Paxil Blocks Effect of Tamoxifen

Paxil blocks effect of breast cancer drug

from the Toronto Star

February 9, 2010

Joseph Hall

HEALTH REPORTER


A popular antidepressant eradicates the benefits of life-saving breast cancer drug tamoxifen, a new Ontario study shows.
The study of 2,430 women taking tamoxifen showed the drug's potent cancer-fighting capacity was lost in patients using paroxetine anti-depression drugs such as Paxil.
"If someone is on tamoxifen for five years ... and they're taking paroxetine the entire time, they've effectively not been on tamoxifen," said study co-author Dr. David Juurlink, a researcher with the Institute for Clinical Evaluative Sciences.
"And what this study shows for the first time is that that translates into an increased risk of deaths because the patients are being deprived of a very important drug."
The study was published Monday in the British Medical Journal.
Conducted between 1993 and 2005 on women 66 and older, it showed that those treated with Paxil-like drugs for 40 per cent of the time they were taking tamoxifen had a significantly greater risk of dying of breast cancer within five years of diagnosis.
This combination resulted in one additional death for every 20 patients so treated, the study showed.
Juurlink said about 30 per cent of women taking tamoxifen were on antidepressants, and most of those were prescribed Paxil-like drugs.
While other antidepressants, most notably Prozac and Wellbutrin, can also interfere with tamoxifen's effectiveness, there are others that won't, Juurlink said.
"There are many other options out there that ... are almost certainly better choices for women who are receiving tamoxifen ... It's not a reason to withhold antidepressants."
Women taking Paxil with their tamoxifen should not stop the antidepressant abruptly, Juurlink said.
"There's a well-recognized withdrawal syndrome for people who stop it suddenly, so if it's going to be discontinued it needs to be tapered off over a couple of weeks," he said.
An email from Paxil maker GlaxoSmithKline Canada said the company had been aware of reported interactions between the two drugs and had posted a warning on the antidepressant's monograph.
"GSK will review these additional data and will work with regulatory authorities to determine next steps," the email said.

Managing Your Treatment

Breakthrough Breast Cancer - Patient Response to Herceptin

Breakthrough Breast Cancer scientists have taken a significant step towards personalising cancer treatment by developing a new method to predict a patient's response to the drug Herceptin.

Scientists based in Edinburgh are the first to use computer modelling to predict individual responses to cancer treatment. The results are published in the journal Cancer Research on 28 July 2009.

Lead scientist, pathologist Dr Dana Faratian from the Breakthrough Breast Cancer Research Unit, at the University of Edinburgh, said: "This work is a major step forward because despite Herceptin benefiting thousands of women, it does not work for some patients.

"The impact of this new approach could be huge. It shows we can use computer modelling to answer clinical questions and potentially refine the treatment of women with breast cancer."

The team devised a mathematical model to represent the interactions of 56 different molecules involved in breast cancer. The scientists identified that the amount of the protein PTEN in a cell was related to resistance to anti-HER2 therapy. This model was confirmed in breast cancer cells grown in the laboratory.

The scientists examined 122 samples of metastatic breast cancer tumours treated with Herceptin. They demonstrated that the amount of PTEN was related to overall survival and patients whose breast cancer tumours had high levels of PTEN survived on average 22 months longer than those with low levels.

Researchers now need to find ways to translate these findings on predicting a patient's response to Herceptin from the laboratory into a test that could work in the clinic.

These important results would not have been possible without the use of the amazingly powerful AQUA microscope. Costing £150,000 and one of a very small number in the UK, it allows scientists to see where and how much of a protein is in a cell.

About one in five of the nearly 46,000 cases of breast cancer in the UK are HER2 positive and those women may be offered Herceptin as part of their treatment. Herceptin has made a major impact in breast cancer treatment but clinical trials have shown that some HER2 positive breast cancer patients may not respond to Herceptin or become resistant to the drug.

These results come just a year after the Breakthrough Breast Cancer Edinburgh Research Unit was opened by Breakthrough's Patron, HRH The Prince of Wales.

Breakthrough Breast Cancer's research is funded almost entirely by voluntary donations.

About Breakthrough Breast Cancer

Breakthrough Breast Cancer is the UK's leading charity committed to fighting breast cancer through research, campaigning and education. In 1999 Breakthrough established the UK's first dedicated breast cancer research centre. The Breakthrough Toby Robins Breast Cancer Research Centre is housed in the Mary-Jean Mitchell Green building at The Institute of Cancer Research in association with the Royal Marsden Hospital. Breakthrough Breast Cancer campaigned for Herceptin to be made available on the NHS to all breast cancer patients who may benefit from it.

About the Breakthrough Breast Cancer University of Edinburgh Research Unit at the Western General Hospital

Scientists at the Breakthrough Breast Cancer Edinburgh Research Unit carry out research using human breast cancer tissue samples. They use cutting-edge technology to examine biological changes in these tumours and develop new treatments for this form of the disease. They are particularly interested in drug resistance - when a treatment stops working. They aim to find ways to overcome or avoid this problem. Ultimately, this will ensure women are treated in the most appropriate and effective way for their particular cancer, potentially benefiting thousands of women in Scotland and across the UK.

The research in this paper was funded by Breakthrough Breast Cancer with support from the BBSRC (Biotechnology and Biological Sciences Research Council).

Source
Breakthrough Breast Cancer

Breast Self Exam Video

A healthy reminder on how to do your own breast self exam.

http://video.yourtotalhealth.ivillage.com/player/?id=975341

Genetic Key to Breast Cancer's Ability To Survive and Spread

An interesting article from Science Daily about cell research at Memorial Sloan-Kettering Cancer Center and the gene product Src. We may not ever have all the answers but there is hope that scientists continue to work towards discovering the how and the why of breast cancer.

Read here.

May 4, 2005 - The Mammogram That Changed My Life

This is a blog post I created on May 4, 2009 on my Everyday Possibilities blog and felt it would also be helpful to post it here.

Four years ago today I had the mammogram that changed my life. A routine mammogram as part of my overall physical. The doctor had done a thorough (and I do mean thorough) manual examination and felt nothing but as it had been two years since my last mammogram she wrote me a referral. I was blessed at my age to be having regular mammograms...they aren't "the norm" in Ontario until age 50. In my 30s I had felt a lump (turned out to be a cyst) and had it checked with a mammogram which became my baseline. The fact that my maternal grandmother had died of metastasized breast cancer factored into my continuing to be checked on a regular basis.

I had a busy day May 4, 2005 with a job interview at 11:00 a.m. but when I had called to make the appointment for the mammogram, the only time available was 8:00 a.m. that day or I would have had to wait another month. Providence? Divine intervention? I took the appointment without hesitating. Instinct maybe more than anything because I had learned many years ago to listen when that little voice in my head tells me to do something. Your body always has a way of communicating with you.

I spent the day running between appointments and when I reached home to have a cup of tea, I had just sat down when the phone rang. It was 3:00 p.m. There are some details you just never forget. It was my family doctor (actually it was a wonderful young woman who was filling in for my own doctor who was on a maternity leave) telling me there were some concerns with the mammogram and we'd need to do further exams. It appeared that there were microcalcifications on the right breast.

My stomach dropped to the floor and my hand was shaking as I replaced the receiver on the phone. And I knew. I am not a negative person. I'm not a pessimist. But I knew that those microcalcifications were cancer. Was it something in the tone of the doctor's voice? Or the urgency of re-testing and then an appointment with a surgeon? Again, I think it was everything hitting me at once and that "knowing" of me listening to my body and accepting the fact. I kept an open mind during the testing the the two biopsies. The day I met with the surgeon and was told that indeed I did have breast cancer...IDC (Infiltrating Ductal Carcinoma) I was already prepared for what was ahead of me, and everyone else who was part of my world.

It is traditional to mark the anniversaries of survivorship by the date of the last treatment. For me that would be May 2007 when I had completed chemotherapy, radiation and herceptin. However I have never been one to hold completely with tradition. The anniversary I follow is the day I had the mammogram. That was the beginning of my survivorship.

It changed my life in so many ways. Oh yes, cancer is a tenacious, aggressive beast. Once it "marks" you it haunts you for the rest of your life. But there is so much more to life than just having to deal with cancer which I always spell with a small "c". I would never give it a capital - would give it much too much importance. It deserves no respect.

And yet. Through all of the tests and treatments, with all that I put my body through both physically, psychologically and emotionally I don't dwell on the negative aspects. I still say to this day that it was the best thing that ever happened to me.

I rediscovered my faith, I realized that I have always been a spiritual person and my spirit grew and expanded as I allowed myself to live within it. I was reminded daily of the important values in life and I rediscovered joy and beauty. I learned to live each day just as it is, for all that is and all that it can be.

I give thanks every single day for every blessing in my life. And every May 4th I will continue to celebrate the mammogram that saved my life in every.single.way.

New Balance - Running on Hope

An email I received today which may be of interest to others.

My name is Elisa Garcia-Rey and I work with New Balance on their breast cancer awareness campaigns. I wanted to share a description of our current campaign in the hopes that you might find it relevant to yourself and your loyal readers. New Balance is currently celebrating their 20-year partnership with Susan G. Komen for the Cure with a special documentary that will feature the real life story of a participant in the Komen Race for the Cure. To select the featured runner/survivor, we are asking for people to share their story with us as part of our "Running on Hope" contest. The person who is selected will be invited to Washington, D.C. for the Global Race for the Cure® on June 6, 2009 where they will be featured in New Balance's documentary about our history of supporting the cause. Entrants can share what running in the Race for the Cure® means to them in a 1-minute video that they can upload at

www.newblance.com/runningonhope.

One winner will be chosen from among these entries. We hope that this contest will allow people the chance to inspire others in the same way that they inspire us, and that you’ll be able to share this with others in your extended community. Thanks so much for your time and consideration.