Menopausal Symptoms Vary with Tamoxifen or Exemestane for Breast Cancer

NEW YORK NOV 14, 2007 (Reuters Health) - Among postmenopausal women receiving adjuvant therapy for early breast cancer women, exemestane is associated with fewer hot flashes than is tamoxifen but with more difficulty sleeping, according to a study published in the October 20th issue of the Journal of Clinical Oncology.

"Hormonal breast cancer treatment increases menopausal symptoms in women," note Dr. Stephen E. Jones and colleagues from US Oncology Research Inc., Houston, Texas.

They used self-report questionnaires to assess 10 common symptoms in 1614 patients during the first year of a double-blind, randomized trial of tamoxifen or exemestane after surgery and chemotherapy for early hormone receptor-positive breast cancer.

The prevalence of baseline symptoms ranged from 2% (vaginal bleeding) to 60% to 75% (bone/muscle aches and low energy).

Patients who received tamoxifen experienced significantly more vaginal discharge than those who received exemestane. Those receiving exemestane had more bone/muscle aches, vaginal dryness, difficulty sleeping, and decreased libido.

In both treatment groups, hot flash scores peaked at about 3 months and decreased thereafter. Patients in the tamoxifen arm had a significantly higher mean hot flash score at 12 months than those in the exemestane arm.

"These are common complaints and the treatments used make some worse," Dr. Jones commented to Reuters Health. "Oncologists and other oncology health professionals need to be aware of the commonplace nature, and attempt to help wherever possible," he said. For example, he suggested, it may be necessary "to treat the hot flashes if they are impacting quality of life."

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