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Home: Oncology Leader Commentary: Charles Loprinzi, MD

Click on the topic below for comments by Dr Charles Lorpinzi to comment on. You will also find links to related articles and clinical trials.

Clonidine for hot flashes
Physiology of hot flashes
Quality of life impact of hot flashes
Incidence of vasomotor symptoms in breast cancer patients
Soy, Vitamin E for hot flashes
Progestins for hot flashes
Estrogen for hot flashes
Dosing of progestins
Venlafaxine for hot flashes
Current trials of management of hot flashes
Soy for hot flashes

Clonidine for hot flashes

Interview with Neil Love, MD from Breast Cancer Update for Medical Oncologists, Program 4 2000

Play Audio Below:

Dr. Loprinzi: We started off looking at clonidine, which is something that has been around for a long period of time. End result was, from our trials that – and most of our trials have been a week of nothing where they keep track of their hot flashes with a diary that looks at number of hot flashes per day and how severe each hot flash is. From that you can easily develop a hot flash score or you can just use number of hot flashes because you can get the same answer pretty much. And the clonidine study demonstrated that there clearly is a reduction in hot flashes with clonidine, but we saw that there was a fair amount of toxicity and that toxicity helped counterbalance the benefit, and therefore, it wasn’t all that useful in most women, it appeared.

Dr. Love: What was the major toxicity you saw?

Dr. Loprinzi: The major side effect we saw with the clonidine: Dry mouth, constipation, lightheadedness, as I recall. And we used the transdermal patch-type 1TTS, which is equivalent to 0.1 mg/day, and we had some itchiness under the patch.

Relevant Articles:

The incidence of positive margins with breast conserving therapy following mammotome biopsy for microcalcification
Cangiarella, J.; Cross, J.; Symmans, W. F.; Waisman, J.; Petersen, B.; D'Angelo, D.; Singer, C., and Axelrod, D.. Journal of Surgical Oncology. 74(4):263-266, 2000 Aug.

Outcomes and factors impacting local recurrence of ductal carcinoma in situ.
Weng, E. Y.; Juillard, G. J. F.; Parker, R. G.; Chang, H. R., and Gornbein, J. A. Cancer. 88(7):1643-1649, 2000 Apr 1.

Risk of subsequent invasive breast cancer after breast carcinoma in situ
Warnberg, F.; Yuen, J., and Holmberg, L. (Reprint available from: Warnberg F Univ Uppsala Hosp, Dept Surg S-75185 Uppsala Sweden).. Lancet. 355(9205):724-725, 2000 Feb 26.

Impact of young age on outcome in patients with ductal carcinoma-in-situ treated with breast-conserving therapy
Vicini, F. A.; Kestin, L. L.; Goldstein, N. S.; Chen, P. Y.; Pettinga, J.; Frazier, R. C., and Martinez, A. A.. Journal of Clinical Oncology. 18(2):296-306, 2000 Jan.

Sentinel node biopsy in ductal carcinoma in situ patients.
Pendas, S.; Dauway, E.; Giuliano, R.; Ku, N. N.; Cox, C. E., and Reintgen, D. S.. Annals of Surgical Oncology. 7(1):15-20, 2000 Jan-Feb.

Carcinoma in situ of the breast: correlation of histopathology to immunohistochemical markers and DNA ploidy.
Ottesen, G. L.; Christensen, I. J.; Larsen, J. K.; Larsen, J.; Baldetorp, B.; Linden, T.; Hansen, B., and Andersen, J. (Reprint available from: Ottesen GL Univ Copenhagen, Inst Forens Med, Dept Forens Pathol Frederik Vs Vej 11,POB 2713 DK-2100 Copenhagen O Denmark).. Breast Cancer Research & Treatment. 60(3):219-226, 2000 Apr In process

Radiotherapy in breast-conserving treatment for ductal carcinoma in situ: first results of the EORTC randomised phase III trial 10853.
Julien, J. P.; Bijker, N.; Fentiman, I. S.; Peterse, J. L.; Delledonne, V.; Rouanet, P.; Avril, A.; Sylvester, R.; Mignolet, F.; Bartelink, H., and Van Dongen, J. A. Lancet. 355(9203):528-533, 2000 Feb 12.

Differences in the pathologic features of ductal carcinoma in situ of the breast based on patient age.
Goldstein, N. S.; Vicini, F. A.; Kestin, L. L., and Thomas, M.. Cancer. 88(11):2553-2560, 2000 Jun 1.

Application of the Van Nuys prognostic index in a retrospective series of 367 ductal carcinomas in situ of the breast examinated by serial macroscopic sectioning: Practical considerations.
de Mascarel, I.; Bonichon, F.; MacGrogan, G.; de Lara, C. T.; Avril, A.; Picot, V.; Durand, M.; Mauriac, L.; Trojani, M., and Coindre, J. M. Breast Cancer Research & Treatment. 61(2):151-159, 2000 May. In process

Factors associated with local recurrence of mammographically detected ductal carcinoma in situ in patients given breast-conserving therapy.
Kestin, L. L.; Goldstein, N. S.; Lacerna, M. D.; Balasubramaniam, M.; Martinez, A. A.; Rebner, M.; Pettinga, J.; Frazier, R. C., and Vicini, F. A.. Cancer. 88(3):596-607, 2000 Feb 1.

Postexcision mammography is indicated after resection of ductal carcinoma-in-situ of the breast.
Waddell, B. E.; Stomper, P. C.; DeFazio, J. L.; Hurd, T. C., and Edge, S. B. Annals of Surgical Oncology. 7(9):665-668, 2000 Oct. In process

Ductal carcinoma in situ of the breast: A surgeon's disease.
Silverstein, M. J. (Reprint available from: Silverstein MJ Univ So Calif, Kenneth Norris Jr Comprehens Canc Ctr 1441 Eastlake Ave,Room 7415 Los Angeles, CA 90033 USA). Annals of Surgical Oncology. 6(8):802-810, 1999 Dec. No abstract

Role of specimen radiography in patients treated with skin-sparing mastectomy for ductal carcinoma in situ of the breast.
Rubio, I. T.; Mirza, N.; Sahin, A. A.; Whitman, G.; Kroll, S. S.; Ames, F. C., and Singletary, S. E. Annals of Surgical Oncology. 7(7):544-548, 2000 Aug. In process

Carcinoma in situ of the female breast. 10 year follow-up results of a prospective nationwide study.
Ottesen, G. L.; Graversen, H. P.; Blichert-Toft, M.; Christensen, I. J., and Andersen, J. A. (Reprint available from: Ottesen GL Univ Copenhagen, Inst Forens Med, Dept Forens Pathol Frederik Vs Vej 11,POB 2713 DK-2100 Copenhagen Denmark).. Breast Cancer Research & Treatment. 62(3):197-210, 2000 Aug In process

Treatment selection in ductal carcinoma in situ.
Morrow, M. and Schnitt, S. J. (Reprint available from: Morrow M NW Mem Hosp, Lynn Sage Comprehens Breast Ctr 251 E Huron St,Galter 13-174 Chicago, IL 60611 USA).. Jama: Journal of the American Medical Association. 283(4):453-455, 2000 Jan 26. No abstract
FULL TEXT:

Outcomes and factors impacting local recurrence of ductal carcinoma in situ.
Lagios, M. D. and Silverstein, M. J. (Reprint available from: Lagios MD St Marys Med Ctr, Breast Canc Consultat Serv San Francisco, CA 94143 USA).. Cancer. 89(11):2323-2324, 2000 Dec 1. In process

Sentinel lymph node biopsy: Is it indicated in patients with high-risk ductal carcinoma-in-situ and ductal carcinoma-in-situ with microinvasion?
Klauber-DeMore, N.; Tan, L. K.; Liberman, L.; Kaptain, S.; Fey, J.; Borgen, P.; Heerdt, A.; Montgomery, L.; Paglia, M.; Petrek, J. A.; Cody, H. S., and Van Zee, K. J. Annals of Surgical Oncology. 7(9):636-642, 2000 Oct. In process

Relation of a recurrent intraductal carcinoma (ductal carcinoma in situ) to the primary tumor
Fisher, E. R. and Fisher, B. (Reprint available from: Fisher B NSABP Sci Directors Off 4 Allegheny Ctr,Suite 602 Pittsburgh, PA 15212 USA).. Journal of the National Cancer Institute. 92(4):288-289, 2000 Feb 16. No abstract

Research on complementary/alternative medicine for patients with breast cancer: A review of the biomedical literature.
Jacobson, J. S.; Workman, S. B., and Kronenberg, F. Journal of Clinical Oncology. 18(3):668-683, 2000 Feb.

Evaluation of soy phytoestrogens for the treatment of hot flashes in breast cancer survivors: A North Central Cancer Treatment Group trial.
Quella, S. K.; Loprinzi, C. L.; Barton, D. L.; Knost, J. A.; Sloan, J. A.; LaVasseur, B. I.; Swan, D.; Krupp, K. R.; Miller, K. D., and Novotny, P. J. Journal of Clinical Oncology. 18(5):1068-1074, 2000 Mar.

Estrogen deficiency: In search of symptom control and sexuality.
Loprinzi, C. L. and Barton, D. Journal of the National Cancer Institute. 92(13):1028-1029, 2000 Jul 5. No abstract

Managing menopausal symptoms in breast cancer survivors: Results of a randomized controlled trial.
Ganz, P. A.; Greendale, G. A.; Petersen, L.; Zibecchi, L.; Kahn, B., and Belin, T. R.. Journal of the National Cancer Institute. 92(13):1054-1064, 2000 Jul 5.

Relevant Clinical Trials:

Phase III Randomized Study of Hormone Replacement Therapy in Menopausal or Perimenopausal Women with Prior Stage O-II Breast Cancer

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