Video Q&A about Cancer Immunotherapies

Wed, Feb 6, 2019
9:30am to 10:00am CT

Description

Dr. Roxana Dronca is chair of the Hematology/Oncology department at Mayo Clinic's campus in Jacksonville, FL. She is speaking to a group interested in immunotherapies for women's cancers and has invited the public (via Connect and Facebook Live) to watch her presentation and participate in a Q&A session.

Location

Online

@audreylaine

Hey @cmd03, I sent your question to Dr. Dawn Mussallem. She had several deadlines she was up against and apologized for the delayed response. Here's what she said:
Great question! This is one that physicians and cancer researchers are interested in too. To date, the relationship between cholesterol and breast cancer risk has not been a consistent finding in high quality human studies. IN other words some research suggests high cholesterol may be protective when other studies suggest the opposite. This is because when known breast cancer risks such as postmenopausal obesity and diet are factored into the research it is really challenging to make a conclusion specific to cholesterol and breast cancer risk. The UK ACALM Big Data registry is the most recent, comprehensive well designed study on the topic. In this study of over 16,000 patients, those with hyperlipidemia were almost half as likely to develop breast cancer and in those that did there was a 40% reduction in mortality and improved long-term survival. Statins are suggested to be the possible link. Other studies have suggested similar benefit of statins however due to conflicting evidence to date it would be misleading to suggest that statins prevent or treat breast cancer. Bottom line: the importance of maintaining a healthy body weight, regular exercise and a low fat diet should be emphasized first and if one continues to have high cholesterol despite lifestyle change then statins should be considered when recommended by your physician.

It is important to know that natural products are not standardized and can cause harm. Just because something is natural doesn’t mean it is safe. So replacing a statin with something natural isn’t necessarily better for you.

Metformin has been used for over 50 years to improve blood sugar levels in patients with type 2 diabetes. It may also lower LDL-cholesterol levels and reduce the risk of cardiovascular disease and cancer. Research is ongoing.

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Thank you for this information.
I greatly appreciate it–

@ihnsbc

I am one of the approximately 20 % of Estrogen-positive women who are walking away from Aromotase Inhibitors because of devestating side effects. Is there concensus and support on how we proceed with monitoring our health? I have a supportive oncologist who believes, as I do, that quality of life matters. But I think there is a lack of information and wonder if there is interest in or attention to this group. Thank you.

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20%?? @ihnsbc? Recent studies show it is closer to half that do not complete the full course of anti-hormonal treatment due to the debilitating side effects. (Links supporting that statement and quotes from the studies are below.) Other sources do show higher compliance, more like the 80% you state.

That is good your oncologist supports you in maintaining a reasonable quality of life. One encouraging comment I was given was that women who could not tolerate the drugs initially sometimes did better 5-10 years later. You could also give Tamoxifen or Raloxifene a try. Very recent studies show that low-dose Tamoxifen is effective.

https://journals.lww.com/amjclinicaloncology/Abstract/2018/05000/Patient_reported_Adherence_to_Adjuvant_Aromatase.14.aspx
“Using the MMAS (Morisky Medication Adherence Scale), only 50% of women with stage 1 to 3 breast cancer reported high adherence to AI therapy, consistent with other reports showing suboptimal adherence to adjuvant endocrine therapy.”

https://www.nursingtimes.net/home/behind-the-headlines/women-who-stop-taking-breast-cancer-drugs-risk-early-death/5056861.article#
“Looking at prescription data the researchers found women were on average less likely to stick to their treatment over time. This is known as adherence to treatment. In the first year, for example, women adhered to treatment 90% of the time. This figure dropped to 50% by the fifth year."

https://www.karger.com/Article/Abstract/100444
"In clinical practice settings, only 2 reports addressed longer-duration (>4 years) adherence to adjuvant tamoxifen use. In these, tamoxifen was prematurely discontinued by 30–50% of the patients. Conclusion: Adherence to prescribed breast cancer hormone therapy has not received concerted attention."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731975/:
Van-Herk-Sukel et al. reported that about 50% of the breast cancer patients discontinued tamoxifen or any endocrine treatment before the recommended treatment period of 5 years [13]. Hershman et al. suggested that only 49% of breast cancer patients took adjuvant endocrine therapy for the full duration.

https://www.ncbi.nlm.nih.gov/pubmed/20058066
"Half of breast cancer patients discontinue tamoxifen
and any endocrine treatment before the end of the recommended
treatment period of 5 years: a population-based analysis" That’s the title of the report

https://www.sciencedirect.com/science/article/pii/S0748798311006986
"Non-compliance rates are similar in patients treated with AIs, tamoxifen (TAM), or a sequence of both, and ranges between 40 and 60%. Reports confirm that these high rates are largely attributable to the presence and severity of adverse effects."

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