NICE one?

Tamoxifen for 'high risk' women
The National Institute for Health and Clinical Excellence (NICE) has started a consultation to find out if the drug tamoxifen could be given by the NHS to women with a familial history of breast cancer.
NICE's draft guidelines for England and Wales are due for approval later this year and if they go ahead will be a first for the UK. NICE said more needed to be done to target women who have a high genetic risk of breast cancer (including those who have a mother, sister or aunt who was diagnosed with the disease before the age of 50). The new guidelines would update those made in 2006 and could see high risk women being prescribed tamoxifen for five years.
Research has estimated there would be 20 fewer cases of breast cancer for every 1,000 women who took the drug. Professor Mark Baker, director of the centre for clinical practice at NICE, said they did not fully know the causes of the disease. He added: "However, we do know that having a family history of breast, ovarian or a related cancer can significantly increase the risk of developing breast cancer, including developing the cancer at a younger age."
"It is also more likely that people with family members affected by cancer who then develop breast cancer themselves could develop a separate tumour in the other breast following initial treatment."
"This is why it's wise for any person with a family history of cancer to receive appropriate investigations and screening that would otherwise be unnecessary if a family history did not exist."

HOWEVER...
Beware of the Dark Side of Tamoxifen
There has been much ado in the press recently about the wonders of the drug tamoxifen. It has been heralded as a major breakthrough in the treatment and possible prevention of breast cancer. Tamoxifen is now the number one recommended drug treatment for women recovering from breast cancer. With half a billion dollars in annual revenues, it is currently used by more women with breast cancer than any other prescription drug.
Despite tamoxifen's supposed ability to reduce recurrence in postmenopausal women, major studies have shown that tamoxifen reduces death from breast cancer only marginally. The majority of women who take tamoxifen live no longer than women who refuse it. It is with great alarm that researchers are finding that some breast cancers actually learn how to use tamoxifen to stimulate their growth.
Blood Clots
Tamoxifen irritates the walls of the veins. The constant irritation and inflammation weakens the veins causing bleeding, clotting, thrombophlebitis, and in the worst cases -- obstruction of the blood vessels serving the lungs which can be deadly and occur with little warning. Several studies showed that the risk of developing life-threatening blood clots increased as much as seven times in women taking tamoxifen.
Breast Cancer Awareness Month which is held in October was started by Imperial Chemical Industries- a parent company to Zeneca Pharmaceuticals, now AstraZeneca. This has been a controversial issue for years since they sell Tamoxifen- a drug used to prevent breast cancer, but has been shown to cause endometrial cancers, blood clots, and strokes in some individuals. Their trademark slogan, “Early Detection is Your Best Prevention” seems to make sense to some people. However, this is a secondary prevention- since in order for it to be detected, the cancer has to be there already. I am grateful for the National Breast Cancer Awareness Month and their resources that are available to cancer patients and their families. However, I think that primary prevention steps need to be taken reduce cancer morbidity.

So…. what are those primary prevention steps? One of them is eating a healthy diet. A major international report titled Food, Nutrition, and the Prevention of Cancer: A Global Perspective found that 60 to 70 percent of ALL cancers can be prevented by staying physically active, not smoking, and “choosing predominantly plant-based diets rich in a variety of vegetables and fruits, legumes, and minimally processed starchy staple foods.” The report reviewed over 200 studies on the link between fruits and vegetables and cancer. They found that 78% of the studies showed that fruit and veg had a protective effect against cancer, while 22% showed no significant link, and no studies showed an increase in cancer.
The British Medical Journal stated: “What is remarkable about the diet-cancer story is the consistency with which certain foods emerge as important in reducing risk across the range of cancers. Millions of cancer cases could be prevented each year if more individuals adopted diets low in meat and high in fruits and vegetables.”

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