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Home: Oncology Leader Commentary: Craig Hederson, MD

Click on the topic below for comments by Dr Craig Henderson to comment on. You will also find links to related articles and clinical trials.

Historical perspective on adjuvant endocrine therapy
More recent trials of adjuvant ovarian ablation
Intergroup trial of adjuvant endocrine therapy
Is tamoxifen more effective in a low estrogen environment
Zoladex plus tamoxifen as adjuvant therapy
Choosing a method of ovarian ablation
Age and menopausal status
Adjuvant chemotherapy and the ovaries
Emotional issues in decision-making
Combining tamoxifen and an aromatase inhibitor in postmenopausal women
Taxanes as adjuvant therapy
Nodal status and choice of adjuvant systemic therapy
Timing of radiation therapy with AC-Taxol
Dose of adjuvant chemotherapy
Liposomal delivery of cytotoxics


Emotional issues in decision-making

Interview with Neil Love, MD from Breast Cancer Update for Medical Oncologists, Program 2 2000

Play Audio Below:

When you have a patient with a 50% or 80% chance of recurring and dying of their disease, you have a tendency to, first of all, want to make sure you’re giving them everything. And secondly, you know, we have a tradition that goes back to Hippocrates. Hippocrates said that, "dire diseases require dire remedies." And I think sometimes we think that things such as tamoxifen can’t possibly be so effective against cancer because, after all, they don’t cause many side effects. It just is not part of our culture.

As the years have gone by I’ve given more and more credit to the effects of chemotherapy on ovarian function and less and less credit to its direct effect. The other thing that’s kind of interesting is that you usually see the effects of chemotherapy, the relative effects of ovarian ablation, and tamoxifen versus chemotherapy, the chemotherapy having a greater impact on disease-free survival and overall survival. In other words, the added benefit is greater in prolonging time of occurrence than it is in actually prolonging time to death.

Relevant Articles:

Building bridges between physicians and patients: Results of a pilot study examining new tools for collaborative decision making in breast cancer.
Sepucha, K. R.; Belkora, J. K.; Tripathy, D., and Esserman, L. J.. Journal of Clinical Oncology. 18(6):1230-1238, 2000 Mar.

Effect of providing cancer patients with the audiotaped initial consultation on satisfaction, recall, and quality of life: A randomized, double-blind study.
Ong, L. M. L.; Visser, M. R. M.; Lammes, F. B.; van der Velden, J.; Kuenen, B. C., and de Haes= JCJM.. Journal of Clinical Oncology. 18(16):3052-3060, 2000 Aug.

Anticipated versus actual emotional reactions to disclosure of results of genetic tests for cancer susceptibility: Findings from p53 and BRCA1 testing programs.
Dorval, M.; Patenaude, A. F.; Schneider, K. A.; Kieffer, S. A.; DiGianni, L.; Kalkbrenner, K. J.; Bromberg, J. I.; Basili, L. A.; Calzone, K.; Stopfer, J.; Weber, B. L., and Garber, J. E. Journal of Clinical Oncology. 18(10):2135-2142, 2000 May.

Anxiety in cancer patients [Review].
Stark, D. P. H. and House, A. (Reprint available from: Stark DPH St James Univ Hosp, Imperial Canc Res Fund, Dept Med Oncol Beckett St Leeds LS9 7TF W Yorkshire England). British Journal of Cancer. 83(10):1261-1267, 2000 Nov. In progress

Utilization of professional supportive care services by women with breast cancer.

Gray, R. E.; Goel, V.; Fitch, M. I.; Franssen, E.; Chart, P.; Greenberg, M.; Bakker, D.; Labrecque, M.; Hollowaty, E.; Godel, R., and Hampson, A. W. (Reprint available from: Gray RE Univ Toronto, Toronto Sunnybrook Reg Canc Ctr, Psychosocial & Behav Res Unit 2075 Bayview Ave Toronto ON M4N 3M5 Canada). Breast Cancer Research & Treatment. 64(3):253-258, 2000 Dec

Relevant Clinical Trials:

Randomized Study of Methods in Education for Breast Cancer Genetics

Randomized Study of Stress Reduction in Older Women With Stage II, III, or IV Breast Cancer

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