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Cancer Therapies and Cardiac Dysfunction
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Victoria Shklar, Katherine Godfrey, Michelle E. Bloom
HER2-targeted therapies are associated with the development of left ventricular (LV) systolic dysfunction and HF.45,51 In general, cardiac dysfunction resulting from trastuzumab occurs early, has variable severity, is dose independent, and is usually reversible without ultrastructural changes.8,52 The incidence of trastuzumab cardiac toxicity varies, but overall portends a relative risk of 5.1 when compared with non-trastuzumab-containing breast cancer chemotherapy regimens53 Combination therapy with trastuzumab and pertuzumab is sometimes used due to mechanistic synergy, and, despite initial concerns for the potential of additive toxicity, the incidence of HF with dual HER-2 blockade appears to be comparable to single-agent therapy.54,55 High rates of toxicity are seen in patients that receive HER2 therapies and concurrent or prior treatment with anthracyclines, with the time between the two correlating inversely with risk.56,57 Other risk factors for HF are not unique to HER2 therapy, and include age, low baseline LVEF, obesity, coronary artery disease, hypertension, valvular disease, smoking, and renal failure.21,32
Cancer
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
For patients with lobular carcinoma in situ, daily oral tamoxifen can be administered. Raloxifene is sometimes substituted for tamoxifen in postmenopausal women. With invasive breast cancer, chemotherapy is usually started quickly after surgery. If systemic chemotherapy is not needed, hormone therapy is usually started quickly after surgery. In postmenopausal patients, aromatase inhibitors such as exemestane, letrozole, and anastrozole block peripheral estrogen production. These drugs are more effective than tamoxifen.
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
Figure 130.1 Hypothalamic-pituitary-gonadal axis. The negative and positive feedbacks of the sex hormones, testosterone, and estrogen occur at the pituitary and hypothalamic levels. morbidity of adjuvant chemotherapy. Bines et al. reported that CRA rates varied with age, anticancer drugs, and cumulative dose 5*. The average CRA rate was 68% (range: 20%-80% ) in combination chemotherapy with cyclophosphamide, methotrexate, and fluorouracil [5]. Cyclophosphamide, the most widely used drug, is known to affect CRA in a dose-dependent manner. Generally, younger women require a higher dose to produce menopause 6*. A retrospective review reported that the addition of paclitaxel to the standard anthracycline-based adjuvant chemotherapy did not increase the CRA rates when used to treat breast cancer patients under 40 years old 7*. As in cases of breast cancer, chemotherapy can damage ovarian function in premenopausal women. Meirow et al. reported that ovarian failure was noted in 34% of young women who received chemotherapy for hematological malignancy or breast cancer 8*. The risk for developing ovarian failure was highest with alkylating agents, followed by cisplatin.
The impact of video-assisted education on quality of life of women with breast cancer receiving chemotherapy treatment
Published in Contemporary Nurse, 2021
Filiz Ünal Toprak, Neşe Uysal, Sevinç Kutlutürkan, Ayten Şentürk Erenel
First of all, a literature survey for the material development process was conducted. Breast cancer, chemotherapy and symptom control issues were examined. Later on, interviews were held with the patients with breast cancer receiving chemotherapy; in the interviews, questions were asked about the patients’ most common symptoms, their most annoying symptoms and which issues they needed information and support for in this process. The training material prepared for this purpose consists of two main parts: “Information About Cancer” and “Symptom Management”. The following issues have been covered in the general information section: (1) “What is breast cancer?”, (2) “What are the breast cancer risk factors?”, (3) “What are breast cancer symptoms?”, (4) “How Is Breast Cancer Diagnosed?” and (5) “What are the treatment methods of breast cancer?”.
The cost-effectiveness of sexual and reproductive health and rights interventions in low- and middle-income countries: a scoping review
Published in Sexual and Reproductive Health Matters, 2021
Andrea Hannah Kaiser, Björn Ekman, Madeleine Dimarco, Jesper Sundewall
HPV vaccination against infection with two and four different types of HPV (bivalent and quadrivalent vaccines) of pre-adolescent girls prior to sexual initiation to prevent cervical cancer was cost-effective in nearly all country settings analysed. Vaccinating adolescent boys was not cost-effective. Cervical cancer screening with visual inspection with acetic acid (VIA) and VIA followed by cytology one to three times per lifetime was cost-effective in countries within all WHO regions. Provider-collected HPV-DNA testing one to three times per lifetime was also cost-effective, while the cost-effectiveness of HPV self-collection was inconclusive. Only a few publications reporting on cervical cancer treatment were identified, suggesting lesion removal, radiotherapy, chemotherapy, and radical hysterectomy with pelvic lymph node dissection to be cost-effective. For early breast cancer detection, clinical breast examination was cost-effective in all settings, while the results for mammography screening varied greatly. Similarly, results for evaluated breast cancer chemotherapy regimens differed, rendering a statement on their cost-effectiveness impossible. Treatment with lumpectomy, radiotherapy, mastectomy, adjuvant oophorectomy, and tamoxifen were cost-effective. Regarding other forms of reproductive cancer, neoadjuvant chemotherapy in advanced ovarian patients was not cost-effective, while a population-based prostate cancer screening programme was suggested to be cost-effective.
Doxorubicin derivative loaded acetal-PEG-PCCL micelles for overcoming multidrug resistance in MCF-7/ADR cells
Published in Drug Development and Industrial Pharmacy, 2019
Xin-Cheng Zhong, Wen-Hong Xu, Zi-Ting Wang, Wang-Wei Guo, Jie-Jian Chen, Ning-Ning Guo, Tian-Tian Wang, Meng-Ting Lin, Zhen-Tao Zhang, Yi-Ying Lu, Qi-Yao Yang, Min Han, Dong-Hang Xu, Jian-Qing Gao
Breast cancer is the most frequently diagnosed cancer in the majority of the countries and newly diagnosed cases of female breast cancer are estimated to be more than 2 million in 2018 [1]. At present, the main treatment of breast cancer [2], chemotherapy, accounts for a large proportion but it still faces many difficult problems [3], such as chemotherapy resistance, which often leads to the failure of breast cancer treatment [4]. Doxorubicin hydrochloride (DOX) is a first-line treatment for a variety of cancers, such as breast cancer [5], ovarian cancer [6], and acute lymphoblastic leukemia [7]. But it faces enormous obstacles due to multidrug resistance caused by continuous chemotherapy [8]. The reason is that the overexpression of P-gp, a drug efflux protein, inhibits the accumulation of anticancer drugs in tumor cells, which also makes it difficult for DOX to enter the nucleus to exert therapeutic effects [9–11]. Therefore, the development of drug delivery systems targeting mitochondria is of great significance [12,13].