Pseudo-estrogens may cut cancer risk
| • | Trying to ease the anxiety over hormone drugs |
| • | Doctors share their answers to common questions |
| • | Alternative hormone therapies abound |
By Beverly Creamer
Advertiser Staff Writer
They're being called "designer estrogens," and they're the most encouraging new prospect as an alternative to hormone replacement therapy.
While studies continue on the newest of these formulations, they seem to offer much of what hormone therapy does, but without the same risks, says Dr. Richard Wasnich, an osteoporosis specialist and medical director of Radiant Research.
Designer estrogens are pseudo-estrogens — meaning they behave like estrogens but aren't. The first was tamoxifen, used in the treatment of breast cancer. The discovery that tamoxifen also prevented bone loss led to this line of inquiry and to development of new medications such as raloxifen, being tested for breast cancer and used against bone loss.
The substances are known as selective estrogen receptor modulators — SERMs for short. "They provide the same effect on bone as estrogen; however, they block estrogen on the breast," said Wasnich. "The result of that is a significant reduction of breast cancer risk by taking these drugs."
At the moment, the best SERM on the market, raloxifen, also known as evista, doesn't have the ability to modify symptoms of menopause. But one study has shown it reduced cholesterol a little and did not cause any increase in cardiovascular troubles, Wasnich said.
Pharmaceutical companies are racing to find "the ideal SERM," Wasnich said, one that would fight bone loss, protect against breast and uterine cancer, and also offer relief from menopausal symptoms such as mood swings, hot flashes and night sweats.
Already, three potential candidates are undergoing clinical trials, in Hawai'i and elsewhere, to see if early expectations will be borne out. One, tibolone, already has been approved for use in Europe and has been shown to be protective against breast cancer and bone loss, with an ability to curb hot flashes.
"It seems like a magic bullet," said menopause specialist Dr. Neal Winn.
Dr. Bruce Kessel, a reproductive endocrinologist, said he hopes SERMs will prove as useful as they now appear to be. He said he expects definitive answers within three or four years.
You can reach Beverly Creamer at bcreamer@honoluluadvertiser.com or 525-8013.
