Adjuvant Endocrine Therapy for Breast Cancer Survivors, Dr Jekyll and Mr. Hyde by Jeffrey Dach MD
Marjorie is a 54 year old stay at home mom who had a lumpectomy and radiation therapy for breast cancer about four years ago. Ann had been taking an estrogen blocking drug called letrozole, an aromataste inhibitor (AI) which inhibits production of estrogen, leading to undetectable serum estrogen levels. The letrozole estrogen blocking drug is causing severe menopausal symptoms, vaginal dryness, recurrent urinary tract infections, hot flashes, night sweats and insomnia. Marjorie is so miserable, she is thinking of stopping the estrogen blocking drug and starting hormone replacement, a plan vigorously opposed by her oncologist. In this newsletter, we review the mainstream oncology treatment of breast cancer with the two most common estrogen blocking drugs, tamoxifen and the aromatase inhibitors (AIs). Even mainstream medicine recognizes the Dr. Jekyl and Mr. Hyde qualities of this class of medications, in some cases they help and in others they harm.