Presentation given to delegates from a range of support, counselling and psychotherapy services on a training day facilitated by Compass Counselling - Liverpool.
The document discusses the influence of four nature photographers on the author: Ansel Adams, known for black and white photos that enhance natural beauty; Brett Weston, who uses black and white to draw viewers into intriguing natural scenes; William Guion, who photographs abnormal trees in black and white to make the trees the sole focus; and Nadia Isakova, who photographs brightly colored natural objects to highlight contrasts and blends between hues. The author aspires to achieve a professional standard of photography like these influential artists.
The document describes CASPER, a computer application that incorporates mapping technology to support agencies in monitoring and responding to missing person cases, suicides, and suicide attempts that occur in outdoor locations. CASPER aims to 1) provide an understanding of past incidents at outdoor locations, 2) calculate average search distances for missing persons, and 3) inform search strategies. It is intended to help police and emergency services while also providing public health analysts with tools to monitor response locations and develop coordinated action plans to reduce risks. Feedback is sought to improve CASPER.
This document discusses inspiring stories of people working in suicide prevention and well-being promotion. It lists several individuals and organizations, including Thomas Joiner who developed a theory of why people die by suicide involving acquired ability, burdensomeness, and failed belongingness. It also mentions the "5 Ways to Wellbeing" framework of connecting, being active, taking notice, keeping learning, and giving. The document advocates for prevention through promoting well-being, intervention with a destigmatized view of those at risk as having skills to learn, and postvention following models like Frank Campbell and Barry McGale to support families and communities after a suicide.
1) Suicide rates are highest among males aged 75 and over, and methods like hanging and self-poisoning are common in older adults.
2) Risk factors for suicide in later life include depression, physical illness, social isolation, and bereavement. Only a small percentage of older adult suicide completers had recent contact with mental health services.
3) Community-based prevention programs that educate primary care physicians about depression and increase screening have been shown to reduce elderly suicide rates. Tele-monitoring services may also help prevent suicide in at-risk older adults.
IAPT services play a role in preventing suicide by treating depression, which is a major risk factor for suicide. IAPT services provide talking therapies for depression and anxiety using a stepped care approach. They screen for suicide risk using standardized measures and directly ask clients about suicidal thoughts and plans. For those at risk, IAPT therapists develop safety plans that provide coping strategies and identify sources of support to help prevent suicide crises. They document risk assessments, management plans, and follow up arrangements to coordinate care.
This document summarizes suicide prevention efforts and data from Mersey Care NHS Trust and Henry Ford Health System. It shows suicide rates and numbers from 2005-2011 in Mersey Care, breakdowns by age, gender, diagnosis and method. Henry Ford achieved a 75% reduction in suicides through rapid investigations, clear risk assessment and interventions, and a culture shift toward pursuing perfection in depression care. Mersey Care's improvement plan aims to reduce suicides among its service users by 100% over 4 years through understanding evidence, treating depression effectively, enhancing safety pathways and staff skills, improving care transitions and engagement with carers.
This document summarizes the role that third sector organizations can play in preventing suicide in Cumbria. It discusses how third sector groups can help give a voice to at-risk groups, reach those groups, provide direct services, advocate for prevention, and share expertise. The document also outlines the benefits of collaboration between third sector groups and other agencies, such as increased impact, shared resources, and innovation. It provides examples of specific third sector organizations' suicide prevention and training programs that have been effective. Finally, it emphasizes the importance of continuing and expanding suicide prevention training efforts.
Dr. Sharon McDonnell presented on the experiences and perceived needs of parents bereaved by suicide. Her research found that parents had negative experiences with professionals breaking the news of their child's death and a lack of follow up care. However, some parents reported positive interactions with doctors who were compassionate and supportive. McDonnell is developing a training program to help professionals better support those bereaved by suicide, as understanding in this area has improved but specialists services are still needed.
The document discusses the influence of four nature photographers on the author: Ansel Adams, known for black and white photos that enhance natural beauty; Brett Weston, who uses black and white to draw viewers into intriguing natural scenes; William Guion, who photographs abnormal trees in black and white to make the trees the sole focus; and Nadia Isakova, who photographs brightly colored natural objects to highlight contrasts and blends between hues. The author aspires to achieve a professional standard of photography like these influential artists.
The document describes CASPER, a computer application that incorporates mapping technology to support agencies in monitoring and responding to missing person cases, suicides, and suicide attempts that occur in outdoor locations. CASPER aims to 1) provide an understanding of past incidents at outdoor locations, 2) calculate average search distances for missing persons, and 3) inform search strategies. It is intended to help police and emergency services while also providing public health analysts with tools to monitor response locations and develop coordinated action plans to reduce risks. Feedback is sought to improve CASPER.
This document discusses inspiring stories of people working in suicide prevention and well-being promotion. It lists several individuals and organizations, including Thomas Joiner who developed a theory of why people die by suicide involving acquired ability, burdensomeness, and failed belongingness. It also mentions the "5 Ways to Wellbeing" framework of connecting, being active, taking notice, keeping learning, and giving. The document advocates for prevention through promoting well-being, intervention with a destigmatized view of those at risk as having skills to learn, and postvention following models like Frank Campbell and Barry McGale to support families and communities after a suicide.
1) Suicide rates are highest among males aged 75 and over, and methods like hanging and self-poisoning are common in older adults.
2) Risk factors for suicide in later life include depression, physical illness, social isolation, and bereavement. Only a small percentage of older adult suicide completers had recent contact with mental health services.
3) Community-based prevention programs that educate primary care physicians about depression and increase screening have been shown to reduce elderly suicide rates. Tele-monitoring services may also help prevent suicide in at-risk older adults.
IAPT services play a role in preventing suicide by treating depression, which is a major risk factor for suicide. IAPT services provide talking therapies for depression and anxiety using a stepped care approach. They screen for suicide risk using standardized measures and directly ask clients about suicidal thoughts and plans. For those at risk, IAPT therapists develop safety plans that provide coping strategies and identify sources of support to help prevent suicide crises. They document risk assessments, management plans, and follow up arrangements to coordinate care.
This document summarizes suicide prevention efforts and data from Mersey Care NHS Trust and Henry Ford Health System. It shows suicide rates and numbers from 2005-2011 in Mersey Care, breakdowns by age, gender, diagnosis and method. Henry Ford achieved a 75% reduction in suicides through rapid investigations, clear risk assessment and interventions, and a culture shift toward pursuing perfection in depression care. Mersey Care's improvement plan aims to reduce suicides among its service users by 100% over 4 years through understanding evidence, treating depression effectively, enhancing safety pathways and staff skills, improving care transitions and engagement with carers.
This document summarizes the role that third sector organizations can play in preventing suicide in Cumbria. It discusses how third sector groups can help give a voice to at-risk groups, reach those groups, provide direct services, advocate for prevention, and share expertise. The document also outlines the benefits of collaboration between third sector groups and other agencies, such as increased impact, shared resources, and innovation. It provides examples of specific third sector organizations' suicide prevention and training programs that have been effective. Finally, it emphasizes the importance of continuing and expanding suicide prevention training efforts.
Dr. Sharon McDonnell presented on the experiences and perceived needs of parents bereaved by suicide. Her research found that parents had negative experiences with professionals breaking the news of their child's death and a lack of follow up care. However, some parents reported positive interactions with doctors who were compassionate and supportive. McDonnell is developing a training program to help professionals better support those bereaved by suicide, as understanding in this area has improved but specialists services are still needed.
This document discusses the relationship between unemployment rates and suicide rates during economic recessions. It provides evidence from a 2012 BMJ study linking increases in suicides in England from 2008 onward to the financial crisis. Regions with larger rises in unemployment experienced greater growth in suicide rates, particularly among men. Charts show unemployment levels and suicide rates rising together in countries like Spain and falling together in Sweden. The conclusion is that unemployment increases due to economic downturns can contribute to elevated suicide rates.
Public Health England (PHE) aims to improve public health and well-being through partnerships. PHE's Health and Wellbeing Directorate uses an integrated approach to support population health programs and address social determinants of health. The Directorate focuses on mental health, diet and obesity, tobacco control, alcohol, HIV, and a life course perspective. PHE will establish local government partnerships, build workforce capacity, develop leadership, deliver resources and make an impact on mental health over five years.
The document discusses gender differences in suicide rates in the UK from 1981-2011. It shows that while depression is equally common in men and women, women are twice as likely to be diagnosed and treated for it. The tables provided show female suicide rates peak between ages 35-44, while male suicide rates are highest between ages 25-34 and remain elevated among older age groups. Overall, male suicide rates are significantly higher than female rates across all age groups.
The document discusses implementing a Community Response Plan (CRP) to prevent suicide clusters from occurring in a local area. The CRP aims to facilitate early detection of potential clusters and provide a timely multi-agency response. It outlines criteria for activating the full CRP, including unusual death circumstances, potential media interest, or a rise in suicides over a short period. It also describes the roles of various organizations in monitoring suicides and implementing the CRP through different response levels to address concerns until the risk level decreases. The CLEAR partnership helps build community capacity to assist during a suicide and ensures support services are clear and accessible.
The Greater Manchester Suicide Prevention Partnership was initiated in 2002 following the UK's National Suicide Prevention Strategy. It brings together agencies responsible for or interested in suicide reduction, including public health, local authorities, mental health providers, police, ambulance services, universities, and voluntary organizations. The partnership aims to share information and develop collaborative strategies. Recent achievements include installing Samaritan signs in hot spots, identifying vulnerable groups like men aged 35-49, improving information sharing between agencies, and developing audit tools to prevent suicide among hospital patients.
The document discusses suicide prevention from the perspective of Greater Manchester Police (GMP). It provides data on suicide deaths in the region, including that 19 people reported missing between 2012-2013 later committed suicide, most by hanging or drowning. It then describes a referral scheme between Bury Police Public Protection Investigation Unit (PPIU) and Samaritans, where police can refer at-risk individuals to Samaritans for confidential support with their consent. The scheme aims to help those struggling with issues beyond suicidal thoughts.
This document discusses suicide and fire deaths in Greater Manchester from 2007-2012. It found that non-preventable fire deaths, including those from suicide, increased 133% during this period. Suicide accounted for 37% of non-preventable fire deaths, with many involving self-immolation among middle-aged individuals. In response, Greater Manchester Fire and Rescue Service aims to study self-immolation prevalence and circumstances to identify partnership opportunities for prevention. A mixed methods research approach is proposed to gather data, review literature, conduct case studies and make recommendations.
The 3rd part of the presentations from the ground-breaking Reducing Suicide Summit 2011, hosted by CALM and focusing on the Cheshire & Merseyside regions of the UK. More info at http://www.thecalmzone.net
The 2nd part of the presentations from the ground-breaking Reducing Suicide Summit 2011, hosted by CALM and focusing on the Cheshire & Merseyside regions of the UK. More info at http://www.thecalmzone.net
This document summarizes information presented at the Reducing Suicide Summit 2011. It provides statistics on suicide rates nationally and in the Cheshire and Merseyside region. High-risk groups for suicide are identified as men under 50, those in mental health care, offenders, and people who self-harm. Methods discussed include hanging, poisoning, and jumping from heights. Strategies to reduce suicide rates involve limiting access to lethal means, promoting mental health, and responsible media reporting.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
This document discusses the relationship between unemployment rates and suicide rates during economic recessions. It provides evidence from a 2012 BMJ study linking increases in suicides in England from 2008 onward to the financial crisis. Regions with larger rises in unemployment experienced greater growth in suicide rates, particularly among men. Charts show unemployment levels and suicide rates rising together in countries like Spain and falling together in Sweden. The conclusion is that unemployment increases due to economic downturns can contribute to elevated suicide rates.
Public Health England (PHE) aims to improve public health and well-being through partnerships. PHE's Health and Wellbeing Directorate uses an integrated approach to support population health programs and address social determinants of health. The Directorate focuses on mental health, diet and obesity, tobacco control, alcohol, HIV, and a life course perspective. PHE will establish local government partnerships, build workforce capacity, develop leadership, deliver resources and make an impact on mental health over five years.
The document discusses gender differences in suicide rates in the UK from 1981-2011. It shows that while depression is equally common in men and women, women are twice as likely to be diagnosed and treated for it. The tables provided show female suicide rates peak between ages 35-44, while male suicide rates are highest between ages 25-34 and remain elevated among older age groups. Overall, male suicide rates are significantly higher than female rates across all age groups.
The document discusses implementing a Community Response Plan (CRP) to prevent suicide clusters from occurring in a local area. The CRP aims to facilitate early detection of potential clusters and provide a timely multi-agency response. It outlines criteria for activating the full CRP, including unusual death circumstances, potential media interest, or a rise in suicides over a short period. It also describes the roles of various organizations in monitoring suicides and implementing the CRP through different response levels to address concerns until the risk level decreases. The CLEAR partnership helps build community capacity to assist during a suicide and ensures support services are clear and accessible.
The Greater Manchester Suicide Prevention Partnership was initiated in 2002 following the UK's National Suicide Prevention Strategy. It brings together agencies responsible for or interested in suicide reduction, including public health, local authorities, mental health providers, police, ambulance services, universities, and voluntary organizations. The partnership aims to share information and develop collaborative strategies. Recent achievements include installing Samaritan signs in hot spots, identifying vulnerable groups like men aged 35-49, improving information sharing between agencies, and developing audit tools to prevent suicide among hospital patients.
The document discusses suicide prevention from the perspective of Greater Manchester Police (GMP). It provides data on suicide deaths in the region, including that 19 people reported missing between 2012-2013 later committed suicide, most by hanging or drowning. It then describes a referral scheme between Bury Police Public Protection Investigation Unit (PPIU) and Samaritans, where police can refer at-risk individuals to Samaritans for confidential support with their consent. The scheme aims to help those struggling with issues beyond suicidal thoughts.
This document discusses suicide and fire deaths in Greater Manchester from 2007-2012. It found that non-preventable fire deaths, including those from suicide, increased 133% during this period. Suicide accounted for 37% of non-preventable fire deaths, with many involving self-immolation among middle-aged individuals. In response, Greater Manchester Fire and Rescue Service aims to study self-immolation prevalence and circumstances to identify partnership opportunities for prevention. A mixed methods research approach is proposed to gather data, review literature, conduct case studies and make recommendations.
The 3rd part of the presentations from the ground-breaking Reducing Suicide Summit 2011, hosted by CALM and focusing on the Cheshire & Merseyside regions of the UK. More info at http://www.thecalmzone.net
The 2nd part of the presentations from the ground-breaking Reducing Suicide Summit 2011, hosted by CALM and focusing on the Cheshire & Merseyside regions of the UK. More info at http://www.thecalmzone.net
This document summarizes information presented at the Reducing Suicide Summit 2011. It provides statistics on suicide rates nationally and in the Cheshire and Merseyside region. High-risk groups for suicide are identified as men under 50, those in mental health care, offenders, and people who self-harm. Methods discussed include hanging, poisoning, and jumping from heights. Strategies to reduce suicide rates involve limiting access to lethal means, promoting mental health, and responsible media reporting.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.