug.
What Is The Problem
Most birth control pills prevent pregnancy with a combination of estrogen and progestin, which are female reproductive hormones. Various pills may contain different types of synthetic hormones at different doses. Generally, doctors prescribe the lowest-dose pill unless a woman has a medical reason for needing a higher dose, such as breakthrough bleeding.
Unfortunately, high doses of estrogen have been linked to higher rates of breast cancer in several studies, according to the National Cancer Institute.
Estrogen normally stimulates a womans breast to enlarge and produce milk during pregnancy. When a woman takes estrogen in a birth control pill, it stimulates epithelial cells to proliferate and grow. Every time a cell divides and grows, there is a tiny chance it will make a mistake in its DNA that causes the cell to become cancerous.
According to experts from the National Institute of Health :
Proliferation of normal cells from exposure to estrogen creates a vulnerability to spontaneous mutations, some of which might represent a first step on the pathway to cancer.
The risk of breast cancer may be even higher for women with inherited risk-factors, such as BRCA1 and BRCA2. About 5-10% of all breast cancers occur in women with these genes.
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How To Cope With Side Effects Of Letrozole
Menopause symptoms such as hot flushes, difficulty sleeping, tiredness and low mood usually improve during the first months of taking letrozole. However, if they’re severe or last longer than a few months, talk to your doctor or breast cancer nurse.
Find out more about treating symptoms of the menopause.
What to do about:
How Targeted Therapy Works
Targeted therapies are created to attack specific parts of cancer cells to prevent cancer growth or to shrink existing tumors.
Each type of targeted therapy works a little differently, but all tend to interfere with the ability of cancer cells to grow, divide, repair, and communicate with other cells.
Here are some of the common types of targeted therapy:
- Monoclonal antibodies. These medications are often combined with toxins, chemotherapy drugs, and radiation. They attach to targets on the surface of cancer cells and deliver these substances, causing cancer cells to die without harming healthy cells.
- Small molecule inhibitors. These drugs generally target and inhibit specific pathways and processes that cause cancer cells to proliferate. They must be small enough to be able to enter the cell and interfere with proteins on both the inside and outside of the cell.
- Angiogenesis inhibitors. These drugs inhibit the formation of new blood vessels, which fuel the growth of cancer cells.
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What To Do In Case Of Overdose
If you think youve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.
You should take Arimidex according to your doctors or healthcare providers instructions.
The Impact Of Generic Medications On Breast Cancer Prevention
Nhuan Nguyen, PharmD, MBA, ChEClinical PharmacistUniversity of Georgia College of PharmacyAthens, Georgia
US Pharm. 2016 41 :14-18.
ABSTRACT: Breast cancer is one of the most common cancers in American women. The high cost of brand-name breast cancer medications results in a low rate of chemoprevention of invasive breast cancer. Patient adherence is also affected by misconceptions about the efficacy of generics. Following the approval of less-expensive generic formulations of brand-name breast cancer medications, more women are using generics for prevention. Cost savings from generics have significantly increased adherence rates, and the impact of generic medications on breast cancer survival rates is expected to be significant in the long term. By making recommendations about generic versions of breast cancer medications to high-risk patients, pharmacists can play a significant role in increasing the number of women opting for breast cancer chemoprevention, thereby increasing the survival rate.
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Assessment Of Risk For Breast Cancer
Various methods are available to identif y women at increased risk for breast cancer, including formal clinical risk assessment tools or assessing breast cancer risk factors without using a formal tool.
Numerous risk assessment tools, such as the National Cancer Institute Breast Cancer Risk Assessment Tool,5 estimate a woman’s risk of developing breast cancer over the next 5 years. There is no single cutoff for defining increased risk for all women. Women at greater risk, such as those with at least a 3% risk for breast cancer in the next 5 years, are likely to derive more benefit than harm from risk-reducing medications6 and should be offered these medications if their risk of harms is low. Some women at lower risk for breast cancer have also been included in trials documenting reduced risk for breast cancer when taking tamoxifen, raloxifene, or aromatase inhibitors.3,4 However, when balancing the harms associated with these medications, the net benefit will be lower among women at lower risk.
Women not at increased risk for breast cancer, such as women younger than 60 years with no additional risk factors for breast cancer, or women with a low 5-year risk of breast cancer should not be routinely offered medications to reduce risk of breast cancer because the risk of harms from these medications likely outweighs their potential benefit.
How Can I Prevent Breast Cancer
Over 40% of breast cancers that are diagnosed are self-detected and the National Breast Cancer Foundation recommends you perform a self-examination of your breasts once a month. Always seek further investigation if you ever feel any sort of lump in your breast or breasts.
Mammograms are a type of X-ray that is commonly used for screening. They can detect tiny lumps, as small as 2 millimeters in size, which is about the size of a pencil tip. You would never be able to feel a lump this small. Most breast cancer tumors cannot be felt until they are at least 22 mm in size, or about the size of a small pea.
In general, the earlier cancer cells are detected, the better the outcome. Very effective treatment is available for all stages of breast cancer however, outcomes are usually more favorable when the cancer is found at stage 1 or stage 2.
To reduce your chances of developing breast cancer, keep to a healthy weight, exercise daily, sleep well, don’t drink alcohol, avoid exposure to chemicals including nicotine, and breastfeed your babies if possible.
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How Is Hormone Therapy Used To Treat Breast Cancer
There are three main ways that hormone therapy is used to treat hormone-sensitive breast cancer:
Adjuvant therapy for early-stage breast cancer:Tamoxifen is FDA approved for adjuvant hormone treatment of premenopausal and postmenopausal women with ER-positive early-stage breast cancer, and the aromatase inhibitorsanastrozole, letrozole, and exemestane are approved for this use in postmenopausal women.
Research has shown that women who receive at least 5 years of adjuvant therapy with tamoxifen after having surgery for early-stage ER-positive breast cancer have reduced risks of breast cancer recurrence, including a new breast cancer in the other breast, and reduced risk of death at 15 years .
Until recently, most women who received adjuvant hormone therapy to reduce the chance of a breast cancer recurrence took tamoxifen every day for 5 years. However, with the introduction of newer hormone therapies , some of which have been compared with tamoxifen in clinical trials, additional approaches to hormone therapy have become common .
Some premenopausal women with early-stage ER-positive breast cancer may have ovarian suppression plus an aromatase inhibitor, which was found to have higher rates of freedom from recurrence than ovarian suppression plus tamoxifen or tamoxifen alone .
Men with early-stage ER-positive breast cancer who receive adjuvant therapy are usually treated first with tamoxifen. Those treated with an aromatase inhibitor usually also take a GnRH agonist.