Modern hormone therapy of cancer with Tamoxifen
Despite higher rates of detection and treatment of breast cancer, it remains the second leading cause of cancer mortality among women in Australia. An accurate assessment of a person’s risk for breast cancer is crucial in breast cancer prevention efforts. Pharmacological preventive interventions have been found to reduce the risk of breast cancer significantly, but it should be noted that the accuracy of individual risk cannot be guaranteed. Especially treatments and personalized medicine have become new buzzwords in oncology. Knowledge of breast cancer subtype and molecular targets has led to extraordinary advances in tailoring systemic therapy.
Radiation therapy (RT) plays an important role in the management of breast cancer. In all situations, RTs must be delivered in a manner that will properly treat the target tissues and minimize the risk to neighboring healthy tissues. For patients who want breast preservation therapy (BCT), lumpectomy plus breast RT is usually the preferred approach because it provides long-term survival equivalent to that achieved with mastectomy. BCT with lumpectomy plus breast RT is suitable for most women with duct cancer in place. Radiation therapy has played an important role in the treatment of patients with locally advanced disease. There is also increasing acceptance of the usefulness of mastectomy after radiation therapy (PMRT). Adjuvant systemic therapy for breast cancer has been one of the main objectives of cancer research for over 40 years. Breast cancer is an example of a disease that has greatly benefited from the cumulative effect of small incremental improvements involving all available therapeutic modalities that may explain the recent decline in breast cancer mortality in some countries.
One of the components of success in the treatment of breast cancer, the most important element of antitumor drug exposure, is the achievement of endocrine therapy.
Breast cancer treatment with hormonal drugs
In clinical practice, a number of hormonal drugs are used as antitumor agents - agonists and antagonists of androgens, estrogens, gestagens, and other hormones. These agents are indicated primarily for hormone-dependent tumors. Hormonal antitumor therapy is important in the treatment of cancer of the breast, endometrium, prostate gland. Hormonal drugs are also used to treat cancer of the kidney, carcinoid, some tumors of the pancreas, melanoma, etc.
The interaction between hormones and hormone-dependent tumors was first discovered in 1896 when a Glasgow surgeon J. Beatson published data on the successful treatment of three women with advanced breast cancer who underwent bilateral ovariectomy.
According to the mechanism of action, hormonal drugs differ from cytotoxic antitumor agents. Their main role is the restoration of impaired humoral regulation of cell function. At the same time, a specific effect on tumor cells is not excluded: they inhibit cell division to a certain extent and contribute to their differentiation.
Estrogens are prescribed to suppress the action of androgens in the body (for example, with prostate cancer), androgens, on the contrary, to reduce the activity of estrogens (with breast cancer, etc.). For breast and uterine cancer, progestins (medroxyprogesterone) are also used.
More than twenty years ago, the appearance of the first of the antiestrogen drugs, tamoxifen, not only improved the quality of life of patients with breast cancer in menopause but also significantly increased their life expectancy. Nolvadex price is affordable for everyone.
How Tamoxifen effects the tumor cells
It is shown that generic Nolvadex acts on tumor cells through estrogen and progestin receptors, and can also affect the activity of growth factors:
- stimulates the production of paracrine glands, which enhance the inhibitory effect of the beta growth factor of stromal fibroblasts on the tumor;
- reduces the production of factor-alpha transforming growth, which stimulates tumor growth;
- inhibits the synthesis of insulin-like growth factor, which enhances the growth of tumor cells;
- inhibits angiogenesis and accelerates apoptosis.
Thus, we can conclude that the antitumor effect of the drug that do not contain estrogen receptors is obtained precisely due to its impact on growth factors.
It is on the fact of the presence of estrogen receptors in the tumor that the theory of predicting the response to endocrine therapy of breast cancer cells is built. In patients who do not have estrogen receptors in the tumor, the chance of success is approximately 10%.
Dosage and administration of Nolvadex
Tamoxifen pills are taken orally, without chewing, washed down with water. For adult patients, the recommended dose is 20 mg once a day. With advanced cancer, the daily dose may be increased to 30-40 mg. The permissible dose per day is 40 mg.
Usually, a positive effect is observed after 4-10 weeks of use, but if there are metastases in the bones, a measurable therapeutic effect can occur only after several months of treatment.
Usually, the treatment is long, and Nolvadex cost and the duration depends on the severity of the disease.
Nolvadex interaction with other medicines
As a result of the combination of cheap Nolvadex with indirect anticoagulant drugs the effect of the latter increases. This requires constant monitoring of the patient’s health in order to adjust the dosage of anticoagulants timely. If to buy Tamoxifen tablets in combination with letrozole, its density in the blood plasma decreases. Cytostatic pharmaceuticals used in conjunction with the medication in question increase the likelihood of developing blood clots in blood vessels.
In combination with tegafur, the formation of cirrhosis of the liver tissue is possible with the subsequent formation of signs of hepatitis. When co-administered with chemicals containing female hormones - estrogens, such as birth control drugs, a decrease in the effectiveness of both medicines is observed. Pharmaceutical products that reduce the amount of excreted calcium cations, such as thiazide diuretic drugs, increase the risk of developing high levels of calcium in the blood substance. The complex administration of bromocriptine and Nolvadex without prescription leads to an increase in the density of the latter in the serum. The drugs used to lower the acidity of gastric secretions, which include antacids and antihistamines, provoke an early onset of dissolution of the protective surface of the capsules. The shell must maintain its protective function until the drug enters the intestinal section. For this reason, the time of use of antiestrogen tablets and antacids should not coincide for at least one hour.