Low Breast Cancer Drug Use May Be Fatal

Study: Women Who Fail To Take Tamoxifen As Prescribed May Have Increased Death Risk

(WebMD)  Women who fail to take the breast cancer drug tamoxifen as prescribed may be placing themselves at substantially increased risk of dying, a study of more than 2,000 women shows.

"Our most significant finding was that women who filled 70 percent or fewer of their tamoxifen prescriptions had a significantly - 16 percent - increased risk of death [compared with women who filled all their prescriptions]," says Alastair Thompson, MD, professor of surgical oncology at the University of Dundee in Scotland and one of the researchers.

In the study, one in 10 women filled 70 percent or fewer of their tamoxifen prescriptions, he tells WebMD.

Refills are a well-accepted surrogate for how many pills a person actually takes, as it is rare for people to buy medication if they still have some left.

The research is being presented here this week at the 2007 Breast Cancer Symposium, co-sponsored by the American Society of Clinical Oncology and four other cancer care groups.

Findings Apply to Newer Hormone Drugs, Too
Doctors have been using tamoxifen to fight tumor growth in women with breast cancer who have tumors that are fueled by estrogen for over 25 years.

More recently, newer hormone drugs known as aromatase inhibitors, such as Aromasin, Arimidex, or Femara, have been shown to shrink tumors better, with fewer side effects.

While tamoxifen deprives breast cancer cells of the estrogen they need to grow, aromatase inhibitors actually block an enzyme needed to make estrogen, thereby slashing the body's production of estrogen altogether.

Nonetheless, tamoxifen still has an important role in breast cancer treatment, says Julie R. Gralow, MD, an associate professor of medical oncology at the University of Washington School of Medicine in Seattle, and moderator of a press briefing on the findings.

Aromatase inhibitors can only be given to postmenopausal women, leaving tamoxifen as the cornerstone of hormone therapy in younger women, she points out.

Plus, the less expensive tamoxifen is still more commonly prescribed in many other parts of the world, Gralow says.

The new findings also have implications for women taking aromatase inhibitors, she says.

"The study clearly shows that you need to take the majority of your pills to really get benefit. As we move toward greater use of aromatase inhibitors, which do not stay in the body as long, taking the drug as prescribed becomes even more important," Gralow tells WebMD.

Less Than Half of Women Took Tamoxifen for 5 Years
For the study, the researchers reviewed the records of 2,080 women treated for breast cancer between 1993 and 2002 in Scotland. Of the total, 79 percent were prescribed tamoxifen to reduce the risk of breast cancer returning after surgery.

Thompson notes that in Scotland, every patient has a unique 10-digit health number. This allowed the researchers to link data on each person's health status to pharmacy records.

Among the results:

• Although a 5-year course of tamoxifen is typically recommended, women took the drug for an average of 2.42 years.


• 37 percent of women stopped taking tamoxifen before 5 years, with 19 percent discontinuing its use 2 years into therapy.


• Less than half of women, 49 percent, took tamoxifen for 5 years.


• Women who didn't take tamoxifen at all had a 50 percent increased risk of dying, compared with women who took the drug.

Side Effects May Cause Fall Off
While the research was performed in Europe, U.S. studies have also shown that people with cancer often fail to take their drugs as prescribed, Thompson says.

The researchers did not ask women why they stopped taking tamoxifen, but he notes that the drug can cause hot flashes and other difficult-to-tolerate side effects that mimic symptoms of menopause.

Gralow advises women to talk about the isue with their doctors. "If you want to stop taking a drug because you don't feel good, it's really important to tell your doctor. There is often something else we can do for you," she says.

More than 180,000 new cases of breast cancer will be diagnosed in the United States in 2007, and more than 40,000 women will die from the disease, according to the American Cancer Society.

[grammawhamma]

godofredo29

I am thinking you are a male. I hope you would not encourage your wife to stop taking a life saving drug because it might put a damper on your relationship with her!! (At least that''s the tone I got from your post.)

[godofredo29]

Tamoxifen is a potential lifesaver for women at risk for breast cancer. But, when a woman''s doctor prescribes it, her significant other is usuallly not warned about the likelihood that it will throw her into early (say, in her thirties) menopause (not to mention the other potentially serious side effects). The impact on their relationship can be devastating.

[grammawhamma]

"The researchers did not ask women why they stopped taking tamoxifen."

This is considered research when they didn''t even ask the reason why? ***!

[drinuk]

Simply more Big Pharma hustling and hype to go along with the ten million dollar a year lobbying of politicians.

The whole of America should be made aware of the FACT that these crooks are currently spending millions in persuading Washington to change the patent laws so that they may gain a patent on natural herbs and plants such as Graviola and Bitter Melon which they already know kill tumours but which they suppress until they can earn mega bucks from them. They will get this done prior to Bush leaving office, whereupon HE will claim some success in the fight against cancer.

The Patent laws are fine, you cannot patent living things invented by the creator, you simply need to find them and use correctly.

[andor3]

missing fact: who funded the study?

a drug company perhaps? maybe the makers of tamoxifen?

It also seems to ignore other (possibly significant) factors: lifestyle, age, or economics. It may be that women who can''t afford drugs have other issues from economic stress that lead to shorter lifespan.

[incog-nito]

According to the latest study, scientists have determined that people who don''t take medication for their illness tend to die from their illness. They cautioned, however, that results are preliminary and that more research is needed, or in the words of a researcher: "We need more grant money, lots of it."

[toldyouso21]

What an insipid and stupid article. Try this: anyone who fails to take any drug prescribed for a life threatening condition is likely to die for failing to take it. No news there. So... I wonder what perks the manufacturers of Tamoxifen have to dole out to get this endorsement and article from the MDs and writer? The fact is, failure to take meds needed to fight cancer can lead to an earlier demise--but even more ominous--marketing, touting, endorsing and pushing drugs at consumers through ads, commercials and having drs act as shills for pharm companies is far worse than the few who neglect their meds. How many people now have gastro intestinal reflux, get unnecessary surgeries or pills and why are drugs marketed on tv like they are new shoes--to "ask " your doctor about? Right.