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GYN: On the Breast Cancer Front From: art fougner, md (evsono@pipeline.com) Mon Nov 6 07:26:23 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: K Dent: "MFM units" Previous message: art fougner, md: "Re: triplet management" This in today's news - New Breast Cancer Tests Too New, Experts Decide Reuters Nov 3 2000 8:02PM WASHINGTON (Reuters) - New tests are being developed that should eventually help doctors tailor treatment for breast cancer patients, but they are still too experimental to use on most patients, experts said on Friday. They said the tests, including genetic tests meant to show whether a tumor will be affected by a certain drug, need to be assessed further in clinical trials to make sure they will actually make a difference to women. The experts, including top oncologists and researchers from around the country, spent three days debating the best breast cancer treatments at a National Institutes of Health ''consensus conference". "It is not to say they these (new tests) shouldn''t be studied," Dr. Patricia Eifel, a professor at the M.D. Anderson cancer center at the University of Texas and chair of the panel, told a news conference. "A lot of these are not sufficiently validated to use in determining therapy at this point." "They have a lot of potential," added Dr. Jose Costa of the Yale University School of Medicine. The trouble is, only a very small percentage of cancer patients take part in clinical trials, so it is hard to quickly get useful information about potential new treatments. This year more than 180,000 U.S. women will be diagnosed with breast cancer and 41,000 will die of it, according to the American Cancer Society. A woman has about a one in 10 chance of developing breast cancer. Experts say most breast cancer cases are now caught early, and the standard treatment is to cut out either the tumor or the whole affected area. Radiation and chemotherapy add to the success of the operation, the idea being to catch any tiny little tumors too small to detect. But there is no real consensus on which chemotherapy drugs are the best to use, who should get them and when. The experts said their statement would begin to address this issue. Gene chips and similar devices that measure proteins produced by cells may play a role one day in determining the best drug therapy, but not yet. HORMONE TREATMENT KEY FOR HALF OF ALL BREAST CANCERS One main piece of advice is to test tissue samples from all patients to see if the tumor cells respond to female hormones. If they do, or if the test is uncertain, all patients should be offered hormone therapy, which includes the drug tamoxifen, using surgery or radiation to destroy the ovaries, or other drugs such as aromatase inhibitor drugs including anastrozole, made by AstraZeneca under the name Arimidex or lutenizing hormone releasing hormone (LHRH) agonist drugs such as goserelin (AstraZeneca''s Zoladex). The experts strongly endorsed the use of tamoxifen, the only drug shown to prevent breast cancer in women at high risk. They said it should be given to women for at least 5 years. "Although tamoxifen has been associated with a slight but definite increase in the risk of endometrial (uterine) cancer and venous thromboembolism (blood clots), the benefit of tamoxifen treatment far outweighs its risks in the majority of women," they wrote. They said there was not enough evidence to justify the use of osteoporosis drugs such as raloxifene, sold by Eli Lilly and Co under the name Evista, which are being tested to see if they might work to prevent breast cancer in the way that tamoxifen does. One practicing oncologist who served on the panel said she could take the information straight to her patients. "I can go back to my practice on Monday and help them know where we are at," Dr. Carolyn Hendricks of Bethesda, Maryland, said in an interview. Hendricks said, for instance, that it was exciting to know that temporarily shutting off a woman''s ovaries -- called ovarian ablation -- could be an effective way to fight breast cancer. "If you have a very young woman and she wants to preserve her future childbearing ... there is no evidence that it is not equal to chemotherapy," she said. Copyright © 2000 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similiar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. All active hyperlinks have been inserted by AOL.com. art -- art fougner, md A series of 1000 cases begins with but a single anecdote. Next message: K Dent: "MFM units" Previous message: art fougner, md: "Re: triplet management"

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