What do you know about the adverse effects of breast cancer endocrine treatments?
Introduction
Breast cancer is one of the most malignant tumours in women, and endocrine treatment plays a key role in integrated treatment. The long-term use of endocrine treatment for breast cancer patients with estrogen receptor (ER) and/or pregnancy hormone receptor (PR) positive significantly reduces the risk of relapse. However, these drugs are often accompanied by a series of adverse reactions that pose challenges to the quality of life of patients. Understanding and effectively managing these adverse effects is an important part of ensuring that treatment is carried out successfully.
Common endocrine treatment drugs and mechanisms
(i) Selective estrogen receptor regulation (SERM)
He’s a typical representative. It acts as an anti-estrogen resistance in breast tissues through competitively integrated estrogen receptors, but has some estrogen activity in uterus, bones, etc. The mechanism is to curb the growth of breast cancer cells by changing the composition of estrogen receptors.
(ii) Aromatic enzyme inhibitors (AI)
It’s not like I’m going to have to go to school. They reduce estrogen levels by inhibiting the activity of aromatic enzymes and reducing the transformation of the body to estrogen. In post-menopausal women, estrogen-dependent breast cancer cells are effectively inhibited.
(iii) Declination of estrogen receptor (SERD)
The fluoris can be combined with estrogen receptors and contribute to their degradation, reducing intracellular estrogen receptors and further inhibiting tumour cell activity.
III. Common adverse effects and management
(i) The tide
1. Symptoms: Patients suddenly feel red and hot on their faces, necks and chests, accompanied by sweating, with symptoms ranging from minutes to half an hour. The heat can be frequent, which seriously affects the daily lives and quality of sleep of patients.
2. Management measures: Patients should wear loose, air-transmitting cotton clothing to facilitate heat dispersion. Keep indoor temperatures cool and well ventilated. When the tide is hot, you can try to breathe deep and relax. If the symptoms are serious, drugs such as Gabahedin and Venafazin may be used under medical supervision. At the same time, appropriate physical exercise, such as yoga, Tai Chi, etc., helps to regulate the autonomous nervous system and to reduce the symptoms of tidal fever.
(ii) Artificial muscle pain
1. Symptoms: Patients who use aromatic enzymes inhibitors are more common, in the form of joint pain, rigidity, muscular sores, which can affect their mobility and reduce their ability to provide for themselves.
2. Management measures; encouragement of moderate low-intensity sports, such as walking, swimming, etc., to enhance muscle strength and improve joint flexibility. Assistive devices such as canes, joints, etc. may be used to reduce the joint burden. In case of severe pain, a non-paralytic anti-inflammation drug, such as Broven, may be used under the direction of a doctor, with attention to the adverse gastrointestinal effect. At the same time, vitamin D and calcium supplements could be considered, with some relief for joint pain.
(iii) Osteoporosis
Symptoms: Long-term use of aromatic enzymes inhibitors accelerates loss of bone and increases the risk of fracture. Patients may experience symptoms such as back pain, low height and hunchback, with severe fractures leading to long-term bed rest and a series of complications.
2. Management measures: Bone density tests are conducted regularly and are generally recommended for inspection every 1-2 years. Patients should ensure adequate calcium intake, with daily calcium intake appropriate at 1000 – 1200 mg, supplemented by diet (e.g. milk, beans, etc.) and calcium. At the same time, vitamin D is replenished to promote calcium absorption, through sun-burning or the use of vitamin D preparations. For patients with severe reduced or fractured bone density, anti osteoporosis treatments such as bisphate-based medications, and land sap resistance are available.
(iv) Cardiovascular adverse reaction
1. Symptoms: Some endocrine therapeutic drugs may have the potential to cause hematoma and increase the risk of cardiovascular disease. Patients may experience haematological abnormalities, such as elevated cholesterol and triester glycerine, which can lead to the hardening of anorexia in the long term, increasing the risk of cardiovascular events such as coronary heart disease and heart infarction.
2. Regulatory measures: periodic inspection of blood resin and maintenance of a healthy lifestyle, including low-fat diet, appropriate exercise, cessation of smoking and alcohol. In the case of patients with abnormally high blood resins, the use of lipid-reducing drugs, such as carcasses, can be made under the direction of a doctor. At the same time, cardiovascular risk factors such as blood pressure and blood sugar are actively controlled.
(v) Gynaecology Adverse Effects (for estrogen-based drugs such as Moxiphine)
Symptoms: Symptoms such as uterine membrane increase, vaginal haemorrhage, white belt increase, and long-term use may increase the risk of uterine cancer.
2. Management measures: periodic gynaecological examinations, including gynaecology ultrasound, cervical smears, etc. In the event of an irregular vaginal haemorrhage, timely medical treatment should be conducted, including diagnostic carving, in order to eliminate uterine membranes. Patients are required to take care of personal hygiene, keep their genitals clean and prevent infection. For patients with a marked or other abnormal increase in the uterine endomelet, there may be a need to adjust treatment programmes.
(vi) Gastrointestinal adverse reaction
1. Symptoms: Discomfort in the gastrointestinal tract, such as nausea, vomiting, appetite, constipation or diarrhoea, is more common and affects the nutritional intake and quality of life of patients.
2. Regulatory measures: To adjust diets, to eat less, to choose digestible, light foods and to avoid the consumption of spicy, greasy, irritant foods. If it is gross and vomiting is severe, anti-opamine drugs, such as methyloxychloropamine, can be used under medical supervision. In the case of constipated patients, dietary fibre intake may be increased, appropriate quantities of drinking water may be provided, appropriate exercise may be carried out and, if necessary, the use of slow-disposal agents may be used.
IV. Psychological problems and responses
(i) Presentation of psychological problems
Long-term adverse reactions and the vulnerability of patients to adverse feelings of anxiety, depression, fear, fear of re-emergence, treatment effects and long-term physical effects of adverse reactions may further exacerbate the symptoms of discomfort.
(ii) Responses
Medical personnel and family members must provide adequate psychological support and encourage patients to express their feelings. Patients can participate in breast cancer rehabilitation clubs or mutual assistance groups, share experiences and encourage each other. For patients with apparent mental disorders, help can be sought from a professional psychologist or psychologist, using anti-anger and depression medication if necessary.
The relationship between drug dependence and adverse response management
Maintaining patients ‘ drug dependence is key to the success of endocrine treatment. However, the emergence of adverse reactions may affect patient dependence. In the course of treatment, the doctor is therefore required to inform the patient fully about possible adverse reactions and coping methods and to prepare the patient psychologically. At the same time, the adverse response is closely monitored and treatment programmes are adjusted in a timely manner to reduce the discomfort of the patients and to increase their confidence and dependence to continue treatment.
Concluding remarks
The management of chronic endocrine treatment of drug adverse effects for breast cancer patients is a comprehensive process that requires close collaboration between the patient, his family and the medical team. Early identification, active prevention and effective intervention of adverse effects can reduce the suffering of patients, improve their quality of life, guarantee the smooth implementation of endocrine treatment and ultimately improve the long-term survival and rehabilitation of breast cancer patients. To enable patients to better respond to the challenges of treatment and regain their health and life confidence in their struggle against disease.
Breast cancer
