Q:
If I have to get chemo, how often and for how long will I be treated?
A:
For newly diagnosed breast cancer, chemotherapy can last from three to six months. Some regimens are given once a week, others every two weeks, and some every three weeks.
Q:
What are the chances I'm a candidate for hormone therapy?
A:
Between 75% and 80% of breast cancer is estrogen-receptor-positive, which means it responds to hormone therapy because estrogen encourages it to grow. (If you're eligible and opt to take the treatment, you'll probably stay on it for a period of five to ten years, after completing chemotherapy and other therapies.)
Q:
What's the difference between the two different classes of hormone therapy?
A:
The choice is between aromatase inhibitors (AIs)—such as exemestane (Aromasin), anastrozole (Arimidex), and letrozole (Femara)—and selective estrogen receptor modulators (SERMs), such as tamoxifen. AIs don't work if you have functioning ovaries, so in younger women, tamoxifen is the standard choice, though we could use drugs to temporarily shut down the ovaries. After menopause, it's an equal choice between AIs and tamoxifen. I prefer the AIs, but they can cause bone loss and osteoporosis, joint and muscle aches, and an increase in cholesterol. Tamoxifen can cause blot clots, and it carries a tiny increase of uterine cancer risk. These risks increase with age.
Q:
If I'm premenopausal, can I still have children after hormone therapy?
A:
Yes, most women remain fertile. Premenopausal women who take anti-estrogen therapy may, however, start menopause at a different age than they might have without. Premenopausal women don't normally take aromatase inhibitors because of the fertility issue, but if we use ovarian-blocking hormones, the function usually returns quickly after stopping treatment.
