Breast Cancer Drug That Raises
Survival Chances by a Third
by Jenny Hope

A new treatment for breast cancer which improves survival rates by a third was last night hailed as the biggest breakthrough against the disease for more than twenty years. Early results from a major trial show women, who use a sequence of two drugs, dramatically cut the risk of their cancer coming back.

They took tamoxifen, the 'gold standard' treatment for the disease, for two to three years before switching to the new drug, exemestane, for the rest of their therapy. Those of them who took tamoxifen for the full five years did not record such good results.

Each year, 41,000 British women develop breast cancer and it claims 13,000 lives.

Specialists believe that 'aromatase inhibitors' such as exemestane will challenge tamoxifen as the standard treatment following surgery. Of the 30,000 women who develop breast cancer after the menopause, around 20,000 are prescribed tamoxifen for five years after surgery because of its record in preventing the disease from recurring.

The latest research was co-ordinated by Cancer Research UK and studied 4,700 post-menopausal women worldwide, including 600 from Britain, for five years. They all started on tamoxifen but, after two or three years, half switched to exemestane. The others continued with tamoxifen.

For every 100 patients who changed to exemestane, eight had a recurrence within three years and 92 stayed free of cancer. For every 100 patients who continued with tamoxifen, 13 had a recurrence within three years and 87 were cancer free.

Taking the combination of drugs also cut the chance of a new cancer developing in the other breast by 50 per cent. And there was a big drop in side effects, including clotting, while the risk of other cancers seemed to be cut.

Dr John Troy, medical director of Cancer Research UK, said the study published in the New England Journal Of medicine was "a very exciting advance". Judith Bliss, director of the charity's clinical trials and statistics unit, said the results were published before the study was officially finished because of their 'magnitude and statistical certainty'.

Professor Charles Coombes said too many women relapse within five years of surgery because their cancer becomes resistant to tamoxifen.

"This can be devastating," said Professor Coombes, director of the charities' laboratories at Imperial College, Hammersmith and Charing Cross Hospitals in London. "It can be a death sentence when it spreads to other sites in the body. In terms of changing the disease, these results show we are achieving something." Daily Mail, 11th March 2004.

PS Anastrozole and letrazole are aromatase inhibitors licensed for advanced breast cancer and work in a similar way to exemestane. They are effective in two thirds of patients where the tumours are stimulated by the female hormone oestrogen and only work in women who have passed the menopause. While tamoxifen works by blocking oestrogen's effects on cancer cells, aromatase inhibitors shut down the body's supply.

PHILLIP DAY'S COMMENT: Exemestane, like those other cancer drugs before it, will prove a disappointment in reality. Here's why. Every time you hear Cancer Research UK or the American Cancer Society speak of survival rates, they are talking about the cancer patient surviving five years after initial treatment, not surviving the disease for good. If a patient survives five years, even if they die six months later, they are still hailed as a cancer survivor. Cured and dead. Thus, if you are a drug company, you need to see if you can jig things so the patient lasts at least five years after initial treatment. If you succeed, you can issue press releases claiming you have 'greatly increased people's chances of surviving cancer' with your drug, and your share price will surely rocket. Needless to say, the hapless Joe in the street, shovelling fivers into the charity money tins because his dog just died of cancer, is completely unaware of this scam.

The reality is, cancer does not become 'resistant' to Tamoxifen. Tamoxifen is an estrogen blocker. Estrogen-positive breast cancer is the result of stem (healing) cells being stimulated by estrogen as part of a normal healing process into a morphogenetic stimulus which produces the lump. Artificially suppressing estrogen does not answer the problem of why there is estrogen dominance in the woman's body in the first place. This is akin to facing an overflowing sink and grabbing the mop rather than the tap. Tamoxifen, Arimidex, Exemestane, or even fairy dust for that matter, certainly do not solve the environmental, dietary or pathological reasons why the patient has too much estrogen and not enough progesterone in their body. These problems can only be dealt with through dietary and lifestyle changes. And that's before we look at whether there are fungal concerns in the patient too.

I have another problem with this announcement which concerns the human rights issue. As Cancer Research UK well knows, the Department of Health produces strict guidelines to all doctors on the subject of informed consent. These state that the patient should be made aware of the benefits and risks of any treatment given. I sincerely doubt whether patients given Tamoxifen are told it can cause liver cancer and was put on the Californian Carcinogens Register in the mid 1990's. Might that just change the drug's sparkly reputation? Is it any wonder patients feel better when they stop taking it? What about Exemestane? Like almost all other chemos, is it a carcinogen? Total silence on that one so far too, I'm afraid.

By the way, the Department of Health also states patients be given full knowledge on alternative treatments. Ho-hum. Don't hold your breath there either.

Further Resources:
The ABC's of Disease by Phillip Day
Cancer: Why We're Still Dying to Know the Truth by Phillip Day
Great News on Cancer in the 21st Century by Steven Ransom