Breast cancer is one of the most prevalent issues for women. Given the fact that we know that BRCA-1 and BRCA-2 can be identified, one would think we could cut the dramatic effects of this trauma for women. But, we still haven’t.

Having either of these two genes means you have 5X the risk of developing breast cancer. These two genes are extremely prevalent among Ashkenazi Jewish women. (Many of my friends carry both genes, which spikes the risk dramatically.) Interestingly, those that carry either gene are more likely to have a girl, should they get pregnant.

But, given the fact that many young women (as opposed to those in their 30’s and 40’s) are developing breast cancer, the odds of them having a child is greatly diminished. Because the BRCA-1 and 2 genes are associated with primary ovarian insufficiency.  Add to that that the drugs that we use to treat breast cancer may lead to premature ovarian failure, this is a double whammy to the psyche of these young women.

So, it is great news that researchers are now considering using hormone-suppression therapy to cause a shut down of ovarian function when the patient is undergoing chemotherapy. (This is yet another situation in the treatment of cancers. We also know that survivors of pediatric cancers tend to have cardiac issues, should they survive the disease.)

This kind of thinking is what can help insure the mental and medical states of patients undergoing cancer therapy. This kind of “out-of-the-box” thinking reminds me of the tests done by Eliot Rosen at MIT/Harvard some 40 years ago. He postulated that putting patients on 100% oxygen would allow lower (and, therefore, less toxic) dosages of chemotherapy drugs. Because oxygen affords the cells the ability to grow faster, and the cancer cells already grow faster than normal cells, the uptake of the chemicals would be enhanced in those cancerous cells, thereby lowering the dosage.  The hope was that this lowered dose would not affect normal cells. (It turns out oxygen therapy creates other problems.)

Goserelin (an AstraZeneca version of the hormone) can be administered to those patients who don’t have estrogen or progesterone hormone receptors. It should be noted that these are preliminary results. This is a relatively new idea, which was first mentioned in the Journal of Clinical Oncology in 2012, and described the early results of this study under the direction of Dr. Kathy S. Albain.

The clinical study, POEMS (Prevention of Early Menopause Study), just released its phase III results at ASCO (American Society of Clinical Oncology) in Chicago. The program attempted to enroll 400 participants- but only got slightly more than half that number. The subjects are women under 50 who don’t have those two hormone receptors above and had breast cancer confined to the breast itself, or maybe the addition of some nearby lymph nodes.

It turns out that goserelin reduced the rate of ovarian failure to around 8%, which is considerably lower than the 22% failure rate without the drug combination. On top of that, it is possible using the drug increased the patients’ fertility rates; instead of 7% of those undergoing therapy having babies, 15% of those who also received the goserelin had babies.

Now for the clincher… Survival rates for those also receiving goserelin were 92%. Those who did not have the drug adjuvant had a survival rate of 82%.

Now, we may have a new quill in our stash of tricks to help young women battle cancer. Up to now, their only hope to have children was to harvest eggs before undergoing therapy- and hoping those eggs could lead to viable children after they completed their treatment.

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