Share this story!            

Experts suggest drug combo for breast cancer

* Estrogen-limiting drug combo good for post-menopausal breast cancer patients
* AIs limit estrogen and thus fight breast cancer
* Chemo patients must be careful about bones afterwards

By Ali Raza Mehdi

KARACHI: Studies have shown that some medicinal techniques, especially a combination of drugs, can help post-menopausal breast cancer patients by improving their quality of life and preventing a recurrence of the tumor.

This was discussed at a seminar on Oncology updates organized at a local hotel Thursday by Singapore Medicine, SingHealth and ParkwayHealth, in collaboration with a pharmaceutical company. The panelists included Senior Consultant Medical Oncologist Parkway Cancer Centre Singapore Dr Foo Kian Fong, Head Oncologist Hayatabad Medical College, Peshawar Dr Abid Jameel and Consultant Oncologist AKUH Dr Nadeem Abbasi.

The pros and cons of a combination of drugs known as aromatase inhibitors (AIs) were laid bare in the seminar. According to Dr Fong, various surveys have shown that estrogen levels and breast cancer in post-menopausal women have a relatively defined relationship. High estrogen levels are often associated with internal processes in the body that may ultimately lead to the onset of breast cancer.

“Aromatase inhibitors are a combination of drugs that are employed to limit estrogen levels in a woman’s body. This in turn means that they can be effectively used as tools for fighting breast cancer. One of their limitations, however, is that they can only be used by post-, and not pre-menopausal breast cancer patients,” said Dr Fong.

AIs form part of one of the more popular methods of controlling any type of cancer - endocrine, or hormone, therapy. In layman’s terms, this therapy uses chemicals injected into a person’s body to “kill” the cancerous growth of cells, or the tumor. Dr Fong said that studies have shown that AIs are at least as good as the popular cancer drug Tamoxifen and in some cases more than good too. AIs reduce the risk of the recurrence of breast cancer from 3%-43% more when compared with Tamoxifen. It also fares better when it comes to disease-free survival (DFS). While saying that this by no means establishes AIs as a better option than Tamoxifen, Fong suggested that a combined course of the two often provides a better result.

On the other hand, one of its principle drawbacks, as pointed out by Dr Jamil, is that it damages bones in the long run. Like all drugs employed in chemotherapy, AIs too lower a person’s BMD (bone mineral density). Dr Jamil said that breast cancer patients already have 5 times lower BMDs when compared with other cancer patients, and when they start taking AIs, the situation worsens. He said that annual doses of a drug known as zoledronic acid should be used along with daily supplements of calcium and vitamin D to maintain the BMD.

He also deplored the fact that most Pakistani oncologists ignore the harmful effects of chemotherapy on their patients’ bones. “Most breast cancer patients suffer from hip and spine fractures,” he reported.

Dr Nadeem Abbasi then talked on the incidence of head and neck cancers in Pakistan. He pointed out quite a few features common to only Pakistani patients that their unfortunate counterparts in the rest of the world do not suffer. One of them is that most Pakistanis suffer from T3 and N2 types of cancer; Western patients have hardly been diagnosed with less harmful forms of T2 and N1. There are basically two types of cancers, T and N, and the lower the number the less harmful.

While commenting on the high incidence of oral cancer (mouth cancer) in Karachi, he said that people in Karachi use the crudest possible form of tobacco, ghutka and paan, there is available in the country. He stressed the need for further use of chemotherapy and radiotherapy, along with a technique known as GTV (Gross Tumor Volume), to fight the rising number of cancer cases in the country.

He also spoke on the need for regional collaboration, especially with Far Eastern countries, so that third world countries such as Pakistan can also benefit from newer technology and cancer-fighting techniques.

Home | Karachi

Share this story!