More Years of Hormonal Therapy
ASCO hasn't even really started yet, and this report is already all over the news. We have known it was coming, and there have bee preliminary studies reported in the past, but an updated guideline from the NCI suggests that women with ER positive breast cancers should (usually/often) stay on hormonal therapy for ten years. I suspect that this soon eventually be qualified to something like "at least ten years."
Just yesterday there was a discussion in one of my groups about the duration of treatment with a hormonal therapy. Two women havve just started taking an AI, one quite reluctantly, and they were talking about the need to stick with it for five years. That will now be ten. The studies have mostly looked at Tamoxifen, but you can be sure that oncologists will think carefully about stopping other therapies, specifically the AIs, after five years.
The quick science behind this is that many ER positive breast cancers are "indolent" and rather slow growing. Over the years, there was an increase in late, mor than five years after diagnosis, recurrences. When researchers looked at the data and began studies in which women stayed on the therapies for more than five years, those late recurrences diminished. Very honestly, in my full skepticism mode, I wonder whether this is kicking the can down the road and means that there will be more late recurrences after, say, fifteen years. Maybe yes, maybe no. But even if it is "yes", all of us would be happier to have fifteen recurrence free years than seven. We will keep taking the therapies and see where this all goes.
Here is the start of a summary from Consumer Health Day and then a link to read more. If you Google the title, you will find many other articles about the same study.
New Guidelines Recommend Longer Tamoxifen Treatment
Breast cancer survivors may benefit from taking the estrogen-blocking drug for up to 10 years, experts say
TUESDAY, May 27, 2014 (HealthDay News) -- The hormone-blocking medication tamoxifen should be given for as long as 10 years following treatment of certain types of breast cancer, according to updated guidelines from the American Society of Clinical Oncology (ASCO).
"Tamoxifen taken for five years has been the standard . . . but we now have evidence to recommend up to 10 years of tamoxifen for women with hormone receptor-positive breast cancer," guideline update panel co-chair Dr. Harold Burstein said in an ASCO news release.
The new guidelines include women with hormone receptor-positive breast cancers between stage 1 and stage 3.