BREAST CANCER COMPLICATIONS OF CHEMOTHERAPY UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS

BREAST CANCER COMPLICATIONS OF
CHEMOTHERAPY UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS

●● Selective estrogen receptor modulators, called SERMs for short,
block the effects of estrogen in the breast tissue. SERMs work by sitting
in the estrogen receptors in breast cells. If a SERM is in the estrogen
receptor, there is no room for estrogen and it can't attach to the cell. If
estrogen isn't attached to a breast cell, the cell doesn't receive estrogen's
signals to grow and multiply.


Cells in other tissues in the body, such as bones and the uterus, also have
estrogen receptors. But each estrogen receptor has a slightly different
structure, depending on the kind of cell it is in. So breast cell estrogen
receptors are different from bone cell estrogen receptors and both of
those estrogen receptors are different from uterine estrogen receptors. As
their name says, SERMs are "selective" - this means that a SERM that
blocks estrogen's action in breast cells can activate estrogen's action in
other cells, such as bo
Answer: How do SERMS works?


●● There are three SERMs:


-Tamoxifen
-Raloxifene

,-Toremifene


Tamoxifen in pill form (also called tamoxifen citrate; brand name:
Nolvadex) and in liquid form (brand name: Soltamox)
Evista (chemical name: raloxifene)
Fareston (chemical name: toremifene)
Answer: Which meds are the SERMS?


●● -women and men diagnosed with hormone-receptor-positive, early-
stage breast cancer after surgery (or possibly chemotherapy and
radiation) to reduce the risk of the cancer coming back (recurring)
-women and men diagnosed with advanced-stage or metastatic hormone-
receptor-positive disease
Answer: Tamoxifen is the oldest and most-prescribed selective estrogen
receptor modulator (SERM). Tamoxifen is approved by the U.S. Food
and Drug Administration (FDA) to treat:


●● Since its approval in 1998, tamoxifen has been used to treat millions
of women and men diagnosed with hormone-receptor-positive breast
cancer. While an aromatase inhibitor is the first hormonal therapy
medicine choice for postmenopausal women, tamoxifen is the first
choice for premenopausal women and is still a good choice for
postmenopausal women who can't take an aromatase inhibitor.


Tamoxifen can:

,•*reduce the risk of breast cancer coming back by 40% to 50% in
postmenopausal women and by 30% to 50% in premenopausal women*
•*reduce the risk of a new cancer developing in the other breast by about
50%*
•shrink large, hormone-receptor-positive breast cancers before surgery
•slow or stop the growth or advanced (metastatic) hormone-receptor-
positive breast cancer in both pre- and postmenopausal women
•lower breast cancer risk in women who have a higher-than-average risk
of disease but have not been diagnosed


Tamoxifen
Answer: Benefits of tamoxifen


●● -increased tumor or bone pain
-*hot flashes*
-nausea
-*fatigue*
-*mood swings*
-depression
-headache
-hair thinning
-constipation
-*dry skin*

, -loss of libido
Answer: Tamoxifen most common side effects


●● Tamoxifen's selective estrogen activation effects can cause some
serious side effects, including blood clots, stroke, and endometrial
cancer. If you and your doctor are considering tamoxifen as part of your
treatment plan, tell your doctor if you smoke or have a history of blood
clots or heart attack
Answer: Tamoxifen
-important side effects to educate your patient about


●● Strong inhibitors:


Bupropion Wellbutrin
Fluoxetine Prozac
Paroxetine Paxil
Quinidine Cardioquin
Thioridazine Mellaril
Perphenazine Trilafon
Pimozide Orap
Clomipramine Anafranil
Ticlopidine Ticlid
Terbinafine Kanusuk