Wednesday, July 25, 2007 Simply better, Part 2 By Zosimo T. Literatus, R.M.T.Breakthroughs
LAST week, we painted a picture on how tamoxifen performs against breast cancer.
Latest studies have indicated its potential in increasing the risk for uterine cancer. This complication placed a choice between two cancers in the use of tamoxifen. Meanwhile, scientists turned their hopes to adjuvants (enhancers) such as aromatase inhibitor (AI).
AI prevents the enzyme aromatase from transforming androgens into estrogens, a process of importance in sexual development.
Inhibition of the enzyme leads to very low estrogen levels and slowed down breast cancer growth.
Researchers J. Gines Rubion, F. Fernandez Cortes, and J. Rifa Ferrer made a large-scale review (meta-analysis) on AI for the past five years to find out.
Rubio and Cortes are pharmacists, while Ferrer is an oncologist of Hospital Son Dureta in Palma de Mallorca, Spain. The review involved seven stage III clinical trials and around 9,270 patients.
Results, published in Farmacia Hospitalaria (2007), show that AI (such as anastrozole, exemestane and letrozole) increases disease-free survival (DFS) when administered regularly for two to three years following two to three years or five years of tamoxifen treatment. What is surprising, it is found more effective in treating hormone receptor positive (HR+) breast cancers alone compared to tamoxifen.
One study observed a high degree of relapse around the second year for patients treated with tamoxifen, which has not been observed among patients treated with anastrozole. The relapse rate peaks at two to three years after surgery and is especially notable in patients considered to be at “high risk” of relapse (cancer cells involving four ganglia or a tumor more than 3 cm in diameter). A ganglion is a harmless swelling on joint or tendon.
Suppression of estrogen potentially lowers its protective effect against heart attacks, as observed in studies with exemestane and letrozole. Bone-related complications (osteoporosis, bone pains, and fractures) are higher with AI. AI causes around two percent per annum of loss in bone mineral density (BMD).
So much for complexity.
A study of human history reveals a very complex world. “Ancient Egyptians, medieval people and contemporary man,” observed Frederick Herzberg in his book Work and the Nature of Man, “all have kinship in sharing the feeling that the world is too complicated for them.”
Nevertheless, simplicity remains more life-saving than complexity. Henry David Thoreau reminds from his Walde; or, Life in the Woods: “ Our life is frittered away by detail...Simplicity, simplicity.”
