[Vic]

Hi Alaska Angel,

I'm not sure why it wouldn't work, but when I rechecked it from my note, it didn't work for me either. But, when I went to "Search" and put in "estrace" to find Hutch's note, I opened it from there and it worked fine. Go figure. If you can't read it all from here, I would suggest that.

Be well,

Vicki

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<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD class=breadcrumptd vAlign=top colSpan=3>Home > Meeting Coverage > SABCS </TD></TR><TR><TD class=breadbanner vAlign=top float="left">

• Medical News from
  SABCS: San Antonio Breast Cancer Symposium Meeting

</TD><TD vAlign=top align=left><TABLE cellSpacing=0 cellPadding=5 width=220><TBODY><TR><TD>Coverage of Hormonal Therapies at The San Antonio Breast Cancer Symposium is supported in part by unrestricted educational grants from </TD></TR><TR><TD></TD></TR></TBODY></TABLE> </TD></TR></TBODY></TABLE><TABLE cellSpacing=0 cellPadding=0 width=500 align=center border=0><!--startclickprintinclude--><TBODY><TR><TD style="FONT-WEIGHT: bold; FONT-SIZE: 17px; COLOR: #003399; FONT-FAMILY: georgia" vAlign=top height=40>SABCS: Testosterone Relieves Atrophic Vaginitis in Breast Cancer Patients

<!--startclickprintexclude--></TD></TR><TR><TD style="BORDER-TOP: #ccc 1px solid; BORDER-BOTTOM: #ccc 1px solid" height=40><TABLE width="100%" border=0><!--endclickprintexclude--><TBODY><TR><TD style="PADDING-RIGHT: 0px; PADDING-LEFT: 0px; PADDING-BOTTOM: 5px; PADDING-TOP: 5px">By Charles Bankhead, Staff Writer, MedPage Today
Published: December 17, 2007
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine. </TD><!--startclickprintexclude--><TD style="PADDING-TOP: 5px" align=right> </TD><!--endclickprintexclude--></TR></TBODY></TABLE></TD></TR><TR><TD style="PADDING-TOP: 10px">SAN ANTONIO, Dec. 17 -- Intravaginal testosterone may offer relief from atrophic vaginitis without the risks of estrogen to breast cancer patients taking aromatase inhibitors, according to a pilot study. Action Points <!--- ---> <HR style="BORDER-TOP-WIDTH: thin; BORDER-LEFT-WIDTH: thin; BORDER-LEFT-COLOR: #9b9b9b; BORDER-TOP-COLOR: #9b9b9b; BORDER-BOTTOM: #9b9b9b thin dotted; BORDER-RIGHT-WIDTH: thin; BORDER-RIGHT-COLOR: #9b9b9b" width="90%">

• <LI class=APP>Explain to patients that a cream containing a small amount of testosterone has shown promise for reducing symptoms of treatment-induced atrophic vaginitis in breast cancer patients.
  
  <LI class=APP>Note that the compound is investigational and has been evaluated in only a small number of patients.
  
• Note also that the findings were reported at a medical conference and as a published abstract and should be considered preliminary until they appear in a peer-reviewed journal.

Daily use of the investigational compound decreased vaginitis symptom scores by two-thirds after a month of treatment, Sabrina Witherby, M.D., of Brown University in Providence, reported at the San Antonio Breast Cancer Symposium. The total symptom score remained 50% below baseline a month after treatment stopped.

"The results are encouraging and we intend to move forward with a study aimed at identifying the optimal dose of testosterone for treating atrophic vaginitis," said Dr. Witherby.

Vaginal atrophy is a frequent adverse effect of treatment with aromatase inhibitors, which cause more vaginitis symptoms than tamoxifen does, said Dr. Witherby. Systemic or topical estrogen effectively relieves symptoms of atrophic vaginitis, but topical estrogen tends to increase estradiol levels, making the therapy controversial for breast cancer patients.

In contrast, testosterone induces proliferation of vaginal epithelium, but the hormone's conversion to estradiol is blocked by aromatase inhibition. That led Dr. Witherby and colleagues to hypothesize that topical testosterone would be a safe and effective alternative to estrogen for treatment of aromatase inhibitor-induced atrophic vaginitis.

Investigators evaluated a topical compound containing 300 µg of testosterone in a cream vehicle. Ten postmenopausal breast cancer patients receiving adjuvant aromatase inhibitor therapy applied the cream daily to the vaginal and perineal epithelium. Atrophic vaginitis symptoms were assessed at baseline, after 28 days of treatment with the testosterone cream, and four weeks after treatment ended.

Patients rated vaginal dryness, vaginal itching or irritation, and dyspareunia on a scale of 0 (none) to 3 (severe). The total symptom score averaged 6 at baseline, decreased to 2 after 28 days of treatment with testosterone cream (P=0.008), and remained at 3 a month after treatment ended (P=0.065 versus baseline).

Cytopathology showed improvement in the maturation value of the women. Side effects were minimal and included mild vaginal rash in one woman and transient headache and pruritis in another. No thrombosis, hirsutism, or increased acne were noted. The testosterone cream is prepared by a compounding pharmacist and is not commercially available. Dr. Witherby said the next phase of investigation will be an evaluation of a cream containing 150 µg of testosterone.

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Primary source: Breast Cancer Research and Treatment
Source reference:
Witherby S, et al. "Efficacy and safety of topical testosterone for atrophic vaginitis in breast cancer patients on aromatase inhibitors: a pilot study." Breast Cancer Res Treat. 2007;106(Suppl):Abstract 6086.
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