By Marsha Ginsburg, San Francisco Examiner
SAN
FRANCISCO -- Advocates for breast cancer patients denounced a
leading group of cancer specialists for recommending that doctors
offer the widely debated drug tamoxifen to healthy women worried
about developing breast cancer.
The
recommendation was issued Tuesday by the American Society of Clinical
Oncology at its annual meeting in Atlanta. It was based largely
on earlier research that indicated tamoxifen cuts almost in half
some women's risk of developing the cancer.
But
the drug has been criticized by many advocates of breast cancer
patients because of the side effects caused by the medication.
Tamoxifen has been linked to hot flashes and increased risk of
uterine cancer and potentially fatal blood clots.
The
lead doctors writing Tuesday's statement said a woman's fear of
breast cancer is perhaps the most important consideration in deciding
whether to take the drug.
``We
are not recommending that women take it. We are recommending that
women be offered it,'' said Dr. Rowan Chlebowski of the University
of California at Los Angeles, the co-chair of the committee of
cancer specialists.
The
move was denounced by Barbara Brenner, head of Breast Cancer Action
in San Francisco, who attended the conference. She said she was
outraged at oncologists' hypocrisy for suggesting the drug be
offered without actually recommending it.
``This statement will make a woman's decision more difficult,
not easier,'' Brenner said. ``How in God's name do they make a
distinction about whether to offer it or whether to recommend
taking it? Do they not think that women rely on their doctors?''
Chlebowski
said the decision to use tamoxifen ``depends on a woman's actual
risk and the importance of that risk to her.''
The
group's recommendation said tamoxifen may be offered to women
who have at least a 1.7 percent relative risk -- meaning nearly
double the average risk -- of getting breast cancer over the next
five years.
Beth
Crawford, a genetic counselor at the University of California
at San Francisco, said that figure means a woman has a 24 percent
chance of contracting the disease over her lifetime. The average
U.S. woman's chances of developing breast cancer in her lifetime
is 12 percent.
About
29 million women, or 20 percent of the U.S. female population,
are in the 1.7 percent relative-risk category, including all women
over 60.
Crawford
said fear of getting the disease would likely make high-risk women
seriously consider taking the drug, but that they needed to weigh
the risks against the benefits. Like many genetics specialists,
Crawford said she believes most women overestimate their chances
of developing breast cancer.
In
Marin, the Nothern California county that has the highest rate
of breast cancer in the country, the head of Marin Breast Cancer
Watch did not agree with the recommendation on tamoxifen.
``Healthy
women should be putting healthy things into their bodies, not
toxic substances,'' said Francine Levien, president of the group.
``This is going to make millions of dollars for the company that
owns this. Do I think it's a political issue? Yes, I do.''
The medication is being marketed by the British-Swedish drug manufacturer
AstraZeneca Plc.
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