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Why Women Are Not Flocking to Tamoxifen

Why Women Are Not Flocking to Tamoxifen

 

It was a great moment in Pharma funded physician "education." At a symposium at the American Psychiatric Association's 2010 meeting called "Mood, Memory and Myths: What Really Happens at Menopause," two Wyeth/Pfizer funded speakers tried to resurrect the benefits of cancer-linked hormone therapy. But the mostly-female audience was having none of it: what can we do about our "tamoxifen brain" from the cancer we already have, they wanted to know.

 

Women are to be forgiven if they are cynical about this week's news about the cancer drug tamoxifen saving lives. Since the 1940s women were told they needed to be on hormone replacement therapy (HRT) for the rest of their lives only to find in 2002 it was causing breast cancer, heart disease, strokes and blood clots. Studies that looked as solid as this week's tamoxifen study assured women that lifelong HRT would prevent heart disease, dementia and other blights --when it turned out to be just the opposite.

 

The harm from HRT, recommended by the medical mainstream for decades, was so dramatic, when women quit HRT in 2002, the incidence of US breast cancer fell 15 percent among women with estrogen-fed cancer. Fourteen thousand women who were expected to get breast cancer didn't because they eliminated the source, said news reports. Rather than a "cure" for breast cancer, this was a literal "cause." Unfortunately, women, their clinicians and the medical press have already forgotten this man-made cause of cancer and HRT is making a comeback.

 

Why should women be cynical about this week's study in the Lancet that finds women who stay on the blockerbuster cancer drug Nolvadex/tamoxifen for 10 years instead of the usual five years are less likely to die and have cancer recur?  (Inspiring some to already suggest women should stay on tamoxifen, "for life.")

 

The first reason is because the study was partially funded by AstraZeneca who makes Nolvadex or tamoxifen. AstraZeneca, formerly Zeneca, co-founded National Breast Cancer Awareness Month as a "public relations scam," says the Center for Media and Democracy's SourceWatch, even as its parent company, ICI Pharmaceuticals/Imperial Chemicals Industries, manufactured pesticides and organophosphates linked to breast cancer. Some accused the drug giant of literally playing both sides of the street, especially since tamoxifen shares some chemical properties with endocrine disrupting pesticides.

 

The second reason for cynicism is: tamoxifen carries its own risks which are not such a great trade off (unless you are Big Pharma). "Treatment with 5 years of tamoxifen can cause side-effects such as endometrial cancer and thromboembolic disease and continuing tamoxifen for an additional 5 years is likely to increase these side-effects," says the Lancet article.  3.1 percent of women undergoing the extra 5 years of tamoxifen therapy got endometrial cancer versus 1.6 percent who did have extra years of the drug.

 

There is an increasing backlash among women breast cancer survivors against tamoxifen and such trade-offs.  "My cancer had a one percent chance or recurring and I was told tamoxifen would cut my chances in half," says Kay, a Chicago fitness instructor who underwent surgery and radiation for ductal carcinoma in situ (DCIS) at the age of 50. "That means if I exposed myself to the risks and side effects of tamoxifen, my chance of recurrence would be .5 percent. No thinking women would agree to that."

 

And there is a another source of cynicism for women beyond the downside of tamoxifen and the external causes of cancer, including prescribed hormones, that are largely ignored. In November the New England Journal of Medicine published a study estimating that mammograms have caused more than a million American women to be diagnosed with early stage breast cancers, in the last three decades, that would not have proved fatal if left undetected and untreated. The millions, perhaps billions, spent in health care dollars because of such overdiagnosis and overtreatment and the suffering of women have yet to be fully quantified.

 

"There is more money in treating breast cancer than preventing it," declares Kay who says she studied profiteering on the disease or what she calls "Breast Cancer Inc" since her own diagnosis. "That is why they call DCIS which a stage 0, precancer--'cancer.' There is more money in treating it." END

 

The complete history of the cancer-associated hormone therapy is found in Martha Rosenberg's acclaimed, Born With a Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp The Public Health (Prometheus Books, 2012).

 

Comments

My impression is that the research that found a benefit for HRT was primarily observational. When a large randomized controlled trial was done, the increase in breast cancer and cardiovascular events was found. The ATLAS trial was a randomized controlled trial, so it seems more like the trial that found harms from HRT, unless I am missing something.

I do agree with you that (as with any medical intervention) the benefits and risks should be carefully weighed before making a decision. For someone with a low risk of recurrence, the benefit from an additional 5 years of tamoxifen may not be worth the risk of pulmonary embolism, DVT, stroke and endometrial cancer. The decision is one that must be made based on each patient's individual circumstances.

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