Researchers may have identified a treatment alternative for older women with low-risk forms of breast cancer. It could offer fewer adverse side effects than anti-hormonal drug therapies.
The study found slightly higher survival rates for women over 70 with hormone receptor-positive breast cancer and took anti-estrogen medications than those who were treated with a short dose of radiation. All of the patients had undergone a lumpectomy before these treatments, according to a new report published Monday in the International Journal of Radiation Oncology.
Radiation therapy costs $3,800 or more than anti-hormonal therapy over the average patient's lifetime, the report found.
Still, researchers suggested radiation therapy could be a good alternative to anti-estrogen medications for some women because it could improve their quality of life without higher mortality risks.
"The reality is anti-hormone therapy is not easy to take long-term and doesn't offer significantly greater benefits. It can dramatically impact quality of life." said Dr. Frank Vicini, the report's co-author and principal investigator at 21st Century Oncology, a Florida-based cancer care services operator of 165 centers across 15 states.
Anti-estrogen treatment may be necessary for five to ten years, according to current recommendations. Vicini said as many as 50% of patients who start anti-estrogen treatment had difficulty managing the side effects and end up stopping the treatment during that time.
The medications can reduce the risk of cancer recurrence by up to 50%, according to the National Breast Cancer Foundation. But they must be taken daily and side effects can include joint pain, mood swings, bone-density loss, hot flashes, high cholesterol and weight gain.
"Women taking five years of anti-estrogens have a lot of quality of life issues," said Dr. William Small, professor and chairman of the department of radiation oncology at the Stritch School of Medicine at Loyola University Chicago. "I must admit I always thought this is a hypothesis that is worthy of confirming that it might be just better for the patient simply to get the radiation and not take the hormones."
The report was based on a model that used data taken from 200,000 women, age 70 or older, who participated in three trials and two meta-analyses that tracked eight survival metrics and evaluated cost differentials.
Report authors stated the next step would be to conduct a full research study to find out if the results of their initial model can be replicated.
Small said radiation therapy is usually is done over a course of about 15 sessions for a total time of about three weeks and normally carry milder side effects than anti-hormonal drugs.
But radiation only treats the areas where it is applied. Hormonal therapy medications treat the entire body, which lowers the risk of the cancer recurring, he said.
"The question is, is the risk of disease coming back elsewhere in these women low enough that the side effects of taking the medication outweigh the benefit," Small said. "I think it makes a lot of sense to look at."