Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 3 2000
Play
Audio Below:
Dr.
Davidson: I have a cadre of young women who have had chemotherapy
from adjuvant therapy and who have had the bad luck of having their
disease come back, and usually, on tamoxifen. So, if they’re
actually actively on tamoxifen it’s a pretty simple question.
I would use an LHRH agonist in those women. If for some reason they
didn’t get adjuvant tamoxifen and some of them are late relapses
– so they didn’t because we didn’t give tamoxifen
at the time that they were being treated – then I choose with
them between tamoxifen and ovarian ablation. And usually they have
pretty strong feelings about it. I mean, some people are really
into the notion of either having a surgical castration (I want surgery,
I’m done, I’m out of there), some people come in for the
shots every month, and some say, "No thank you, just give me
the pill". And then, I’m a big proponent of cross-overs.
A lot of those women will do very well on one for a while and then
they can be crossed over to the other. I have, even, some folks
who at this point, assuming that the ovarian ablation was their
second intervention and they still seem hormone responsivish, I’m
adding on the Arimidex or the letrozole as their third-line hormone.
Dr.
Love: So, I guess what you’re saying is then, if you had a
premenopausal woman who say responded to Zoladex, would you keep
the Zoladex going and then add in Arimidex?
Dr.
Davidson: Yeah, if I wanted to use the Arimidex I would keep the
Zoladex going, because I guess I would be concerned about how effective
an aromatase inhibitor by itself is going to be in this women with,
presumably, a lot of ovarian function.
