Letter to the New York Times
To the editor:
I was pleased that the September 8, 2000 issue of The New York Times reported on the results of a Dutch study printed in The Lancet which showed that more women on tamoxifen developed a deadlier form of uterine cancer than women with uterine cancer not on tamoxifen.
However, Denise Grady, the author of the article, is wrong in reporting that the risk of uterine cancer for women over 60 taking tamoxifen is only doubled from 1 in a thousand to 2 in a thousand. A risk-benefit assessment for women taking tamoxifen for breast cancer prevention printed in the Nov. 3, 1999 issue of the Journal of the National Cancer Institute reports that women over 50 quadrupled their risk of getting uterine cancer. In fact, the number of uterine cancers caused by tamoxifen in women over 50 is actually equal to the number of breast cancers that tamoxifen prevents.
In The Breast Cancer Prevention Trial, tamoxifen appeared to prevent the least aggressive kind of breast cancer. Is tamoxifen preventing the most curable type of breast cancer, but causing a more lethal type of uterine cancer?
For almost all women who already have breast cancer the benefits of tamoxifen far outweigh the risks. However, many breast cancer survivors, including myself, believe that clinical trials using toxic drugs in healthy women should show that there is a real survival benefit, not just a reduction in incidence of breast cancer. Otherwise, we run the risk of substituting one disease for another.
Sincerely,
Helen Schiff
New York, New York
I was pleased that the September 8, 2000 issue of The New York Times reported on the results of a Dutch study printed in The Lancet which showed that more women on tamoxifen developed a deadlier form of uterine cancer than women with uterine cancer not on tamoxifen.
However, Denise Grady, the author of the article, is wrong in reporting that the risk of uterine cancer for women over 60 taking tamoxifen is only doubled from 1 in a thousand to 2 in a thousand. A risk-benefit assessment for women taking tamoxifen for breast cancer prevention printed in the Nov. 3, 1999 issue of the Journal of the National Cancer Institute reports that women over 50 quadrupled their risk of getting uterine cancer. In fact, the number of uterine cancers caused by tamoxifen in women over 50 is actually equal to the number of breast cancers that tamoxifen prevents.
In The Breast Cancer Prevention Trial, tamoxifen appeared to prevent the least aggressive kind of breast cancer. Is tamoxifen preventing the most curable type of breast cancer, but causing a more lethal type of uterine cancer?
For almost all women who already have breast cancer the benefits of tamoxifen far outweigh the risks. However, many breast cancer survivors, including myself, believe that clinical trials using toxic drugs in healthy women should show that there is a real survival benefit, not just a reduction in incidence of breast cancer. Otherwise, we run the risk of substituting one disease for another.
Sincerely,
Helen Schiff
New York, New York
