4179F Tamoxifen or aromatase inhibitor (AI) prescribed (ONC)

Name of the Procedure:

Tamoxifen or Aromatase Inhibitor (AI) Prescription

Summary

Tamoxifen or Aromatase Inhibitors (AIs) are medications commonly prescribed to treat hormone receptor-positive breast cancer. They help prevent cancer recurrence by blocking the effects or production of estrogen, which can fuel the growth of breast cancer cells.

Purpose

The primary purpose of prescribing Tamoxifen or AIs is to reduce the risk of breast cancer recurrence and to treat existing hormone receptor-positive breast cancer. The goal is to lower estrogen levels in the body or block its action on cancer cells, slowing down or stopping cancer growth.

Indications

• Hormone receptor-positive breast cancer
• Patients with early-stage or metastatic breast cancer
• Postmenopausal women (primarily for AIs)
• Pre and postmenopausal women (for Tamoxifen)

Preparation

• Discussion with an oncologist about medical history and potential side effects.
• Routine blood tests to monitor liver and kidney function.
• Bone density tests might be required for patients prescribed AIs due to the risk of osteoporosis.

Procedure Description

1. Tamoxifen: Taken orally, usually as a daily tablet. It binds to estrogen receptors on breast cancer cells, preventing estrogen from promoting cancer cell growth.
2. Aromatase Inhibitors (AIs): Also taken orally as a daily tablet. AIs reduce the production of estrogen by inhibiting the enzyme aromatase, which converts androgens into estrogen.

Duration

The course of treatment typically lasts 5-10 years, depending on individual patient factors and response to therapy.

Setting

These medications are taken at home. Regular follow-up appointments with the oncologist are necessary to monitor progress and manage any side effects.

Personnel

• Oncologist
• Oncology nurse
• Primary care physician (for ongoing monitoring)

Risks and Complications

• Tamoxifen: Risk of blood clots, stroke, uterine cancer, hot flashes, and cataracts.
• AIs: Risk of bone thinning (osteoporosis), joint pain, hot flashes, cardiovascular issues.
• Both may cause fatigue, mood swings, and nausea.

Benefits

• Significantly reduces the risk of breast cancer recurrence.
• Slows down or stops the growth of active hormone receptor-positive breast cancer.
• Improves overall survival rates.

Recovery

• Regular medical follow-up to monitor the effectiveness and any side effects.
• Bone density monitoring for patients on AIs.
• Patients can typically maintain normal daily activities with adjustments based on their side effect management.

Alternatives

• Surgery (mastectomy or lumpectomy).
• Radiation therapy.
• Chemotherapy.
• Oophorectomy (removal of ovaries) for premenopausal women.
• Each alternative has its own risks and benefits that should be discussed with a healthcare provider.

Patient Experience

Patients might experience side effects like hot flashes, joint pain, and fatigue. Regular follow-up visits will help manage these. Pain management and lifestyle adjustments might be necessary to improve comfort and quality of life during treatment.