Ovarian Cancer Treatment Protocols Should Include An Aromatase Inhibitor

I’ve pasted an excerpt from a protocol proposal I wrote for an Ovarian Cancer patient later in this blog.

The goal of the protocol was the prolongation of remission, and it was implemented after the patient had completed her cycles of chemotherapy and surgery.

I strongly believe this is appropriate therapy for patients who have reached this stage – and I believe it would be appropriate as an attempt to extend the lives of those who have not been able to achieve remission or who have relapsed.

It is most probable that your physician will not propose it unless you ask her/him to. So, ask!

It might also be appropriate for patients who are receiving chemotherapy treatments – with the caveat that I would not use an aromatase inhibitor within the week before a chemo treatment and for 3 days after the treatment.

The reasoning behind this position lies in the need to have the cancer cells acting like cancer cells for the chemotherapy to kill them. You do not want their growth and progression suppressed when you’re giving chemotherapy. I believe that the aromatase inhibitors will slow down their growth and progression, an undesirable outcome if you’re trying to kill them with chemotherapy.

Anyway, the aromatase inhibitor choice for this patient’s protocol was made by her oncologist. He/she picked Femara® (aka letrozole). It’s expensive. But, there seem to be some coupon programs that will reduce your cost. You can find info about this drug and the coupon program at http://www.femara.com/ .

Additionally, a review of the information that is provided by Micromedex™ (a drug info service healthcare providers and pharmacists trust and reference frequently) indicates that you could probably get by by taking 1/4th of a tablet every day after you’ve taking the full tablet for a week or so if you had to.


Estrogen receptors are reported to drive the growth and progression of many ovarian cancer tumors. In fact, it is reported that > 90% of confirmed ovarian cancers have lost their progesterone receptors’ function. This allows unopposed estrogen receptor stimulation of the tumor’s cells, and it has been reported that > 80% have retained their estrogen receptors’ functionality.74 Thus, it appears mandatory to incorporate an agent into this protocol to block the effect of estrogen on estrogen receptors. Aromatase inhibitors appear to retain their functionality longer than estrogen receptor blockers, and are reported to be better tolerated by patients. Selection of the agent from this category will be left to the patient’s physicians, as they are undoubtedly more familiar with the tradeoffs that must be considered to make this recommendation.

The reference citation for the info in this excerpt is:

S. Ho 2003. Review – Estrogen, Progesterone and Epithelial Ovarian Cancer. Reproductive Biology and Endocrinology 1:73 1-8.

You can get a free copy of it at http://www.rbej.com/content/1/1/73 .

As always, I am providing info for you to take to your physician for discussion. I do not know the details of anyone’s specific cases and I’m a Pharmacist – not a Physician. These recommendations must be reviewed and implemented by your physician. I have done my best to make sure the info and conclusions I’ve presented are correct. But, it is a theoretical discussion that may or may not apply to any specific cancer.

But, if I didn’t strongly believe in what I’ve said above you know I wouldn’t have taken the time to share it with you.

To get more important information and a different point of view read this post. It’s especially important if you’re post-menopausal.

‘Are Many Ovarian Cancers (Especially Post-Menopausal) Driven By Male Hormones???’


Remember, Cancers are Like Snowflakes – each is unique and different from others.

Pharmacists Pharmacist. Doctors Doctor. Patients try to survive. We’re all trying to get to the same goal.