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Breast Cancer Survivors: Managing Treatment Side Effects

Sometimes the cure feels worse than the disease. But new drugs and therapies help reduce the ill effects of chemotherapy and radiation.

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Longer-lasting drugs to treat chemotherapy-induced anemia, which can leave patients drained and dragging, are now available, says Pegram. These red blood cell boosters were once only available as weekly injections, but a newer drug in this category, Aranesp, requires fewer injections and office visits.

According to a study presented at the San Antonio Breast Cancer Symposium in 2004, 94% of patients treated with Aranesp reported a significant improvement in their quality of life. "I don't think that anybody has a magic bullet for fatigue, but maintaining an adequate hemoglobin level is definitely an important goal," says Pegram.

Aiming to Protect Bones, Prevent Osteoporosis
Women diagnosed with breast cancer before going through menopause often endure "chemopause." This short-term or permanent menopause is a result of chemotherapy, which interferes with the production of ovarian cells. Research shows this early and harder-hitting form of menopause (which happens all at once, instead of the slower slide of natural menopause) can lead to an increased risk of osteoporosis.

Medications called bisphosphonates, like Fosamax and Actonel, slow the rate of bone breakdown and are commonly prescribed to improve bone density in people who have already developed osteoporosis. But what about women who are at higher risk for bone loss due to "chemopause" but haven't developed osteoporosis yet? Should they take a drug like Fosamax to help prevent bone loss?

Studies are happening now, says Pegram. "We're waiting for clinical trial data to come in to confirm how these drugs work specifically in women who are in menopause as a result of chemotherapy," he says. "From a scientific point of view, it makes sense that they should work. They are known to be highly effective in controlling bone loss in osteoporosis after natural menopause, and in cancers that have metastasized to the bone, so we believe they're likely to be effective in this situation as well."

Some doctors are already prescribing bisphosphonates for women who've experienced menopause as a result of chemotherapy, but Seidman is cautious. "Do we have data telling us that's the right thing to do in these cases? Not yet," he says. "For now, if menopause occurs early, we need to be more attentive to monitoring bone density and making sure that women get sufficient calcium and vitamin D."

New Drugs in the Works for Mouth Sores, Nerve Damage
Doctors call it mucosal toxicity or mucositis, while most patients just call it "mouth sores." Whatever you call it, the damage done by some powerful anticancer agents to the normal cells lining the mouth and throat can make eating dinner an agonizing chore. What's more, says Pegram, "Mouth sores can leave the patient more vulnerable to infection, which is particularly dangerous for people undergoing chemotherapy."

Researchers are now studying a group of compounds called keratinocyte growth factors. These compounds are similar to a protein substance normally made by the body and could prove to be a potential treatment to prevent mouth sores. They encourage the cells lining the mouth and throat to make more cells more quickly to replace the ones destroyed and damaged by chemotherapy.

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