Hormonal therapies for pre-menopausal?
Meet the Experts
Sandra F. Schnall, M.D. is a medical oncologist/hematologist who practices at Bryn Mawr Hospital in the Thomas Jefferson University Health System outside of Philadelphia, Pennsylvania.
Marisa Weiss, M.D. is an oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.
Question from Nance: Besides tamoxifen, are there any other hormonal therapies for pre-menopausal ER/PR-positive node-negative cancers?
- Answers —Sandra Schnall, M.D.: Tamoxifen is probably the most commonly used agent. Perhaps you can combine it using some other agent such as Zoladex (chemical name: goserelin) to have more complete ovarian shutdown. The newer agents called the aromatase inhibitors are not effective in the pre-menopausal setting.
- Marisa Weiss, M.D., president and founder: It's important to remember that if you're pre-menopausal and you take tamoxifen, you can keep menstruating. Or, if you're close to menopause, tamoxifen may push you over the edge and stop your periods. Some ovarian function might still persist in this case, but not enough for you to have periods. For complete ovarian shutdown in a pre-menopausal woman, Zoladex is usually needed to make the ovaries stop working. Depending on the situation, your doctor may recommend only tamoxifen without full ovarian shutdown. Or your doctor might recommend both tamoxifen and Zoladex. In post-menopausal women, the ovaries are already shut down, so tamoxifen alone is enough. Or your doctor might prescribe an aromatase inhibitor instead of tamoxifen.
Stay tuned for new advances in the field of hormonal therapy for young women. There may be some early study results presented at the American Society for Clinical Oncology meeting this June.
On Wednesday, April 21, 2004, our Ask-the-Expert Online Conference was called Hormonal Therapy Updates. Sandra Schnall, M.D. and Marisa Weiss, M.D. answered your questions about hormonal therapies and answered questions about which ones work best in different situations, how they might fit into your treatment sequence, how to deal with side effects, and more.
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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