Bright Future for Breast Cancer Hormonal Therapy

By Erica Heilman

Both chemotherapy and hormonal therapy have proven effective in the treatment of early breast cancer, but the word this week from the 3rd European Breast Cancer Conference in Barcelona is that gains from hormonal therapy are greater. And researchers predict an even brighter future for the fight against breast cancer using new hormone therapies.

Though estrogen serves many important functions in the body, such as regulating the menstrual cycle and protecting women against osteoporosis and heart disease, estrogen is also the very thing that breast cancer cells need to multiply in most women with the disease. When estrogen binds to the estrogen receptor, a protein on the outside of a breast cancer cell, it fuels that cancer cell's growth.


The goal of hormonal therapies is to stop estrogen from stimulating breast cancer growth, in other words, to starve the tumor of estrogen. There are a couple of different ways this can work. The first method involves blocking the hormone receptors, which is how tamoxifen, the traditional hormonal agent for breast cancer treatment, is used. But women can develop a resistance to tamoxifen, allowing estrogen to reconnect to cancer cells. Recent studies show that a second method may prove even more effective.

A new class of drugs called aromatase inhibitors solves the problem of resistance by stopping estrogen production altogether in postmenopausal women, and these drugs are now used as a first-line treatment for advanced, or metastatic disease. The three aromatase inhibitors that have been approved by the Food and Drug Administration are anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin). Recent studies also suggest that aromatase inhibitors may have advantages over tamoxifen in the treatment of early stage disease, but these advantages have yet to be shown over the long-term (greater than 5 years). Tamoxifen thus remains the standard of care in early breast cancer but patients should stay in touch with their doctors about emerging options.

Sixty percent of postmenopausal women over 50 are good candidates for hormonal therapy, where currently only 30% of women under 50 are good candidates. The reason for this discrepancy is that breast cancers in most younger women do not have estrogen receptors, while breast cancers in postmenopausal women do have the receptors, making them responsive to hormonal therapies.

http://womens_health.healthology.com...future&spg=FLA