News on Arimidex and radiation?
Meet the Experts
Jennifer Griggs, M.D., M.P.H. is a medical oncologist specializing in the treatment of breast cancer, dedicated to developing programs that improve the well-being of women treated for breast cancer.
Question from Marcia: Do you have any information on taking Arimidex while on radiation?
- Answer —Jennifer Griggs, M.D., M.P.H.: The timing of radiation therapy and hormonal therapy is sometimes highly debated among breast cancer providers. Without a lot of data to support either approach, some doctors start aromatase inhibitors independent of the radiation schedule; in other words, they pay no attention to when radiation is given and start the drug when chemotherapy is done or at the time of initial consultation. Other providers wait until radiation therapy is done.
I suppose that there is a theoretical reason to wait in starting any hormonal therapy until someone is done radiation. The reason would be that radiation works on cells that are dividing, and hormonal therapies slow down division of cancer cells and could theoretically reduce the effectiveness of radiation. In the case of tamoxifen, another hormonal therapy, there does not appear to be any downside of starting tamoxifen along with radiation therapy or in the middle of radiation therapy.
In terms of risk of recurrence, starting tamoxifen before radiation was done was not shown to increase recurrence rates. We don't have a similar trial with the aromatase inhibitors, so many doctors just pick an approach and stick with that for their patients.
My feeling is that a patient who has many symptoms as she recovers from surgery and chemotherapy and is facing radiation therapy is probably well served by giving her only one treatment at a time. That is, I let her recover from chemotherapy and her surgery, start radiation, and then add a new drug. In a woman who had just surgery, no chemotherapy, is feeling well, and starts radiation therapy, starting her aromatase inhibitor at the beginning or in the middle is not likely to affect her tolerance of radiation or her long term outcome.
On the other hand, if the radiation therapy doctor who is taking care of the patient has a strong preference to wait until the end of radiation, I'd certainly offer no objection. We work as a team, and respecting the other doctor's opinion is very important. Most radiation lasts 6 ½ to 7 weeks, and holding off on aromatase inhibitors for that length of time is not likely to put the patient at a higher risk of recurrence.
In summary, what your doctors recommend is based on their experience and their preferences, tailored to your individual situation.
On Wednesday, December 19, 2007, our Ask-the-Expert Online Conference was called Updates from San Antonio 2007. Jennifer Griggs, M.D., M.P.H. answered your questions and shared the newest research presented at this year's San Antonio Breast Cancer Symposium.
The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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