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Tamoxifen Can Reduce Breast Pain In Prostate Cancer Patients
Tamoxifen is more effective than radiotherapy at preventing breast enlargement and breast
pain in men with prostate cancer, concludes a randomised trial published online today by
The Lancet Oncology.
A drug called bicalutamide has been licensed in some European countries as an additional
therapy to the main treatment (removal of the prostate or radiotherapy) for early prostate
cancer. Breast enlargement and breast pain are common side effects of bicalutamide therapy,
and can cause some patients to withdraw from treatment. Because early withdrawal from
treatment may compromise outcome, effective management strategies for breast
enlargement and breast pain are needed. Currently, the most commonly used treatment to
prevent breast enlargement in prostate patients is low-dose radiotherapy. Trials have
suggested that preventative treatment with anti-oestrogen drugs, such as tamoxifen, could
also be effective.
Giuseppe Di Lorenzo (University Federico II, School of Medicine, Naples, Italy) and colleagues
undertook a randomised trial to compare the effectiveness of tamoxifen with that of
electron-beam radiotherapy for the prevention and treatment of breast enlargement and
breast pain caused by bicalutamide therapy for prostate cancer. They recruited 151 men who
had received primary treatment for prostate cancer from five Italian centres between January
2002 and February 2004. 51 patients were randomly assigned to 150 mg bicalutamide only
per day, 50 patients to 150 mg bicalutamide per day and 10 mg tamoxifen per day for 24
weeks, and 50 patients to 150 mg bicalutamide per day and one dose of radiotherapy at the
start of treatment.
Patients were followed-up for an average of 25 months. The investigators found that 35 of
the 51 patients assigned to bicalutamide alone developed enlarged breasts, compared with
four of the 50 assigned the bicalutamide and tamoxifen and with 17 of the 50 assigned
bicaluatmide and radiotherapy.
29 of the 51 patients on the drug alone developed breast
pain, compared with three of the 50 receiving additional tamoxifen, and 15 of the 50
receiving an additional dose of radiotherapy. 35 patients assigned to bicalutamide only
subsequently developed breast enlargement or had moderate to severe breast pain and were
randomly allocated to receive additional treatment of 10mg tamoxifen or one dose of
radiotherapy. In this sub-group tamoxifen substantially reduced the frequency of breast
enlargement and breast pain when compared with radiotherapy. The treatments were well
tolerated and the groups did not differ in quality of life or relapse-free survival.
Dr Di Lorenzo concludes: "We have shown that tamoxifen and radiotherapy can prevent
breast enlargement and breast pain in some patients receiving bicalutamide therapy for
prostate cancer, and that tamoxifen is more effective than radiotherapy."
http://www.thelancet.com
Tamoxifen pot reduce Breast durere în cancerul de prostatã Pacienþii - Tamoxifen Can Reduce Breast Pain In Prostate Cancer Patients - articole medicale engleza - startsanatate