Monday, September 19, 2011

Breast Cancer News Weekly Wrap-Up (Sept. 12 to 18)

Today we'll wrap-up last week's breast cancer news. Topics include hot flashes, fatigue, mammography and environmental BPAs. Links to the news and research below may be found on the treatment pages of the website.

Effexor and Catapres effective for hot flashes

Some breast cancer treatments may induce menopause and cause unpleasant side effects such as hot flashes. A September 12 study in the Journal of Clinical Oncology compared Effexor (venlafaxine) to Catapres (clonidine) to a placebo for the treatment of hot flashes in breast cancer patients.

Both Effexor and Catapres were found to be effective in the management of hot flashes. Effexor resulted in a more immediate reduction in hot flashes, but at week 12, hot flashes were lower in the Catapres group. Reports of nausea, constipation and appetite loss were higher in the Effexor group.

A September 12 Family Practice News report on the study included a commentary which noted that the small size of the study was its "main weakness." In the end, only 35 patients took Effexor, 28 Catapres and 17 the placebo. A larger study would be needed to "reliably identify suspected differences between the study arms." Also, the study authors noted that the duration of the study may have been too short to adequately assess side effects.

Nonetheless, in the Family Practice News story, study authors said the "more rapid reduction in hot flashes suggests that venlafaxine is to be preferred over clonidine." They advised 37.5 mg daily in the first week, increasing to 75 mg "if greater efficacy is desired."

Fatigue after treatment associated with pain and depression

Last week EurekAlert! and the UPI covered a study from Spain on fatigue in breast cancer survivors. The study found that patients most affected by fatigue also suffered "episodes of depression, body image deterioration, neck and shoulder pain, and limited arm movement, possibly due to the surgical intervention," such as breast conserving surgery (lumpectomy) and mastectomy.

The lead author noted that these findings should "motivate" patient support programs to provide resources to improve psychological states and pain to improve fatigue.

Higher mammography rates associated with higher mastectomy rates

One of the goals of screening mammography is to detect breast cancer earlier to allow more women to undergo breast conserving surgery (lumpectomy) instead of mastectomy. A recent study in Norway found the opposite to be true.

The study compared breast surgery rates before and after the implementation of a breast screening program and rates between those invited for screening and those not. Screening was associated with an increase in all breast surgery (lumpectomy plus mastectomy) and an increase in mastectomy rates.

A September 13 story in US News and World Report/HealthDay noted that the study did not investigate why mastectomy rates climbed. Possible reasons include overdiagnosis (detecting and treating tumors that might never have posed a risk), poor access to radiation centers (making mastectomy a safer option), improved breast reconstruction techniques (making mastectomy a less "dreadful" choice) and patient decision to undergo more aggressive treatment due to recurrence fears.

BPA may interfere with tamoxifen

There may be another reason to avoid bisphenol-A (BPA). BPAs, which are used to make plastics, have been associated with a variety of health concerns. According to recent study in cells, BPA may not only increase the risk of developing breast cancer, may also interfere with tamoxifen therapy. (Link to the study.)

On September 13, the San Francisco Chronicle covered the study. In the lab, when non-cancerous cells from high-risk patients were exposed to BPA, they started to behave like cancer cells. When these BPA-exposed cells were exposed to tamoxifen, they continued to grow. "The study found that healthy cells exposed to BPA and methylparaben started figuring out ways to bypass drugs like tamoxifen."

Avoiding BPA may not be easy. According to Dr. William Goodson, lead study author, ""It's used so much. We kind of swim in it." Still, efforts to ban BPAs are underway. A current bill (AB1319) on the governor's desk would ban BPA in sippy cups and baby bottles in California.

At, we'll continue to follow the latest breast cancer news and research. You may access links to news articles, medical journal abstracts and FDA information on every breast cancer test and treatment option on our website anytime.

No comments:

Post a Comment