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Chemo may not assist in fighting cancer

1,550 patients in the study into groups based on whether their cancers were affected or not affected by estrogen. There were 350 in the study whose tumors were not affected by estrogen, described in medical terms as being estrogen receptor negative, or ER-negative. There were 1,000 who were ER-positive. For the remaining 75 patients, the ER status was unknown.

About half in each of these groups were treated with chemotherapy followed by five years of tamoxifen. The other half of each group received tamoxifen only. Researchers followed the patients for an average of almost six years and found the value of chemotherapy depended directly on the estrogen sensitivity of the patients' disease.

Among the ER-positive patients, chemotherapy provided no benefit. The five-year, disease-free survival rate for those who only took tamoxifen was 80 percent, while it was 84 percent for those who had both chemo and tamoxifen.

However, for the ER-negative patients, chemotherapy could be a life saver. The five-year, disease-free survival rate for those who had both chemo and tamoxifen was 82 percent. For ER-negative patients who took only tamoxifen, the survival rate was only 60 percent.

Gelber said the study may improve the lives of patients who are ER-positive because it will ensure they don't have to endure chemotherapy's side effects, such as hair loss, nausea and persistent tiredness. Gelber felt that there is a quality of life burden associated with chemotherapy. On the other hand, he said, the study showed that chemo's side effects were not severe enough that the therapy should be avoided by the ER-negative patients who would benefit. Gelber said a quality-of-life segment of the study showed the side effects from chemo are usually temporary and go away after the therapy ends.


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