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Monday, June 05, 2006

Another healthy drug for women: Osteoporosis from breast cancer treatment

more than just osteoporosis -

Further down in this post you will find this paragraph:"Oncologist Julie Gralow, M.D., of the University of Washington and Fred Hutchinson Cancer Center in Seattle said that women should also consider other ways to improve bone strength, "such as exercise and use of bisphosphonates."

So what's this about 'bisphosphonates'?
While Fosamax is a fluoride based drug I ad vise against on the basis that is makes bones hard and brittle, not strong and flexible, while supporessing your thyroid, it just so happens that drugs like Actonel -from Proctor & Gamble pharmaceuticals- are made from by-products of TIDE, other wise known as bisphosphonates.

These drugs can lead to what is called ONJ or osteonecrosis of the jaw. Some call this "bone death" as a literal translation from the Latin might define. What it might mean to you is disfigurement, pain and mouth ulceration. Cancer patients seem to be more at risk receiving the drugs intravenously, as they may have to undergo much more invasive dental procedures.

Well, it just goes to show you that women are still on the second class list when it comes to health care.

It's not enough that mammography promotes cancer or chemotherapy leads to all kinds of health problems. Radiation can cause things like lung cancer and congestive heart failure, not to mention thyroid problems, or the 'Race for the Cure' does nothing to prevent or find the cure.

But now we have a breast cancer drug that gives you osteoporosis.

Just another action point on my 'Think Before You Pink' list.

Five Years of Arimidex Causes Bone Loss
By Peggy Peck, Managing Editor, MedPage Today
Reviewed by Robert Jasmer, MD; Assistant Professor of Medicine, University of California, San Francisco
June 04, 2006

Action Points
*Explain to interested patients that this report suggests that women taking Arimidex can have a significant loss of bone mineral density.

*This study was published as an abstract and presented in a poster at a conference. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication.

J. Leonard Lichtenfeld, M.D.
Amer. Cancer Society

ATLANTA, June 3 —

For women with normal bone density at baseline, however, five years of Arimidex is unlikely to cause osteoporosis, said investigators with the Arimidex, Tamoxifen, Alone or in Combination (ATAC) trial, who reported the findings today at the American Society of Clinical Oncology meeting here.

Women taking Arimidex had about a 40% increase in risk of fractures while on the study, said Robert E. Coleman, M.D., Weston Park Hospital in Sheffield, England. "When the drug was discontinued the excess fracture risk declined," he added.

The overall fracture rate was 7.7% among women taking tamoxifen in the study versus 11% for women taking Arimidex. Dr. Coleman said the difference was significant, but did not report the P value. There was, he said, no statistically significant difference in the rate of hip fractures between women taking Arimidex and those taking tamoxifen.

The rate of bone mineral density loss decelerates over time so that the rate at two to five years was significantly less than the loss over the first two years of treatment, (mean difference in annual rate of change 0.0113, 95% CI 0.006-0.0017; P=0.0002).

Five patients with osteopenia at baseline developed osteoporosis by five years, he said.

After five years, women taking Arimidex lost 6.1% of bone mineral density at the hip and 7.2% at the spine versus losses of 2.8% at the hip and 0.7% at the spine in the tamoxifen group (P<0.0001).

The ATAC trial recruited postmenopausal women with invasive primary breast cancer and randomized them to adjuvant treatment with Arimidex, tamoxifen, or combination therapy. The trial reported that Arimidex was superior to tamoxifen or combination therapy for preventing recurrence of breast cancer.

This 68-month subset analysis compared bone mineral density between 81 women treated with Arimidex and 86 women treated with tamoxifen. Lumbar spine and total hip bone mineral density were measured by dual-energy x-ray absorptiometry at baseline, one year, two years, and five years.

On the basis of these results, Dr. Coleman recommended that women taking Arimidex should have their bone mineral density monitored every one to two years. "They should also take calcium and vitamin D supplements during Arimidex therapy."

Oncologist Julie Gralow, M.D., of the University of Washington and Fred Hutchinson Cancer Center in Seattle said that women should also consider other ways to improve bone strength, "such as exercise and use of bisphosphonates."

J. Leonard Lichtenfeld, M.D., deputy medical director at the American Cancer Society, said the results should not be surprising because oncologists since have been long concerned about possible bone loss with aromatase inhibitors.

Primary source: American Society of Clinical Oncology
Source reference: Coleman RE et al "Effect of anastrazole on bone mineral density: 5-year results form "Arimidex, Tamoxifen, Alone or in Combination (ATAC) trial" Abstract 511.