Newspaper Page Text
Breast cancer medication may be
effective menopause treatment
The link between estrogen
therapy for menopause and an
increased risk of breast cancer
has led doctors at the Medical
College of Georgia to consider a
drug similar to one used in breast
cancer treatment as a new treat
ment for menopause.
Raloxifene, a synthetib hor
mone that works as an anti-es
trogen, is akin to tamoxifen,
which is routinely given to post
menopausal breast-cancer pa
tients. Estrogen — which helps
keep women’s hearts healthy,
their blood vessels open and their
bones sturdy i— also appears to
increase the growth and prolif
eration of breast cancer cells.
Doctors believe the anti-estro
gen raloxiphene produces the
desired protective effects of es
trogen without the breast-can
cer risk.
Many women today are smok
ing more, exercising less and
eating too much fat, which means
that the hot flashes, mood swings
and sleep troubles commonly
associated with menopause are
often the least of their worries,
said Dr. Leo Plouffe, Chief of the
MCG Section of Reproductive
Endocrinology, Fertility and
Genetics. Avoiding heart disease
and thinning bones are the big
reasons most women today are
considered for long-term estro
gen-replacement therapy at
menopause.
“Women have changed their
lifestyles dramatically so that
things they are at a high-risk for
now are not necessarily the
things they were always at high
risk for,” he said. “In this day and
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Tamoxifen, an anti-estrogen, has increased long
term survival for postmenopausal breast-cancer
patients. In fact, studies are being done to see if
tamoxifen therapy can actually prevent breast
cancer. Experience with tamoxifen in breast cancer
patients also has revealed a positive effect on the
blood vessels, heart and bones.
age, the most common cause of
death for a woman in North
America is heart disease. Heart
disease is a function of our diet
and lifestyle. Cigarette-smoking
is a major risk factor because
cigarette-smoking breaks down
estrogen and, until the middle of
this century, women were not
heavy smokers,” Dr. Plouffe said.
At menopause, a woman basi
cally runs out of eggs and the
hormone estrogen, which is re
sponsible for helping eggs ma
ture, loses a job so estrogen lev
els are cut by a half or more. Dr.
Plouffe says that, although the
real relationship between thera
py to raise estrogen levels and an
increased risk of breast cancer is
still controversial, there’s still a
concern. “If there is any risk, it
tends to be small, but it tends to
be higher the longer we use the
medication,” he said. The great
est concern is for women who
already have a strong family his
tory of breast cancer.
Tamoxifen, an anti-estrogen,
has increased long-term surviv
al for postmenopausal breast
cancer patients. In fact, studies
are being done to see if tamoxifen
therapy can actually prevent
Living Better
breast cancer. Experience with
tamoxifen in breast cancer pa
tients also has revealed a posi
tive effect on the blood vessels,
heart and bones. “The bad news
is, if you have a uterus (you
haven’t had a hysterectomy), it
can cause the development of
abnormal cells and ... cause en
dometrial cancer.”
But tamoxifen’s close relative,
raloxifene, appears to have the
desired effects without affecting
the uterus. In the new studies,
Dr. Plouffe will treat healthy
women in menopause with
raloxifene therapy and standard
estrogen/ progesterone therapy.
He’ll be looking at the women’s
bones, blood vessels, lipid pro
files and uteri, following women
for one or three years.
Not to forget the very real issue
of hot flashes, Dr. Plouffe also is
studying a new, non-hormonal
treatment. Non-smokers with
good diets and strong bones don’t
derive much benefit from long
term estrogen therapy at meno
pause, but may require short-term
treatment for hot flashes. “I n some
women, we don’t feel we should
use hormones or women don’t
want to use them,” he said.
Clonidine, a blood pressure med
ication that impacts the central
nervous system, has proven to be
an effective non-hormonal treat
ment for some women.
Dr. Plouffe is now looking at
sertraline, a serotonin-like drug
that affects the portion of the
brain involved in temperature
regulation. “We know that some
serotonin drugs raise people’s
temperatures. They get hot all
the time. Other serotonin drugs
lower people’s temperatures so
they feel cold. What we did was
try to find a serotonin-like drug
that would specifically help with
hot flashes.”
He’s looking first at a well
defined group of women: women
with breast cancer taking
tamoxifen. Women taking
tamoxifen can’t take estrogen
and the classic hot flash occurs
in the context of estrogen depri
vation.
Women tell him the hot flashes
start as a hot feeling in the chest
or torso, radiate down the arm,
up to the face and, ultimately, to
the entire body. “The core tem
perature is reduced so the skin
temperature is trying to warm it
back up. It appears that seroto
nin is one of the mediators of
that,” Dr. Plouffe said, noting
that some sort of miscommuni
cation caused by serotonin, a
chemical messenger that helps
cells communicate, may be the
cause. Should sertraline work,
it will be another indicator of
serotonin’s role in hot flashes
and open up the exploration for
new drugs to help with them, he
said.
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Standard first aid to be taught
by the American Red Cross
This comprehensive 61/2 hour
course (recognized by OSHA as
the recommended minimum
training required for employees)
trains you to respond appropri
ately to medical emergencies.
You will become prepared to han
dle anything from burns and bro
ken bones to choking and heart
attacks in these two sessions.
Upon successful completion, you
will receive an ARC adult CPR
card (valid for one year) and an
Researchers study calcium
absorption in adolescent girls
HOUSTON
Pinpointing peak periods of
calcium absorption during child
hood and adolescence may help
young girls build stronger bones,
says a researcher at the USDA’s
Children’s Nutrition Research
Center.
“Most of an adult’s skeleton is
built and enlarged during child
hood and adolescence, so getting
enough calcium at the right time
is extremely important,” said Dr.
Steven Abrams, an associate pro
fessor of pediatrics at Baylor
College of Medicine in Houston.
Abrams has launched a five
year study to identify critical
periods of bone development by
determining the effect of puber
ty on calcium absorption and
bone formation. He will follow 60
girls — black, white and Hispan
ic—as they age from seven to 12.
Abrams expects findings to
vary among racial groups. Previ
ous CNRC studies indicate dif
ferences in calcium absorption
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ARC First Aid card (valid for
three years). Register at the Red
Cross Office, 811 12th Street or
call 826-4465. Two meetings for
a fee of $33. One session offered
will be held Monday and Wednes
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to 10:00 p.m. for the first class,
6:00 to 8:30 p.m. for the second
class. Second session will be held
Tuesday and Thursday, March
26 and 28 with the same times as
above.
as well as maturation rates of
white and black girls. This study,
however, is the first study of its
kind to include Hispanics.
To determine how calcium is
used before, during and after
puberty, the girls will visit the
Center every six months.
They will have their diets as
sessed, receive a calcium tracer
to determine calcium absorption
and have their bone density and
estrogen levels measured.
“There are some dietary differ
ences that could impact the bone
formation of Hispanic girls,”
Abrams said, noting the high
consumption of corn tortillas,
which are considered a good
source of calcium. “But, we know
little about their ability to ab
sorb calcium and build strong
bones.”
Abrams believes that informa
tion from the study may play a
role in customizing dietary rec
ommendations for specific popu
lations.
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