%0 Journal Article
%T Rationalizing Optimal Timing for Adjuvant Hormone Therapy for Patients with Breast Cancer: Impact on Limited Resource Countries
%A Kamalendu Malaker
%J International Journal of Clinical Medicine
%P 419-432
%@ 2158-2882
%D 2016
%I Scientific Research Publishing
%R 10.4236/ijcm.2016.76044
%X Modern day cancer chemotherapy is complex and involves multiple drugs given either sequentially or concurrently, as an adjuvant or neo-adjuvant. Besides the concentration of the drug, timing, duration and sequencing of individual drugs in combination with other similar agents play a vital role in the final therapeutic outcome. This study constitutes an exhaustive overview of current knowledge of timing and sequencing, specifically of Tamoxifen, based on tumor¡¯s hormone receptor status, as part of a comprehensive treatment plan. It has become apparent that inappropriate timing or sequencing can be detrimental. On the other hand, appropriate timing and sequencing of Tamoxifen, based on breast cancer cell-biology, pharmacokinetics and pharmacodynamics of drugs, the body¡¯s homeostatic response to drugs; surgery and radiation, yield huge benefit for locoregional control, long-term survival and reducing complications in patients with breast cancer. <i>Conclusion</i>: A rational plan for use of Tamoxifen has been recommended, based on this study; for optimal therapeutic benefit. It has also been suggested that in receptor ¡°unknown cases¡±, it is beneficial to prescribe Tamoxifen, since 75% of breast cancers are likely to be estrogen receptor positive and side effects can be minimized with planned vigilance.
%K Optimization
%K Tamoxifen
%K Breast Cancer
%K Limited Resource Countries
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=67904