TREATMENT OPTIONS: Chemotherapy Continued 3…

It was the celebrated Scots surgeon George Beatson, who brought about the regression of advanced breast cancer by removing the ovaries and thus causing a fall in levels of circulating oestrogen in the bloodstream.  Some cancers are treated by surgical removal or ablation (using radiotherapy or drugs) of the endocrine gland involved.  In other instances, a hormone may in fact be administered, since it has been shown that large doses of some natural hormones can overwhelm cancerous tissue. An example of this would be where a breast cancer patient is being treated with additional oestrogen. In other instances, a hormone may be given which the body would not normally secrete.  Men suffering from prostate cancer are not infrequently treated with the female hormone oestrogen, which has been found to inhibit the growth of prostate tissue.  Another, and perhaps the best and most widely publicized, approach is with the use of anti-hormonal agents, of which tamoxifen (which blocks the action of oestrogen) is one example. Here the question lingers, i.e. “Why is tamoxifen the prescribed treatment for some breast cancer patients but not for others?” So let me try to clear the issue up before proceeding further.

When a breast lump is removed at biopsy, a hormone receptor test is performed on the tissue at the same time. This determines whether the cancer (if present) is sensitive to the self-produced hormones of oestrogen or progesterone. If it is, this means that this primary malignant tumour is drawing upon it and is thereafter likely to continue to grow in the presence of that particular hormone. On the other hand, it is likely to wither and die without it. In all such cases, hormone treatment manipulates the hormonal environment inside the body, so that the primary malignant tumour cannot thrive.

One undoubted ‘cost’ of such treatment, especially for pre-menopausal women, (but one which many are prepared, with help and support, to accept and endure) has to do with the premature onset of menopausal symptoms. However, this is in no way to infer that one should simply try to overlook or be disregarding of the sometimes profound emotional and physical consequences of being (as one patient put it) “Thrown into a premature menopause”. When a young woman and her spouse/partner are setting up a home and keenly anticipating ‘graduation’ to parenthood and the beginning (or continuation as the case may be) of family life, such a savage blow is surely a loss and a cause for grief of great magnitude. Not surprisingly, therefore, anger, resentment and depression – and once again – guilt, may very well follow in its wake.

It certainly follows therefore that where a termination of future child-bearing possibilities is the price of recovery, skilled and sensitive care and support (for both husband and wife/partner where required) should always be readily available. Experience teaches that some will take it up, while others will prefer to cope alone. Incidentally, experience certainly taught me that such an important issue is best addressed on the basis of individual need expressed person-to-person (which can vary from day to day) and not in the context of postings of this nature.

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