Tamoxifen can reduce breast pain in prostate cancer patients

Tamoxifen is more effective than radiotherapy at preventing breast enlargement and breast pain in men with prostate cancer, concludes a randomised trial published online today by THE LANCET ONCOLOGY.

A drug called bicalutamide has been licensed in some European countries as an additional therapy to the main treatment (removal of the prostate or radiotherapy) for early prostate cancer. Breast enlargement and breast pain are common side effects of bicalutamide therapy, and can cause some patients to withdraw from treatment. Because early withdrawal from treatment may compromise outcome, effective management strategies for breast enlargement and breast pain are needed. Currently, the most commonly used treatment to prevent breast enlargement in prostate patients is low-dose radiotherapy. Trials have suggested that preventative treatment with anti-oestrogen drugs, such as tamoxifen, could also be effective.

Giuseppe Di Lorenzo (University Federico II, School of Medicine, Naples, Italy) and colleagues undertook a randomised trial to compare the effectiveness of tamoxifen with that of electron-beam radiotherapy for the prevention and treatment of breast enlargement and breast pain caused by bicalutamide therapy for prostate cancer. They recruited 151 men who had received primary treatment for prostate cancer from five Italian centres between January 2002 and February 2004. 51 patients were randomly assigned to 150 mg bicalutamide only per day, 50 patients to 150 mg bicalutamide per day and 10 mg tamoxifen per day for 24 weeks, and 50 patients to 150 mg bicalutamide per day and one dose of radiotherapy at the start of treatment.

Patients were followed-up for an average of 25 months. The investigators found that 35 of the 51 patients assigned to bicalutamide alone developed enlarged breasts, compared with four of the 50 assigned the bicalutamide and tamoxifen and with 17 of the 50 assigned bicaluatmide and radiotherapy. 29 of the 51 patients on the

Contact: Joe Santangelo

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