Factoring other diseases into decisions?


Question from Nellie: Are there any protocols or have any studies been done re: making more complicated treatment decisions for individuals with other diseases, such as MS, systemic sclerosis, etc., that may be negatively impacted by hormonal therapies?
Answers - Sandra F. Schnall, M.D. I don't know of any studies that are looking at those. I think there are probably a limited number of individuals who can qualify for those types of studies. I'd probably discuss the interaction of the medications that may be recommended for the second problem (i.e., not the breast cancer) with the specialist treating the other process to try to sort out any interactions that may develop.
Marisa Weiss, M.D. One example of a medical issue that commonly comes up is osteoporosis, thinning of the bones. If a woman has osteoporosis, she is going to need treatment for the osteoporosis, like calcium, vitamin D, exercise, smoking cessation, and perhaps a medication like Fosamax or Actonel.

This condition can be first discovered when your oncologist is putting you on a hormonal therapy and gets a baseline DEXA scan, which measures bone strength. In this situation, you may be dealing with decisions on two different conditions, breast cancer and osteoporosis, at the same time.

The issue mostly comes up with aromatase inhibitors, which can cause slight bone loss over the first 2 years that they are given. The only other condition that I can think of right now is a history of endometrial cancer. If you have a history of this type of cancer, most doctors would avoid giving you a drug like tamoxifen.

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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