Breast Cancer Drugs:
A Cautionary Note

Letter to the Editor
Copyright 1998 Dow Jones & Co., Inc.
Wall Street Journal (May 13, 1998)

Your April 20 page-one article "New Drugs Give Cause for Hope in Fight Against Breast Cancer" overstates the significance of preliminary unpublished results of clinical trials involving Tamoxifen and Evista. These drugs are neither new nor revolutionary. Tamoxifen has been around for more than 25 years and Evista has been in preclinical and clinical trials for more than five years. No one who follows breast-cancer research should be surprised that these drugs might result in decreased breast cancer among a high-risk population. What we don't know, however, is whether the purported improvement is attributable to treatment of "occult" (as yet undetectable) breast cancer, or whether these drugs are actually working as a preventative. Moreover, many breast cancers are not sensitive to estrogen and therefore are indifferent to these hormonal treatments.

The latest Evista "news" also causes concern, because of the suggestion that this hormonal agent, about which relatively little is known, might be used in otherwise healthy woman. The risks of long-term use of this drug are untested, and it should not be viewed as a panacea by women concerned about the very real risk of developing breast cancer.

In any event, these drugs are not the answer to the search for a cure for breast cancer. Even if more aggressive use of known drugs results in a decrease in today's astronomical rates of breast cancer, we still don't know how to cure or prevent the disease in the majority of people. The "news" does not mean that a new plateau in treatment has been reached. Rather, it is a triumph of old news, and one which leaves these survivors feeling frustrated, angered and frightened.

Ann E. Fonfa
Carol E. Hochberg
New York

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