scholarly journals CHEMOTHERAPY AND HORMONE THERAPY FOR BREAST CANCER AND COMPLICATIONS

Author(s):  
Seema Devi ◽  
Yogesh Kumar Sharma

Breast cancer is second leading cause of death in women. Treatment modalities for breast cancer optimized according to stage at which the cancer is diagnosed. Chemotherapy, hormone therapy   and targeted therapies are used for the treatment of advanced stages of disease. The aim of therapy different like to enhancing the curative rate in adjuvant therapy, reduce symptoms or  improve quality of life in metastatic diseases, reduce the chances of the cancer coming Back. The complications of therapy including mental function; cardiovascular functions; neuromusculoskeletal and movement related functions and structures functions of hematological immunological and respiratory system etc. The benefits of chemotherapy are limited and relative compared to the risk factors. Chemotherapeutic agents use in treatment of breast cancer such as taxanes (docetaxel and paclitaxel), tamoxifen , vincristine, cyclophosphamide, trastuzumab etc. Keyword: breast cancer, hormone therapy, targeted therapy, chemotherapy, adjuvant therapy.

1997 ◽  
Vol 3 (1) ◽  
pp. 68-81
Author(s):  
Fatma M. El Sharkawi ◽  
Mahmoud F. Sakr ◽  
Hoda Y. Atta ◽  
Hafez M. Ghanem

The impact of breast cancer therapy on the quality of life [QL] of Egyptian women was studied. Patients were divided into four groups:1:mastectomy alone;2:surgery plus radiotherapy;3:surgery plus chemotherapy;and 4:triple modality. The results revealed that all the four domains of QL of women having adjuvant therapy [groups 2, 3, or 4] were significantly altered compared to those who underwent mastectomy alone. Triple modality adversely affected global QL the most compared to radiotherapy or chemotherapy;radiotherapy had significantly less effect on QL compared to chemotherapy. Triple modality predicted the worst QL. QL measures should be incorporated with the traditional end points for evaluation of treatment and patients given health education on the effects of each therapy


Author(s):  
Melisa Anderson ◽  
Dwayne Tucker ◽  
Fabian G. Miller ◽  
Kurt Vaz ◽  
Lennox Anderson-Jackson ◽  
...  

Breast cancer is a disease in which there is increased proliferation of malignant breast cells. This disease is more likely to begin in the ducts or lobules rather than the connective tissue. Globally, breast cancer is the most regularly diagnosed cancer. It is also a leading cause of cancer-related mortality in females. While cancer of the breast affects the physical aspect of patients, it can also negatively impact the quality of life (QoL) of survivors. There is a dearth of information, especially in the last decade, on the negative impact of breast cancer and treatment modalities on the QoL of patients. This review of the literature will examine the QoL and well-being of breast cancer patients to present a current perspective on the topic. Major findings of past and present articles that have contributed to improving the care of breast cancer patients will be summarized and included.


1998 ◽  
Vol 16 (4) ◽  
pp. 1380-1387 ◽  
Author(s):  
C Lindley ◽  
S Vasa ◽  
W T Sawyer ◽  
E P Winer

PURPOSE To evaluate the quality of life (QOL) of breast cancer patients who survived 2 to 5 years following initiation of adjuvant cytotoxic and/or hormonal therapy and to characterize relationships between QOL and patient physical symptoms, sexual function, and preferences regarding adjuvant treatment. PATIENTS AND METHODS Eighty-six patients who had completed systemic adjuvant therapy for early-stage breast cancer between 1988 and 1991 were surveyed by written questionnaire and telephone interview. Sociodemographic information was obtained for each patient, and patients were asked to complete the Functional Living Index-Cancer (FLIC), the Symptom Distress Scale (SDS), the Medical Outcomes Study (MOS) Short Form 36 (SF-36), a series of questions regarding sexual function, and a survey about preferences for adjuvant therapy in relation to possible benefit. RESULTS The mean FLIC score among all patients was 138.3 (+/- 12.2), which suggests a high level of QOL. The reported frequency of moderate to severe symptoms was generally low (ie, < 15%), with fatigue (31.4%), insomnia (23.3%), and local numbness at the site of surgery (22.1%) occurring with greatest frequency. Patients reported a wide range of sexual difficulties. Preference assessment showed that more than 65% of patients were willing to undergo 6 months of chemotherapy for a 5% increase in likelihood of cancer cure. CONCLUSION Self-rated QOL in breast cancer patients 2 to 5 years following adjuvant therapy was generally favorable. Less than one third of patients reported moderate to severe symptoms. Selected aspects of sexual function appeared to be compromised. The majority of patients indicated a willingness to accept 6 months of chemotherapy for small to modest potential benefit.


2003 ◽  
pp. 75-89 ◽  
Author(s):  
E Thomas ◽  
G N Hortobagyi

Since the initial studies of adjuvant therapy in the 1970s, it has become increasingly clear that chemotherapy and hormone therapy have had a substantial effect on the survival of women with early breast cancer. It was originally assumed that only women with high-risk features would derive benefit from adjuvant therapy, but it is now apparent from numerous studies that adjuvant therapy improves survival in all subgroups of women with invasive breast cancer, although the absolute benefit varies depending on tumor stage and other prognostic features. Considerable progress has been made in elucidating effective adjuvant therapy regimens, but there continue to be many unanswered questions that are being addressed in ongoing clinical trials of adjuvant hormone therapy and chemotherapy. This paper reviews the current paradigms in adjuvant therapy, the published data that have affected current practice patterns, and the current controversies.


2014 ◽  
Vol 124 (1) ◽  
pp. 5-9
Author(s):  
Marzena Kamińska ◽  
Tomasz Ciszewski ◽  
Agnieszka Bronikowska ◽  
Maria Ferańska ◽  
Agnieszka Pawlak-Warszawska ◽  
...  

Abstract Introduction. Breast cancer is the most frequent cancer diagnosed in women. Its treatment is a combined therapy and the sequence and time are established according to the accepted standards in Poland. Consequences posed by this disease include disorder in the physical, mental and social spheres in women. Adapting to cancer is very important for the process of treatment, and the acceptance of the disease is the determinant. Aim. The aim of the study was to determine and compare the degree of acceptance of the illness and the assessment of quality of life among breast cancer patients during cancer treatment. Material and methods. The survey included 85 ill people treated in a conserving way and 94 ill people treated by breast amputation. Patients after the surgical procedure were subjected to adjuvant treatment involving chemotherapy (90 women) and/or endocrine therapy (87 women). The study used standardized questionnaires EORTC (European Organisation for Research and Treatment of Cancer): QLQC-30 and the scale (AIS Approval IIIness Scale). Results. The highest level of acceptance of the disease, so the best ability to adapt to cancer have those women who have undergone radical mastectomy and adjuvant hormone therapy during the treatment. The lowest level of acceptance of the illness, expressed as a negative assessment was observed in women after BCT and during chemotherapy treatment. The use of the EORTC QLQC-30 to assess the overall health and quality of life of patients allowed us to capture statistically significant differences in the percentages stating good health, with the relatively highest negative response rates which were observed in the subgroups treated with chemotherapy and hormone therapy. With regard to the highest quality of life, the percentage of negative responses was observed in subgroups treated with the use of hormone therapy and after mastectomy. Conclusions. Good acceptance of the disease was obtained by women treated for breast cancer who have undergone mastectomy in the course of adjuvant endocrine therapy. The assessment of general health and quality of life was influenced by oncological treatment. Patients during chemotherapy and hormone therapy showed a negative impact of this form of treatment on overall well-being and functioning.Patients after mastectomy and during hormone therapy treatment showed a comparatively lower quality of life compared to a group of patients after BCT and during treatment with chemotherapy


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12101-e12101
Author(s):  
Vincent Caggiano ◽  
Carol Parise

e12101 Background: The estrogen receptor positive (ER+), progesterone receptor positive (PR+), human epidermal growth factor 2 negative (HER2-) subtype is the most common. Cases of stage 1, ER+/PR+/HER2- are most often treated with hormone therapy alone, although this is not universal. The purpose of this study was to determine if there were differences in mortality for patients with stage 1, ER+/PR+/HER2- breast cancer given no treatment, chemotherapy alone, or both chemotherapy and hormone therapy when compared with hormone therapy alone for four mutually exclusive race/ethnicities. Methods: We identified 58,953cases of Stage 1, ER+/PR+/HER2- first primary female invasive breast cancer from the California Cancer Registry 2000-2014. Cases were stratified into white (n = 41,716), black (n = 2,310), Hispanic (n = 8,186) and Asian/Pacific Islander (API) (n = 6,741). Treatment was categorized as none, hormone therapy alone, chemotherapy alone, or both chemotherapy and hormone therapy. Kaplan Meier survival analysis and Cox Regression were used to assess the risk of mortality associated with treatment using hormone therapy alone as the reference category. Treatment was considered a risk for mortality and hazard ratios (HR) and 95% confidence intervals reported if the Wald χ2 was statistically significant (p < 0.05). Models were adjusted for age, grade, socioeconomic status, and tumor size. Separate analyses were conducted for each race/ethnicity. Results: White women, having no treatment (HR = 1.33; 1.14-1.54), or chemotherapy alone (HR = 1.49; 1.10-2.00) was associated with an increased risk of mortality. For API women, having the combination of chemotherapy and hormone therapy was associated with increased risk of mortality (HR = 2.47; 1.34-4.56). For black and Hispanic women, there was no difference in risk of morality for any combination of treatment when compared with hormone therapy. Conclusions: The effectiveness of treatment modalities for the Stage 1, ER+/ER+/HER2- subtype varies considerably by race/ethnicity.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 527-527
Author(s):  
Nita S. Nair ◽  
Nishu Singh Goel ◽  
Rohini W Hawaldar ◽  
Shabina Siddique ◽  
Vani Parmar ◽  
...  

527 Background: Yoga has been tested in multiple small-randomized studies for its impact on quality of life (QOL) on breast cancer (BC). We propose to study the effect of yoga on disease free survival as the primary endpoint in women with operable breast cancer. (Study methodology details refer to NCT02161900). Methods: Women with non-metastatic BC were randomized to yoga and conventional exercise (YCE) versus conventional exercise only (CE) in addition to standard therapy. Over and above documentation of recurrence and death, QOL was assessed in these women using the EORTC QLQC30, BR23, Brief fatigue inventory (BFI), Visual pain scores (VPS) and a spirituality questionnaire (SQ). EORTC QLQ was assessed at baseline (BL), 6-9 months (mo), 18-21 mo. BFI and VPS at BL, 6-8 mo and 12-15 mo and SQ at BL and 12-15 mo. We report the first interim analysis of QOL in 605 patients randomized to the study with atleast 1 year of follow up. The groups were balanced in both arms with respect to clinico-pathological factors. Results: At 6-9 mo (completion of adjuvant therapy), there was no significant difference in global QOL scores (p = 0.08), however 52% women on YCE showed an improvement from baseline compared to 42% in CE. At 18-21 mo emotional function scores were better in YCE (p = 0.002); with lesser systemic side effects in YCE arm (44% vs 56% p = NS). The median score of fatigue after adjuvant therapy measured by QLQ C30 was lower in YCE (17.37vs22.22, p = 0.003) which was similar to that observed by BFI at 12-15 mo (1.6vs 2, p = 0.04). Also in YCE there was lower reporting of detriment in general activity (41%vs 59%) and mood (34%vs66%) (p = NS). In VPS at 12-15mo, the median scores for pain intensity (p = 0.042), pain on movement (p = 0.038), pain on mobilization (p = 0.008) were lower in YCE. Lastly SQ assessed spirituality and showed no difference, but less deterioration compared to baseline scores in YCE. Conclusions: Yoga did not show a significant difference in global QOL but had a major benefit reaching statistical significance in fatigue, emotional score and pain. Yoga is a low-risk, low-cost complementary therapy that may improve compliance to therapy by improving parameters that can affect day-to-day activity in women with breast cancer. Clinical trial information: NCT02161900.


2020 ◽  
Author(s):  
Josefina Bertoli ◽  
Ewertton Bezerra ◽  
José Angelo Barela ◽  
Luis Alberto Gobbo ◽  
Cristina Elena Prado Teles Fregonesi ◽  
...  

Introduction: Breast cancer and its treatments lead to several physical and psychological repercussions in the short and long term. Furthermore, breast cancer survivors (BCS) tend to present sedentary behavior, which worsens the aforementioned breast cancer treatment side effects. Physical exercise has been demonstrated to be effective for improving physical and psychological BCS aspects. Therefore, the purpose of this study is to investigate the effects of 24 weeks of supervised Mat Pilates on force production, flexibility, postural control, gait, body composition, pain, cancer related fatigue (CRF), body image, physical activity level, quality of life, and nutritional status in BCS undergoing hormone therapy. Methods and design: The HAPiMat Study is a randomized controlled clinical intervention trial comparing Mat Pilates with a control group. The primary outcomes are force production in different muscle groups, upper and lower limb flexibility, and gait and balance parameters. The secondary outcomes are quality of life, pain, cancer related fatigue, body image, sedentary behavior, functional capacity, physical activity level, nutritional intake, anthropometric measurements, and body composition. The safety of the Mat Pilates intervention and physical assessments are monitored throughout the intervention. Discussion: The strengths of this study are that the Pilates Method is mind-body training, which might ameliorate the side effects of breast cancer treatments, and that our intervention is systematized into sets, with the number of repetitions increased every eight weeks, enabling better results in the physical variables. Moreover, to date, no Pilates studies have focused on BCS undergoing hormone therapy only.


1996 ◽  
Vol 14 (5) ◽  
pp. 1565-1572 ◽  
Author(s):  
S M Swain ◽  
J Rowland ◽  
K Weinfurt ◽  
C Berg ◽  
M E Lippman ◽  
...  

PURPOSE A dose-escalation study was conducted to determine the maximum-tolerated dose (MTD) and dose-limiting toxicities (DLTs) of cyclophosphamide (CY) in combination with granulocyte colony-stimulating factor (G-CSF0 and doxorubicin (DOX) given every 2 weeks for eight cycles as outpatient adjuvant therapy for node-positive breast cancer. A pilot study to assess quality of life (QOL) was performed. PATIENTS AND METHODS From March 1991 to April 1993, 19 patients were entered. Patients received escalating doses of CY intravenously (i.v.) (1,000 mg/m2, 1,500 mg/m2, 2,000 mg/m2, or 2,500 mg/m2) with DOX 40 mg/m2, G-CSF 10 micrograms/kg/d on days 2 to 12, and mesna, every 2 weeks for eight cycles. QOL was measured by the Profile of Mood States (POMS), the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), and a 27-item QOL scale. RESULTS The CY dose of 2,500 mg/m2 every 2 weeks elicited toxicities that required dose reductions secondary to a combination of thrombocytopenia, hematuria, and anemia that required transfusion. The dose of 2,000 mg/m2 resulted in an acceptable toxicity profile. Ninety-two percent of cycles at the 2,000-mg/m2 dose were delivered on schedule and 77% without hospitalization. QOL assessments indicated high levels of distress measured by POMS in 47%, poor overall quality of life in 40%, and significant problems with physical symptoms in less than 27% of all patients for any given cycle. CONCLUSION A dose of CY at 2,000 mg/m2 can be administered every 2 weeks with DOX and G-CSF for eight cycles in the outpatient setting with manageable toxicity. The majority of women described levels of physical symptoms and emotional distress as tolerable during treatment.


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