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    After surgery, women diagnosed with hormone-receptor-positive breast cancer usually take hormonal therapy medicine to reduce the risk of the cancer coming back (recurrence). Hormonal therapy medicines work in two ways: There are several types of hormonal therapy medicines. Tamoxifen, a selective estrogen receptor modulator (SERM), is one of the most well-known. Tamoxifen can be used to treat both premenopausal and postmenopausal women. In early 2000, the aromatase inhibitors: were shown to be more effective at reducing recurrence risk in postmenopausal women and are now used more often than tamoxifen to treat women who’ve gone through menopause. Aromatase inhibitors aren’t commonly used to reduce recurrence risk in premenopausal women. Still, in some cases a premenopausal woman may take medicine to suppress the function of her ovaries and take an aromatase inhibitor. where to buy prednisolone 5mg This week, the American College of Obstetricians and Gynecologists (ACOG) endorsed the use of vaginal estrogen in breast cancer survivors to treat urogenital symptoms, if more conservative therapies have failed. Vaginal estrogen contains a black box warning, which tends to deter cancer survivors from its use, though the North American Menopause Society (NAMS) is in the process of trying to get that changed. Given this multi-faceted issue, we contacted both breast cancer experts and OB/GYNs via email to ask: When do you feel it is appropriate for breast cancer survivors to use vaginal estrogen? Do you think the black box warning for vaginal estrogen needs to be changed -- why or why not? The participants this week are: Alice Chung, MD, surgeon with the Saul and Joy Brandman Breast Center and assistant professor of surgery at Cedars-Sinai in Los Angeles Nanette Santoro, MD, professor and chair, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus in Aurora Sarah Mougalian, MD, assistant professor, medicine (Medical Oncology) at the Yale Cancer Center in New Haven, Conn. Renee Horowitz, MD, an OB/GYN at Farmington Hills Obstetrics and Gynecology, a part of Beaumont Health System, in Farmington Hills, Mich. Diana Bitner, MD, an OB/GYN at Spectrum Health in Grand Rapids, Mich. Susan Minton, DO, clinical director, breast medical oncology and associate member, Comprehensive Breast Program at Moffitt Cancer Center in Tampa Limited Research Chung: The effects of hormone replacement in breast cancer survivors are not well studied in the medical literature, but the large randomized trial by the Women's Health Initiative provided solid scientific evidence that the combination of oral estrogen and progesterone caused an increased risk of breast cancer associated with the duration of hormone exposure.

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    Prescription creams, rings or tablets that release estrogen locally in the vagina are available to treat the problem. But whether these products are safe for women who have had an estrogen-fueled tumor remains an open question. Now the American College of Obstetricians and Gynecologists (ACOG) has weighed in. ACOG’s statement, published in the March 2016 issue of Obstetrics & Gynecology, concludes that survivors experiencing symptoms such as vaginal atrophy or pain during intercourse may consider using vaginal estrogen at the lowest effective dose, if nonhormonal moisturizers or lubricants do not work. Women with estrogen-dependent cancers, who make up about three-quarters of all breast cancer cases, typically take an anti-estrogen therapy for five to 10 years to reduce the risk of recurrence. The American Cancer Society estimates that more than 3 million breast cancer survivors are in the U. Most frequently prescribed are the aromatase inhibitors, used to treat postmenopausal women, and tamoxifen, prescribed for premenopausal and postmenopausal women. From 50 to 75 percent of breast cancer survivors taking these drugs experience symptoms like vaginal dryness or pain. Nonhormonal moisturizers and lubricants can provide some relief. Breast cancer survivors represent a unique patient population with a high prevalence of menopausal symptoms. Given the improved longevity of cancer patients, the consequences of menopause have become an increasingly important and challenging management issue. To date, considerable attention has been paid to the management of menopausal vasomotor symptoms and bone health among breast cancer patients. As a result, numerous nonhormonal treatment options have been developed for the management of these issues. The treatment of urogenital symptoms among this population is poorly understood and relatively understudied. Although systemic or topical estrogen replacement is the most effective method for treating hypoestrogenemic urogenital symptoms, women with a prior diagnosis of breast cancer are cautioned from taking exogenous estrogens in order to avoid a potential contribution to recurrent breast cancer risk. This review focuses on the urogenital consequences of estrogen deprivation therapy in breast cancer patients and provides practitioners with a simple guide of current and future strategies for managing these symptoms.

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    Arch Dermatol Res. 2010 Jan;30211-4. doi 10.1007/s00403-009-0983-1. Epub 2009 Jul 28. Topical tamoxifen therapy in hypertrophic scars or keloids in. clomid ebay Nov 19, 2016. Testosterone Cream, Vaginal Ring Seem Safe Treatment for Dryness, Loss of. Tamoxifen can be used to treat both premenopausal and. Using Julva Cream If You've Had Breast Cancer. ORAL DHEA systemic converting to estrogen can interfere with Tamoxifen use and can decrease its.

     
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