Which of the following is used to treat harmone responsive breast cancer
(D) (Tamoxifen) (568-H 17th) (671 Kalzung 10,h(313-KDT 7th)Breast cancer can be divided into two tvnes of Breast cancer||iEstrogen receptor positive breast cancerEstrogen receptor negative breast cancer||Needs estrogen to growDoes not require Estrogen* Hormonal drug therapy for breast cancer targets estrogen receptor positive breast cancer.* Hormonal drug therapy for breast cancer aims at blocking the action of estrogen on estrogen receptor positive breast cells.* The hormonal therapy of choice for breast cancer in premenopausal woman is Tamoxifen.* Tamoxifen belongs to class of drugs known as ''Selective Estrogen Receptor Modulator"* Tamoxifen binds to the estrogen receptors on tumours and blocks the effect of estrogen on these cells* Tamoxifen is only effective in treating estrogen receptor positive breast cancers.* Therefore the tumour's hormone receptor status should be determined before deciding on treatment optionfor breast cancer.* Tamoxifen is used to treat patients with early stage breast cancer as well as those with metastaticAdjuvant therapy with Tamoxifen- Chemotherapy after primary t/t to increase the chance of cure .- It helps in preventing the recurrence and also helps to prevent the development of new cancers in the other breast. When used as adjuvant chemotherapy it is usually taken for 5years. When taken for 5 years if reduces the chance of the original breast cancer coming back in the same breast or elsewhere. It also reduces the risk of developing secondary primary cancer.Metastatic cancer therapy with Tamoxifen- As a treatment for metastatic breast cancer, the drug slows or stops the growth of cancer cells that are present in the body.- Patient with metastatic breast cancer may have to take tamoxifen for varying lengths of timeTamoxifen may lead to endometrial hyperplasia and endometrial cancer- Tamoxifen is an SERM i.e. it has selective action on estrogen receptors. It will stimulate estrogen receptors in some organs while it will antagonize the estrogen receptors in other organs.- While tamoxifen blocks estrogen receptors on the breast, it stimulates these receptors in the uterus (because tamoxifen is a partial against of ER)Stimulation of estrogen receptors in the uterus may predispose the patients to endometrial hyperplasia and for endometrial cancer.Tamoxifen usage may lead to cataracts (occasional)- Tamoxifen causes retinal deposites decreased visual acuity and cataracts in occasional patients - Goodman Gillman 11TH/ep. 1557Tamxifen usage may lead to thromboembolism- Tamxifen increases the risk of thromboembolic events- Goodman Gillman 1lth/ep. 1557Clominhene Citrate (Antiestrogen)A. Uses (1) To aid in vitro fertilization(2) OligospermiaB. Adverse effects - polycystic ovaries, multiple pregnancy hotflushes, gastric upset, vertigo, allergic, dermatitis,Risk of ovarian cancer may be increased.
Cyptroterone acetate
Clomiphene citrate
Diethylstibestrol
Tamoxifen
Anti-Cancer