Archive for the ‘Medications’ Category
Aromatase Inhibitors (AI) do a great job treating Breast Cancers which are Estrogen dependent. The AI wipe out all Estrogen thereby depriving the breast cancer of a needed stimulus.
Unfortunately, Aromatase Inhibitor treatment will also do considerable damage to your bones unless you take medication to protect your bones. The good news is that we have medication which can completely offset the harm AI treatment could do to your bones. But, you have to take it, and the sooner you start, the better.
Denosumab (Prolia) mimics the natural process that keeps OsteoClasts (the cells that gobble up bone) under control before menopause. OsteoCytes release Osteoprotegrin (OPG) when Estrogen (or Testosterone) is on board. OPG controls the formation and activation of OsteoClasts by blocking RANK-Ligand, which is necessary for OsteoClast formation and activation. This decreases fracture risk.
Evista (Raloxifene) can both prevent breast cancer and prevent osteoporosis! Evista has been approved for both indications. Not often can a woman treat two dreaded conditions with a single pill.
Evista is very similar to human estrogen. Evista is an “Estrogen-Agonist-Antagonist”. That means Evista acts like natural human estrogen when it prevents osteoporosis. But Evista also blocks human estrogen when it prevents breast cancer.
Evista convinces the OsteoCytes that estrogen is on board. The OsteoCytes release Osteoprotegrin (OPG), which is the natural substance that keeps the OsteoClasts (the cells that gobble up your bone) from going wild. Your bone is preserved, just like it was before menopause. This action is just like Hormone Replacement Therapy (HRT).
The most common side effect of Evista is menopausal-like symptoms. Fortunately, these usually fade within 1 to 2 months. Rare side effects include a slight increase in blood clots in persons with a personal history of blood clots or a strong family history. We also suspect a slight increase in heart problems over the age of 70, as in HRT, but not enough women have taken Evista beyond the age of 70 to find out if this is true.
Evista is a daily pill with no heartburn or GERD issues. It preserves bone by stimulating the natural process of a premenopausal state. Evista prevents breast cancer. Evista is a great choice for women looking for that combination.
Take control of your future.
Jay Ginther, MD
Breast cancer is the most common cancer in women. Some women have a family history of breast cancer. They are at especially increased risk. Unfortunately, most women who develop breast cancer do not have a family history. Therefore, all women must be considered to be at risk for breast cancer.
Some breast cancers are stimulated by estrogen. Women with a family history of breast cancer should generally avoid taking estrogen. Exposure to estrogen beyond age 70 is associated with increased breast cancer risk.
Hormone Replacement Therapy does carry an increased risk of breast cancer, especially in women over 70. Most physicians advise stopping HRT before age 70 for this reason.
There are 2 estrogen-like medications which actually decrease breast cancer risk. They do this by competing with a woman’s natural estrogen for the estrogen receptors in breast tissue. Raloxifene (Evista) and Tamoxifen both can occupy the estrogen receptors in breast tissue and block their activation by the woman’s own estrogen. This protects the woman from developing estrogen dependent breast cancer by about 70%.
Tamoxifen is approved for both prevention and treatment of breast cancer. Tamoxifen does not harm bone. The more aggressive modern breast cancer treatments (Aromatase Inhibiters) do harm bone. Unfortunately, Tamoxifen has not been shown to preserve bone either.
Evista preserves bone and decreases Fracture Risk. More about preventing breast cancer and decreasing fracture risk next time.
Jay Ginther, MD