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Management of menopausal symptoms in breast cancer patients.
In breast cancer patients, menopausal symptoms such as hot flashes, urogenital problems, musculoskeletal symptoms and cognitive dysfunction are common, regardless of age at diagnosis. They affect quality of life and systemic therapy will worsen this. Endocrine and/or chemotherapy may induce temporary or permanent ovarian failure and can exacerbate these symptoms. Hormone therapy (HT) has been studied in breast cancer survivors, but safety has been questioned. The HABITS trial investigating estrogen-based HT, as well as the LIBERATE trial investigating tibolone, found a reduction in disease-free survival for those treated. Alternative strategies are needed, as menopause symptoms may reduce compliance with breast cancer treatments. This article reviews recently published strategies to tackle menopausal problems in breast cancer patients. Antidepressants may help with hot flashes. Acupuncture and hypnosis can also be used but the evidence is conflicting. For urogenital problems vaginal moisturizers or topical estrogens can be employed. A musculoskeletal syndrome induced by aromatase inhibitors (AIs) is frequently encountered and currently there are no effective treatment strategies. Bisphosphonates reduce AI-induced bone resorption and can also increase disease-free and overall survival. Standard-dose endocrine and chemotherapy are associated with a decline in cognitive function.
Maturitas. 2010 Dec 22. Loibl S, Lintermans A, Dieudonné AS, Neven P. German Breast Group, GBG Forschungs GmbH, Martin-Behaim-Str. 12, 63263 Neu-Isenburg, Germany.
Anyone who reads my full resume or view my professional signature citation, if and when I list all of my academic degrees, I have more than a few initials after my name. Of course, being in my mid-fifty’s, I have a drawer full of certifications that have associated initials. So the question is: Who cares? In my experience, some of my clients and patients really do care? Others could care less.
One way to simplistically look at this is how a person uses their brain. Some people lead their lives focused on their emotions. How does something make me feel? What does my gut feelings tell me?...
Improving the performance in any given area most likely requires that you stop bad habits and strengthen the necessary parts of your brain and body. When someone is performing poorly they should realize that actually what they're doing is doing their poor performance at an expert level. This proves that they have the ability to achieve mastery. However, they are merely doing it in the wrong way.
Getting rid of an expertly performed bad habit is not easy. In fact the brain and body will resist any efforts to change. Additionally, such efforts will most certainly strengthen the hold that...
“When you are grateful fear disappears and abundance appears” – Anthony Robbins, Self Help Guru
There has been much written in the last couple of years about the law of attraction, attracting wealth and manifesting prosperity. Just rub the universe’s magic lamp and whatever you wish will appear. “The Secret” movie inspired hundreds of thousands to believe temporarily in a universe under our control, rather than a fickle mistress.
But so many people missed the whole point about the law of attraction and abundance. They perceived prosperity and wealth as being only...