Skip to main content

UNC Lineberger members Katie Reeder-Hayes, MD, MBA, and Hyman B. Muss, MD, director of the UNC Geriatric Oncology Program, published an editorial in JAMA Oncology that addressed the risk-benefits of using hormonal treatments to address sexual side effects from preventive treatment for early-stage, hormone receptor-positive breast cancer.

image2
Hyman B. Muss, MD, and Katie Reeder-Hayes, MD, MBA

Reeder-Hayes, who is also an assistant professor in the UNC School of Medicine, and Muss, who is the Mary Jones Hudson Distinguished Professor in Geriatric Oncology in the UNC School of Medicine, wrote the editorial in reaction to the findings of a study published in JAMA Oncology that evaluated the safety of two intravaginal treatments given to ease sexual side effects from preventive treatment for early-stage, hormone receptor-positive breast cancer. The study evaluated the safety of an estradiol-releasing vaginal ring and an intravaginal testosterone cream for women taking aromatase inhibitors, which have been shown to reduce the risk of breast cancer recurrence in postmenopausal women.

“The issue here is, these things work – these vaginal rings and topical testosterone – in women with sexual symptoms from hormone-lowering therapy in breast cancer, but their safety is uncertain,” Muss said.

Muss said these concerns about safety must be weighed alongside the severity of the patient’s level of discomfort. Non-hormonal treatments should be tried first, but if they’re unsuccessful, he said the treatments in question could be considered. He called for larger trials focusing on the long-term safety of these treatments – principally looking at breast cancer recurrence.

“Vaginal testosterone and estradiol-releasing vaginal rings can substantially reduce these side effects, but there remain concerns about their long term safety,” Muss said.