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Breast Cancer Books The
National Cancer Institute's (NCI) published the results of their hormone replacement study
in the Journal of American Medical Association (JAMA) on January 26,2000. This
study, Menopausal Estrogen and Estrogen-Progestin Replacement Therapy and Breast Cancer
Risk, caused quite a stir in the medical community and sent a shock wave through women
taking or considering taking any form of HRT
(hormone replacement therapy).
 Many women became
frightened....
Many women read about this study and it's results in their local newspapers.
Along with local newspapers, other media outlets including the national news sources
presented the results of this study in such a fashion that many women became terribly
frightened and confused.
- The entire story along with the much needed
opportunity to question the study were never provided.
In fact, on such reputable news programs as PBS' Lehrer NewsReport the NCI did
not send any of the 6 authors of this study nor a NCI representative to be interviewed.
- There are many problems with this study.
When the study and the results are read, and it is lengthy, women get a totally
different picture than the blaring headlines," HRT, especially Progestins Increase
Breast Cancer Risk!".
The truth is a long way from the hype.
Here are some of the relevant issues concerning this study:
- The NCI got their results from questionnaires,
not by talking to women who have taken HRT.
- Different doses
The questionnaires were filled out by women who were taking some form of HRT
backed in the 70s. Doses at that time were much higher than the traditional doses of
today's HRT.
- Questionnaire vs. Personal Interview:
The questionnaire style of gathering information for a study is very different;
producing very varied responses than actual in person interviews.
- Many times people filling out questionnaires are apt to
write down one thing when another may be more accurate- for example did these women taker
their HRT as per doctor's orders or did they personally adjust their doses?
- For example:
There are many women who cut their Climara patches in half and other women who
decide for themselves how pills etc... to take on any given day.
- Differing classes of medication
Another problem is that the researchers never revealed what kind of estrogen and
progestins these women were taking. This is so important. There
are over 30 different kinds of birth control pills alone, not to mention all the kinds of
HRT like Estrace, Climara, Prempro and the list goes on. This is crucial for
an accurate report.
- Estrogen & Progestin - Different types
The study didn't reveal the doses of what these women took- how much estrogen and
how much progestin? This is another crucial item when trying to
distinguish any type of relationship between a medication and its results.
- It is impossible to make a reasonable conclusion without
knowing how and what kind of products these women were taking.
- The fact that all 46,000 of these women were NOT taking the
same product in the same doses produces a VERY big credibility problem for this study.
"I never pay attention
to these inaccurate papers...."
  Major experts in this field
of medicine have found this to be major sticking point against this study. Dr.
Steven Goldstein, noted obstetrician/gynecologist, author of Could It
Be...Perimenopause? and head of NYU's sonography department told
The New York Daily News,
" I'm going to tell my patients that articles
like this annoy me.""
Only six out of 46,000....
The study failed to emphasize that of the 46,000 women they sent questionnaire to
only 6 of them developed breast cancer where supposedly they would not have- 6, not
hundreds, but 6 women.
  Women's
health advocate, premature menopause expert, and author of The
Premature Menopause Book, Kathy
Petras had some thoughts as to what this study could mean for the thousands
of women who experience premature or
early menopause.
"All in all, though, this most recent study hasn't
convinced me that it's unwise for us in premature menopause to flush the HRT down the toilet. Here are some of my
thoughts in the interest of discussion, based on a ton of research and interviews with a
few doctors."
Conjugated estrogend vs. "natural"
hormones
"As has already been pointed out (in fact, one of the news reports I saw on
this last night had a doctor explain this in some depth): this particular study was done
using conjugated estrogens (i.e. Premarin)
and a progestin. So the results may be very different for women on natural hormones (i.e.
bioidentical estrogen and progesterone, not progestin). The key word, of course, is
"may" -- since there have been no long term studies done on women taking the
newer forms of HRT. But I do tend
to think that there's a big difference depending on the type of HRT you take.
Older vs.Younger women
Secondly, it's crucial to remember that the study was done with older women --
that is, women in "normal" menopause. From what I've read, many researchers and
doctors believe that it's a different scenario with younger women. Women in early
menopause are not prolonging our exposure to estrogen as do older women."
The body is programmed to normally slow down estrogen production at age 50 or so;
whereas women in premature menopause are slowing down estrogen production decades
earlier than that. So when we take HRT, we're not increasing our exposure to estrogen
beyond the norm. We're literally replacing estrogen and progesterone that we'd normally
have made had we not undergone surgical menopause or POF (aka premature ovarian failure
which is premature menopause). In fact, typically, the HRT we take is lower than the
amount we'd normally have produced had we not gone through this early transition.
The risk of breast cancer in general is much lower
for a younger woman. Here's a quick breakdown of the age-related odds:
- age 25 -- odds are 1 in 19,608
- 35 -- 1 in 622
- 45 -- 1 in 93
- 55 -- 1 in 33
- 65 -- 1 in 17
- 75 -- 1 in 11
- 85 -- 1 in 8
Higher risk of osteoporosis and heart disease....
On the other hand, though, we ARE at a much higher risk of
osteoporosis and heart disease due to low hormone levels. So, in my mind, it ultimately
becomes a question of risk/benefit. Seems to me that if you've got a strong family history
of breast cancer and/or had breast cancer yourself, then it makes a lot of sense to
really think hard and long about HRT -- and discuss all the pros and cons with your
doctor. If you don't have a high risk of breast cancer, then HRT may make a lot of sense
-- in terms of preventing the high risk of osteoporosis and heart disease. "
Women who have life altering perimenopause
and menopause symptoms, have
risks of osteoporosis, heart disease need to talk with their doctors before throwing their
HRT down the toilet. in the These products in the long run may prevent future crippling
and deadly diseases like osteoporosis
(which over 50% of women over 50 have), heart
disease ( the number one killer of women) for high risk women.
The value of this study lies at being nothing more of than a sketchy outline for future
researchers to do the needed studies correctly and properly.
On the other hand...
 Dr. Susan Love in a recent
interview said:
Finally there is growing data to support the notion that
HRT causes breast cancer if taken long enough. The study
last week demonstrated an 8% per year increase in breast cancer for women on
premarin and provera. Again short term use is probably okay but taking hormones for 10-20
years comes with a definite risk.
 Other articles:
Dr.
Jerri Nielsen's South Pole Survival Battle
 Serving as doctor to the Americans "wintering over" at the
South Pole in 1999, Jerri Nielsen made headlines when she discovered a lump in her breast
that a self-administered biopsy revealed to be an aggressive, fast-growing cancer. See
more about how she treated her own cancer while she was forced to stay in the Antarctic as
well as a video clip from the Oprah show. We also have resources to help you calculate
your risk of breast cancer, how to do a breast self exam and more.
Breast Cancer
Statistics
& what they REALLY mean
What does
the 1 in 9 statistic for getting breast cancer really mean for me? This statistic is
always seen when anyone talks about breast cancer risk. A woman's risk for developing
breast cancer depends on many factors. Find out more.
Breast
self exam
 The
instructions are simple and come with illustrations. Please take a look and print out a
copy for yourself. You are worth it. Make a copy for your best friend, your mom and your
sister. Put it into a card and tell them how much you care about them. Do it, before
it’s too late. |
 
Susan Love interview
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Cancer Books
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