Hormones and premature menopause article

[Guest guest]

Gleevec May Disrupt Ovarian Function

By Serena Gordon

HealthDay Reporter

Wednesday, March 5, 2008; 12:00 AM

WEDNESDAY, March 5 (HealthDay News) -- Although it's a much more

targeted treatment than standard chemotherapy, the effective and

much-touted leukemia drug, Gleevec, isn't without side effects.

In women still in their reproductive years, imatinib (Gleevec) might

damage the chances of having a baby in the future, according to a case

report published as a letter in the March 6 issue of theNew England

Journal of Medicine.

" Although the odds are not known, it is possible that imatinib and

drugs with a similar mode of action may impair fertility, " said one of

the letter's authors, Dr. Constantinos Christopoulos, deputy director

of the 1st department of internal medicine at Amalia Fleming General

Hospital in Athens, Greece. " It is not known whether imatinib-induced

infertility is reversible. "

However, Christopoulos was also quick to point out that this was only

a single case report of premature ovarian failure, and it can be

difficult to establish the exact cause of the condition.

" Imatinib is a very effective drug that has revolutionized the

treatment of chronic myeloid leukemia (CML), but knowledge of the

effects of its long-term administration is still limited, and close

medical surveillance of patients receiving the drug is mandatory, " he

said.

The patient Christopoulos and his colleagues reported on was a

28-year-old female who had Philadelphia chromosome-positive CML. Each

year in the United States, just under 5,000 people are diagnosed with

this type of cancer, according to the Leukemia and Lymphoma Society.

She was initially given 400 milligrams of Gleevec daily. About one

year into her treatment, the dose of Gleevec was increased to 600

milligrams per day, because she still had some cancer cells. She

didn't have any severe side effects due to the treatment, though she

experienced some skin discoloration and muscle cramping. During the

first two years, she also reported having regular menstrual cycles.

About two years after she first started taking Gleevec, and about six

months after the dose was increased, the woman reported that she was

having irregular menstrual cycles and then her periods ceased altogether.

Doctors confirmed premature ovarian failure. While it's not possible

to definitively prove that Gleevec caused premature menopause,

Christopoulos said that based on the timing, the lack of other causes,

and the drugs' mode of action, it's the most likely culprit.

Gleevec works by targeting tyrosine kinases, which are proteins that

are very active in cancer cells. However, these proteins are also

expressed by the ovaries.

" There are about 60 tyrosine kinases. Can Gleevec be so specific that

it only interacts with one of the 60? This drug is pretty good at

targeting and hitting the bull's-eye, but it's not perfect, " said Dr.

Bart Kamen, chief medical officer of the Leukemia & Lymphoma Society.

" Is it worth that risk? You better believe it, " Kamen said. " The side

effects of Gleevec compared to what else we do in cancer treatment is

mild. It has a wonderful risk-to-benefit ratio. "

" The advantages of this drugclearlyoutweigh the disadvantages, " said

Dr. Jay , chairman of hematology/oncology at Ochsner Health

System in Baton Rouge, La.

also pointed out that most women with CML are long past their

reproductive years. According to the American Cancer Society, the

average age of CML diagnosis is about 67.

While most women are already counseled about the risks to their

fertility before undergoing any cancer treatment, Christopoulos said

that women of reproductive age receiving Gleevec should know that they

shouldn't become pregnant while taking the drug, and they may want to

freeze some of their eggs before treatment.

More information

The American Cancer Society has more on Gleevec

[Guest guest]

There are a lot more women having difficulties than reported.

I am curious as to who they are monitoring because it's not me or any of the

others I have known on the list and other list over the years.

I agree the benefits outweigh the risk but I believe that Gleevec is the

culprit of inducing menopause on us women who are much younger than 67.

Obviously and hopefully those women are far beyond menopause.

Menopause can be a serious issue and I think they need to be a bit more

interested.

I also feel there is cause for concern regarding cervical cancer in us women

who are having these hormone issues and premature menopause.

If there were research now, that may be prevented.

It's about time we seen an article on this issue, but one woman? We here

know different.

Sorry if I sound so negative about this situation but no one will listen to

me but the women here in the group.

ez