Research examines treatment side effects in estrogen-positive breast cancer patients

Dr. Laura Bozzuto, a breast surgical oncologist and OB-GYN at UW Health | Carbone Cancer Center, researches ways to improve breast cancer survivorship and manage the long-term impacts of treatments.

Bozzuto’s research focuses on younger breast cancer patients with estrogen-positive cancers, or cancers where growth is fueled by estrogen. Following the typical course of treatment, which may include surgery, radiation, and chemotherapy, patients can receive a longer-term treatment focused on reducing the effects of estrogen in the body to reduce the risk of recurrence. For young women, this can sometimes involve medically inducing menopause. These injections, which can be administered for up to five years, signal the brain to tell the patient’s ovaries to stop producing estrogen.

The alternative course to these injections is surgically removing the ovaries, which are the primary producer of estrogen in the body. This stops estrogen production and puts patients into a menopausal state, and for some patients at an earlier age than normal. Bozzuto studies the side effects of both methods.

“There have not been a lot of studies comparing the two: surgery versus medication,” Bozzuto said. “That is one of the areas that I am interested in.”

Many women who receive endocrine therapy end the treatment before the five-year mark due to the severity of its effects on their bodies. Side effects of this treatment can include joint pain, vaginal dryness, fatigue and hot flashes, among others. Terminating endocrine therapy early raises the risk of cancer recurrence.

“A lot of patients of all ages, both older and younger, cannot continue the treatments for as long as they should,” Bozzuto said. “In some studies, 20 to 40% of patients stop early, or do not fully take the medications as prescribed.”

Although there have been incredible advances in the treatments and understanding of breast cancer, with many patients living longer, it is important for them to also have a good quality of life, even beyond their present treatment term.

“I think it is important to understand how these treatments impact people’s quality of life and how we potentially help them,” Bozzuto said. “That, ultimately, may help their ability to stay compliant with the medications and improve their cancer outcomes.”

Additional research is underway to find new answers to these difficult side effects. Bozzuto said there are some non-hormonal options providers can try to help these patients with symptoms, though many choose to stop their injections without talking to their doctors. It’s important to continue discussing all options that may be available. Bozzuto remains a strong advocate for women’s healthcare and better patient outcomes, and she is encouraged by new developments in menopausal care.

“[Menopause] is an area that is not seen as, I don’t know, flashy,” Bozzuto said. “But menopause funding and research is just as important as anything else, and it is nice to see more attention be driven to it and its side effects in recent years.”