“Doctor, stop!” She suddenly orders me. “I can’t handle things.”
I stop halfway through and then in a pause, watch the evolution of hot flashes (also known as hot flashes) in real time.
First her face turns pink, then part of her neck and chest appears on top of the tank top she wears on a ferocious winter morning. Beads of sweat form on her forehead. Her burning ears might warm my still cold fingers. But most notable is her expression, and in a flash she changes from composition to something she has accumulated. She looks like a defeated firefighter, fighting to put the fire under control, relying on simply bidding her time before that.
“Sorry,” she frowns.
Once you pass the clock at the bottom of the screen, the “event” takes two minutes from start to finish. Meanwhile, I had a front seat with dramatic negative effects that oncologists often mention when giving to breast cancer patients using anti-estrogen therapy.
“How often do you experience this?”
“Dozens of times on good days,” she shrugged.
Approximately three-quarters of breast cancer are estrogen receptor positive, meaning that cancer cells are stimulated by estrogen. Women with this type of cancer benefit from estrogen suppression achieved in a variety of ways, including tablets, injections, and removal of ovaries. This induces menopause in young women, and induces more complete estrogen suppression already in the menopause period.
With over 20,000 Australian women and 2 million women worldwide diagnosed with breast cancer each year, an anti-estrogen drugs resemble penicillin in oncology. Every week I write, update and exchange multiple scripts.
However, while all prescribers mention the side effects of the expected side effects, I don’t think anyone has any explanation (including me) at all about the living fear that many patients continue to experience.
why is that?
The woman concluded her laborious trekking of early breast cancer chemotherapy and radiation, expresses her hope that she will never experience this again.
Women with metastatic breast cancer expect that, although they cannot be cured, they can be suppressed for years.
All women’s risk profiles guarantee a customized conversation, but broadly speaking, imagine giving this advice. “There are effective medications to reduce the risk of recurrence and improve survival. You can experience it High temperature flash, stiff joints, irregular sleep, low mood, weight gain, sexual dysfunction. ”
If it sounds like a punishment will be imposed at the end of the punishment diagnosis, then yes. However, if the drug works, oncologists encourage adherence and hope that side effects will not occur or can be managed.
“Vagomotor symptoms” is a medical term for high temperature flashes, affecting up to 90% of women with breast cancer, and is often severe. Half of all women had been prescribed anti-estrogens and stopped taking medication. And they are the people who tell us. All oncologists know the moment of cardiac sinking when a high-risk patient refuses treatment. But we know the sacrifices they have led us to do so.
Given the ubiquitous nature of hot flashes, the lack of a good treatment is frustrating. Panoramics of panopes of advertised options such as cognitive behavioral therapy, acupuncture, hypnosis, diet, exercise, adaptive use of antidepressants and anticonvulsants have not been shown to be useful in any meaningful way.
Next is the irony of taking one drug to counter the side effects of another drug and to acquire weight and related complications in the process.
As a result, most women endured the subsequent costs of having breast cancer.
Now there is hope. in Randomized controlled trials Drugs and placebo once a day pills significantly reduced the massive high temperature flush in women taking anti-estrogen therapy for breast cancer. Elinzanetant It works by affecting brain signals involved in temperature regulation.
At baseline, women experienced an average of 12 episodes each day. By one month, 61% of women receiving aggressive treatment reported a decrease of at least 50% in the daily frequency of moderate to severe high temperature flush, compared to 27% with placebo. As well as overall quality of life, sleep quality has improved. The crossover from placebo to active drugs led to similar findings.
There are no drugs that have no side effects. Over 60% of women in each group reported at least one mild adverse event, but severe adverse events were rare. Slope, fatigue, and diarrhea were reported more frequently in the active therapy group, but may also be caused by cancer therapy. More than 90% of women who completed a one-year treatment chose to continue the option for two years, suggesting high acceptance.
The drug is not yet approved and oncologists will ask for details prior to extensive prescriptions.
Breast cancer outcomes are poor among non-white women, but 88% of participants were white. Will this drug be effective and endure in all eligible patients?
Does taking “treatment” medication improve compliance with key drugs that reduce the risk of cancer? This is the key to prescribing it.
Finally, patients in clinical trials are rigorously selected and frequently monitored. Does real-world experience match your clinical trial experience? We know that it’s rarely the case.
On my way out, I praise the patient’s determination to endure with the difficult treatment, and she smiles in gratitude for her acknowledgements.
She has only been in treatment for two years. I allow myself to imagine a day when there is room for reprieve.
