Science Daily: "Novel Basis Identified for Tamoxifen Failure" (ie, tamoxifen can worsen cancer)

[zazen]

I'm not surprised. In addition to overtreatment of early stage cancer that might have resolved on its own (according to another new study) and potential harm of mamograms to actually dislodge cancer and/or increase radiation to dense tissue, I've suspected that some of these drugs given to women to "reduce risk" may be killing them.

I know the researchers and clinicians mean well, but there are some systemic problems in the BC research and treatment industry that in addition to BC are causing a lot of harm to women.

http://www.sciencedaily.com/releases/2008/12/081203201330.htm

see also original article at http://breast-cancer-research.com/content/10/6/R103

ScienceDaily (Dec. 18, 2008) — Tamoxifen may worsen breast cancer in a small subset of patients. Research published in BioMed Central's open access journal Breast Cancer Research suggests that in patients who show reduced or absent expression of the protein E-cadherin, commonly used anti-oestrogen drugs such as tamoxifen may promote more harmful cancer cell behaviour.

A team of researchers co-ordinated by Dr. Stephen Hiscox, from the Welsh School of Pharmacy at Cardiff University, investigated the selective oestrogen receptor modulator (SERM) tamoxifen on human breast cancer cells, comparing it to the direct effects of oestrogen withdrawal.
Dr. Hiscox said, "Anti-oestrogens, such as tamoxifen, have been the mainstay of therapy in patients with oestrogen receptor positive (ER+) breast cancer and have provided significant improvements in survival. Our experimental studies suggest that in a certain group of patients, it may be much less effective, however, as it appear to promote an aggressive cell behaviour".

[LeftishBrit]

1. It is well known that there are different forms of breast cancer...

and that tamoxifen isn't suitable for all of them.

Giving people the wrong treatment can be dangerous, as pointed out here, and it is good that people are doing more work in differemtiating the different sorts of cancer.

'I know the researchers and clinicians mean well, but there are some systemic problems in the BC research and treatment industry that in addition to BC are causing a lot of harm to women.'

Treatment of breast cancer is by no means perfect; but survival and cure rates are MUCH higher than in the past. And the effects of the treatments are less drastic for most women than in the days of routine radical mastectomy.


'In addition to overtreatment of early stage cancer that might have resolved on its own'

Early stage cancer, at least by the time it's detectable, does *not* usually resolve on its own. And even if it does resolve in the original location, it may still spread without treatment. I knew someone who died of metastatic cancer (not diagnosed till a late stage), where it was suspected that the original (probably lung) cancer had probably burnt out on its own, but had spread before doing so.

This article suggests that treatment should be tailored to the nature of the cancer, and that misdiagnosis and the wrong treatment can be harmful. It does *not* suggest that breast cancer should not be treated in its early stages!

[zazen]

2. I never said it shouldn't be treated in early stages (?); here's Euro study on self-resolving BC

BTW, I'm a BC survivor myself, have had a mastectomy, know many who have died, and keep up with the research. I'm not just shooting off at the mouth here.

I'm describing the larger issue of overtreatment as one of many problems in the BC treatment industry. Some of the increased survival rate to which you refer is because they've been treating DCIS detected through millions of more mammograms, a condition which may or may not have progressed to cancer. But there's even an enormous interrater reliability issue in even diagnosing DCIS vs ADH, which you have to dig very deep to learn (they don't tell patients this). The latter is a serious risk factor too, but should we get mastectomies for risk factors? That's every woman's choice in our country--to have a prophylactic mastectomy-- if she's fully informed and has the insurance/money to pay for it, but scaring the hell out of millions of women each year who have unnecessary biopsies, or whose biopsies yield results that could have had a wait and see approach, creates another class of harmed women.

I guess they're so afraid of being sued for _not_ finding something that they are required to treat everything that's suspicious. That's what I mean--it's a _systemic_ problem. Better informing patients of how little the docs know, of possibilities of misinterpretations and misdiagnosis, and giving the docs/staff MORE staff so that they have time to actually read the case histories of the patients they're treating--these would be good improvements.

But Madoff just bilked these causes of millions in R&D and clinical funds, so we shan't be seeing this anytime soon.

[zazen]

3. Some Cancers Found By Mammograms Would Have Naturally Regressed, Study Suggests-ScienceDaily, 11/08

Some Cancers Found By Mammograms Would Have Naturally Regressed, Study Suggests-ScienceDaily, November 26, 2008

from
http://www.sciencedaily.com/releases/2008/11/081124165117.htm

Per-Henrik Zahl, M.D., Ph.D., of the Norwegian Institute of Public Health, Oslo, and colleagues examined breast cancer rates among 119,472 women age 50 to 64 who were all invited to participate in three rounds of screening mammograms between 1996 and 2001 as part of the Norwegian Breast Cancer Screening Program. They compared these to rates among a control group of 109,784 women age 50 to 64 in 1992, who would have been invited for screening if the program had existed at that time. Cancers were tracked for six years using a national registry, and at the end of that time all participants were invited to undergo a one-time screening to assess breast cancer prevalence.
As anticipated, breast cancer rates were higher among screened women than among the control group before the final prevalence screening. "Even after prevalence screening in controls, however, the cumulative incidence of invasive breast cancer remained 22 percent higher in the screened group," the authors write. Of every 100,000 screened women, 1,909 had breast cancer during the six-year period, compared with 1,564 of every 100,000 in the control group. Screened women were more likely to have breast cancer at every age.

"Because the cumulative incidence among controls never reached that of the screened group, it appears that some breast cancers detected by repeated mammographic screening would not persist to be detectable by a single mammogram at the end of six years," the authors write. "This raises the possibility that the natural course of some screen-detected invasive breast cancers is to spontaneously regress."

. . . .
"Despite the appeal of early detection of breast cancer, uncertainty about the value of mammography continues," write Robert M. Kaplan, Ph.D., of the University of California, Los Angeles, and Franz Porzsolt, M.D., Ph.D., of Clincal Economics University of Ulm, Germany, in an accompanying editorial. "In this issue of the Archives, Zahl et al use a clever study design in an attempt to estimate the value of screening."

"Perhaps the most important concern raised by the study by Zahl et al is that it highlights how surprisingly little we know about what happens to untreated patients with breast cancer," Drs. Kaplan and Porzsolt continue. "In addition to not knowing the natural history of breast cancer for younger women, we also know very little about the natural history for older women. We know from autopsy studies that a significant number of women die without knowing that they had breast cancer (including ductal carcinoma in situ). The observation of a historical trend toward improved survival does not necessarily support the benefit of treatment."

"If the spontaneous remission hypothesis is credible, it should cause a major re-evaluation in the approach to breast cancer research and treatment. Certainly it is worthy of further evaluation," they conclude.

[zazen]

4. I've seen some suggest that the radiation/dislodging itself in mammography could be causative

but I'm not ready to go that far. It's an eerie thought.

[HysteryDiagnosis]

5. Thermography, pros and cons.

http://www.breastthermography.com/

Breastthermography.com is dedicated to providing information on breast thermography, risk assessment, breast cancer, early detection, prevention and ultimately the preservation of the breast and the survival of women.

Current research has determined that the key to breast cancer survival rests upon its earliest possible detection. If discovered in its earliest stages, 95% cure rates are possible. Our center is dedicated to providing one of the most essential tests in breast cancer risk assessment and early detection. See What Patients are Saying and What Doctors are Saying.

ABC News - Live National Interview
Dr. Amalu defends women’s access to breast thermography

Radio Talkshow "Ask Doctor Dawn"
Dr. Amalu is interviewed by Dawn Motyka, MD on worldwide NPR Broadcast


* Dr. Dawn conducts an in-depth 30 minute interview with Dr. Amalu discussing all aspects of breast thermography, including why it isn't as popular as it should be and how it should be used.

[fed_up_mother]

6. I turned down tamoxifen. I'd rather monitor my health very carefully

In my case, it just didn't seem to make sense.