Hormonal Treatments for Breast Cancer: Do Side Effects Matter?

Summary & Participants

For women with hormone sensitive breast cancers there are many treatment choices, each with a range of side effects. Learn what to consider when making decisions with your doctor and how it can affect your quality of life.

Medically Reviewed On: July 23, 2008

Webcast Transcript

ANNOUNCER: Increasingly we're learning more about the nature of breast cancer. One valuable piece of information is whether the cancer is dependent on a woman's own hormones to grow.

CLIFFORD HUDIS, MD: The way in which hormones influence the growth of these cancers is fairly straightforward. That is, there's a receptor for the hormone and that receptor attaches to the hormone when it floats by. And once the receptor and the hormone are bound together, they send a signal to the cell that tells it to grow and divide and grow and divide. So the hormone stimulates the growth of the cancer.

ANNOUNCER: Attacking this kind of hormonally responsive cancer means cutting off the hormone supply. This can be done using medications called aromatase inhibitors.

CLIFFORD HUDIS, MD: One of the enzymes that is important is an enzyme called aromatase. So aromatase takes a precursor to estrogen and converts it into a functional estrogen. So if we inhibit the aromatase, we prevent the production of estrogen.

ANNOUNCER: While a drug called tamoxifen, had once been the drug of choice in hormonally receptive breast cancer, it seems that the aromatase inhibitors are as effective and in some cases more effective than tamoxifen in post menopausal women.

ROBERT SMITH, MD: Early on they saw benefits that showed improved response rate, prolonged time to progression, prolonged time to treatment failure, and more clinical benefit with the letrozole group.

CLIFFORD HUDIS, MD: In each one of the studies, there are pros and cons, but for each one of the studies, there is some sort of an advantage seen for the aromatase inhibitor; again, either more effectiveness or greater safety. In direct comparisons in patients with advanced breast cancer, the aromatase inhibitors, as a group, in comparison to tamoxifen, have demonstrated slightly longer time to progression. And they've done that in a setting where they also have slightly fewer side effects.

ANNOUNCER: Side effects of any treatment are important since they affect how well a patient is able to live their life.

ROBERT SMITH, MD: When we look at side effects that occur with the aromatase inhibitors, there are very few. What it's doing is basically blocking estrogen production in the body. So hot flashes are going to be worse. Sometimes there is some change in symptoms such as nausea, which is very mild.

CLIFFORD HUDIS, MD: They are associated with a little more risk of muscle and skeletal pain, and they may turn out to be a little more harmful in terms of bone density; that's osteoporosis.

ROBERT SMITH, MD: But in general the side effects are very minimal and well managed.

ANNOUNCER: These reduced side effects result in fewer concerns about problems that could arise from other treatments, as in the case with tamoxifen.

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