Tag Archives: BREAST CANCER

ARE CALCIUM CHANNEL BLOCKERS SAFE IN WOMEN?

riskA recent study in JAMA (Journal of American Medical Association) has raised questions about the safety of one of our most commonly prescribed blood pressured medications, the CALCIUM CHANNEL BLOCKERS.

In a case-control study, the researchers demonstrated at 2.5x greater risk of breast cancer in those women on the medication for 10 years or more.

Although this study is ‘suggestive’ of concern, the method that they used in the study has researchers looking into this questions further and is not definitive enough to warrant a change in our approach.  So, the researchers will be doing more studies, and we will keep our eyes on this, but for now, no change in medication has been recommended.

Despite this, if you remain concerned, please come to the office to discuss this further.

<<<<<<<Calcium Channel Blockers include:  Norvasc (Amlodipine), Calan (Verapamil), Cardizem (Diltiazem), Procardia (Nifedipine)>>>>>>>

 

A PATIENT ASKS ABOUT HER MAMMOGRAM….AND I RESPOND

weighing inDear Dr. Lakin,
 
I have been reading so many controversial things on taking mammography….. especially unnecessary radiation.
 
Also, many false positives and that they do not save lives…..
 
I am going to be 79 years old.  I am cystic.  My mother died of ovarian cancer.  (However, I do have a pelvic exam yearly.)
 
Do you think I should still continue with breast mammograms or cut them out completely….
 
Thank you,
 
I.E.
My Response:
I.E.:I think self exam regularly & a mammogram every other year is sensible in your age group.  Nearing 80 and over 80 should consider mammograms less often.
Doctor Doug

LONGER DURATION OF BREAST CANCER TREATMENT IS BETTER

There is controversy over the ideal duration of anti-hormone therapy for women with breast cancer.

In women with hormone responsive breast cancer, we treat them after that initial therapy, with ‘anti-hormone medications’ such as Tamoxifen (in the older days) or Arimidex (newer version).  These ‘anti hormones’ are in two categories:
Tamoxifen (SERM’s….Selective Estrogen Receptro Modulators) vs Arimidex (Aromatase Inhibitors)

Traditionally, therapy after breast cancer includes a 5 year treatment course of these medications, but the latest article in the journal Lancet, from England, shows that ongoing treatment with Tamoifen provides additional protection and benefits, when continued up to 10 years.

It may be that continuing even longer provides additional benefits, but that is to be seen.  For now, we should continue, in general, with these medications, for woman who have been on therapy.  More data will be needed to prove that the Aromatase Inhibitors provide similar benefits to the Tamoxifen, but at this point, until the data is in, this is presumed to be a likely result.  Still, we will await the data for definitive information.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961963-1/abstract

WHAT IS THE TRUTH ABOUT BREAST CANCER RATES?

I just read a NY Times review on a fascinating new book: BREASTS: A Natural and Unnatural History by Florence Williams. The review describes an interesting take on the female (and male) breasts,  both historically and medically, but the review makes the claim that ‘the breast cancer incidence continues to rise,’ and this caught my attention. Why? Because I thought that despite the awareness about breast cancer, all the magazine articles, talk shows, and just plain people talking about it….the fact is that breast cancer is in decline. So which is it? Is breast cancer increasing or decreasing.
Well, in the US, breast cancer is declining, down about 14% since 1990. Of course, there is much more to that statistical detail, and if you are interested read the NIH fact sheet:
http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=73

So….breast cancer remains the preeminent cancer in women due to it’s incidence and scope, but let’s make sure we keep our facts straight and take some strength in knowing that breast cancer, at least in the US, is in decline.

COMPLIANCE WITH MEDICATIONS REMAINS CRITICAL…EVEN FOR CANCER PATIENTS

Compliance is the term doctor’s use to mean ‘adherence’ to a medication regimen. Compliance is critical to gaining the benefits from medication because clearly, you can only benefit from a medication if you take it.
An interesting study of Compliance with breast cancer prevention medications called Aromatase Inhibitors (Aromasin/Arimidex), only 80% of patients took their medication consistently. The reason…increased joint pains from the medication.
Now, if there was any time you would expect someone to take their medication, it is after they have had cancer and are taking the pill to prevent a recurrence, yet 20% of women were not taking it regularly because it caused bothersome symptoms.
The doctor’s involved in the study thought that Compliance was in the 90+% range, so they did not perceive a problem or need to emphasize the importance of taking the medication regularly, presuming the patients are already doing so.
So…..if you are reading this, you are probably a pretty intense and interested participant in your medical issues. I presume Compliance is not an issue for you; but if you are among the 20+% who will forgo your medications for whatever reason, please reconsider such a decision.