Breast cancer
A 50-yr-old woman with positive mammogram undergoes lumpectomy and a small carcinoma is removed. Biochemical analysis of the cancer reveals the presence of estrogen and progesterone receptors.
Questions and tasks
1. Describe briefly synthesis of estrogens and progesterone.
2. What are the physiological effects of estrogens in woman?
3. After the procedure described earlier, which of the following she will receive? Describe the characteristics (including mechanism of action and adverse effects) of the chosen drug.
a) danazol
b) flutamide
c) leuprolide
d) mifepristone
e) tamoxifen
4. Which of the following is a unique property of SERMs?
a) activate a unique plasma membrane-bound receptor
b) have both estrogenic and progestational agonist activity
c) inhibit the aromatase enzyme required for estrogen synthesis
d) act as agonist in some tissues and antagonists in other tissues
e) produce estrogenic effects without binding to estrogen receptors
5. In presence of endometrial deposits on the pelvic peritoneum (leading to regular abdominal pain at the time of menstruation), which of the following is the most appropriate medical therapy for this condition?
a) flutamide, orally
b) medroxyprogesterone acetate by intramuscular injection
c) norgestrel as an IUD
d) oxandrolon by intramuscular injection
e) raloxifen orally
6. Which other options are available for treatment of hormonally active tumors of breast or endometrium?