What are bone modifying agents? What are the risks and benefits of bone modifying agents during breast cancer treatment? In this video, Dr. Jennifer Griggs explains everything you need to know about bone modifying agents early in breast cancer treatment.
Hi in this video i’ll be talking about new data on the use of bone modifying agents in people with breast cancer bone modifying agents are really good for bones they strengthen the bones you may have heard of things on you know regular commercials to help make your bones stronger we use these drugs in people with metastatic breast cancer to the bone or other
Cancers to the bone but we’re talking now about using the bone modifying agents especially the bisphosphonates in people who’ve completed adjuvant therapy just as a quick reminder adjuvant therapy is treatment given before or after breast cancer surgery in the absence of any measurable disease so we’re talking about treatment that goes through the body like
Anti-estrogen therapy or other systemic therapies chemotherapy can be given either before or afterwards but basically this is given in the curative setting so based on some recent studies that were published it looks as though the evidence is mounting that getting a bone modifying agent when you’re done with your surgery or if you get chemo when you’re done with
Your chemotherapy or if you get surgery radiation and chemotherapy when you’re done with all of that that within the next couple months if you’re postmenopausal starting a bone modifying agent in the next couple months can actually reduce your risk of breast cancer recurrence to a small degree but it’s a real degree so if you’re post-menopausal regardless of
Whether it’s a natural menopause or menopause induced by chemotherapy or because we’re suppressing your ovaries with medication talk with your doctor about being on a bone modifying agent specifically a bisphosphonate there are three of those zolindronic acid i’ll have these on the screen solendronic acid abandonate and clogonate which although not available in
The us is available in other countries zolindronic acid is an iv treatment abandonate and chlorinate are pills and the recommendation is that you take them for two to three years now that’s not in everybody you may prefer a more minimalist approach or if your risk of recurrence is quite low the benefit to you is going to be low of additional therapy it’s these
Can be expensive and if you have a high deductible co-pay or if you can’t take on the burden of costs and your doctor’s office can’t help you get that cost lower the risks and benefits may not be worth it for you the benefit between risk and benefit that ratio may not be favorable if you have a lot of other medical problems or if you have side effects related
To the treatment for example fevers or problems with your oral health your dental health and you think this may not be in your best interest then again this is one of the things we factor into it finally for people who have a limited life expectancy we generally don’t recommend that you go on an adjuvant bisphosphonate and that’s because the benefit’s going
To be much lower to you and that toxicity whether it’s side effects or financial toxicity is not you know going to be there for you finally these drugs are not available in every part of the world or perhaps if your pharmacy is low in supply we don’t want you to feel that you’re getting inferior treatment what’s new about this though is that we hadn’t really had
Compelling evidence that there was a reduction in risk of the breast cancer coming back and that’s more pronounced now again small benefit i do have to tell you that even people sitting on the advisory panel have mixed feelings about using these medications because we’re not sure the extent of the benefit or if the downsides outweigh those benefits so just going
To summarize bisphosphonates which are bone modifying agents or strengthen the bones should be considered not recommended but considered between you and your health care team if you’re post-menopausal no matter how you got post-menopausal for two or three years after the completion of all of your other chemotherapy your surgery and your radiation therapy you
Can be on them when you’re on anti-estrogen therapy for a short course but that a lot of things go into whether or not you would go on these i hope it’s been helpful for you i’ve covered a lot and it’s a little complicated if you like drop us a comment in the notes and if this has been helpful or interesting to you click like and subscribe what that will do is
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Transcribed from video
What Are Bone Modifying Agents in Breast Cancer Treatment? By Yerbba – Breast Cancer
