The Fellow on Call: The Heme/Onc Podcast Episode 056: Breast Cancer Series, Pt. 5-Breast Cancer Pharmacology
May 10, 2023
Join Dr. Danielle Roman, an Oncology Clinical Pharmacy Specialist, as she dives into the complexities of breast cancer pharmacology. She covers critical topics like the impact of different anti-estrogen therapies and their side effects. The discussion includes insights on regimens for ER+, HER2+, and triple-negative cases, along with key trial highlights. Dr. Roman also emphasizes supportive care strategies, offering practical guidance for clinicians to better counsel their patients on these treatments.
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Ovarian Suppression: Drugs And Counseling
- Use GnRH agonists (leuprolide or goserelin) to suppress ovarian estrogen production in premenopausal ER+ patients.
- Counsel on initial hormonal surge, injection route differences, and depot dosing schedules.
Tamoxifen Counseling Essentials
- Counsel patients on menopausal-like symptoms for tamoxifen and monitor for rare but serious risks like VTE and uterine cancer.
- Emphasize gynecologic follow-up and report abnormal vaginal bleeding promptly.
Manage Hot Flashes Without Estrogen
- Treat severe hot flashes in breast cancer patients with non-hormonal options like venlafaxine or other SSRIs/SNRIs and consider gabapentin or acupuncture.
- Avoid estrogenic herbal supplements and hormone replacement therapy.