by John M. Curtis
(310) 204-8700

Copyright Dec. 15, 2006
All Rights Reserved.

olting the medical world, U.S. breast cancer rates dropped 7% in 2003 when millions of women stopped taking hormone replacement therapy [HRT], after a National Institutes of Health study linked HRT with breast cancer. While the dramatic drop in breast cancer was welcomed news, it raises disturbing questions about the ill-advised and misguided use of HRT to combat symptoms of menopause. HRT was popularized by New York gynecologist Robert A. Wilson's 1966 book “Feminine Forever,” a 1960s infatuation with endocrinology. For more than 40 years, physicians routinely prescribed HRT, despite conclusive medical evidence that at least 70% of breast cancers were caused by excessive estrogen. Despite growing popularity of HRT, mounting evidence in the 1970s linked estrogen to breast cancer, prompting the drug maker ICI, now AstraZeneca, to invent tamoxifen.

      Tamoxifen was the first Food and Drug Administration approved Selective Estrogen Receptor Modulator [SERM] in 1977, designed to starve estrogen-sensitive breast tumors of chemical growth. For more than 30 years, the oncology community knew perfectly well that most breast cancer was proliferated by estrogen, the very hormone tamoxifen controls. Since Wilson's brainstorm of treating menopausal symptoms with estrogen and progesterone, the medical community—and drug industry—ignored the dangerous link between breast cancer and HRT. Despite alarming rates of breast cancer during the ‘70s, ‘80s and ‘90s, drug companies and physicians routinely ignored the connection between hormones and malignant tumors. When the National Cancer Institute published its findings on HRT in 2002, doctors and patients abandoned HRT abruptly.

      Delivering the news at the San Antonio Breast Cancer Symposium, the study's co-author, Dr. Rowan Chiebowski of the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical, acted stunned. “Our whole group looked at the numbers and said, ‘Is this real?” said Chiebowski, in disbelief over what looked like a medical breakthrough. “After years of trying to defeat breast cancer by reducing it once it has occurred, it was a revelation to think that maybe there's an opportunity to decrease the risk of getting cancer to begin with,” said Chiebowski, acting as if he'd never heard the research on SERM's like tamoxifen. Like the disconnect between federal agencies before Sept. 11, physicians and drug companies must now answer how they could continue prescribing HRT while the best medical evidence showed a link between estrogen and breast cancer.

      Since HRT became popular in the late ‘60s, alarming numbers of women were afflicted with breast cancer, countless others losing their lives. What does the medical community say to the women—and their families—afflicted with breast cancer because of HRT? More than 200,000 cases of breast cancer are diagnosed each year. It's now reasonable to ask how many of those patients received HRT. Among the age-group 50-69—the most likely group taking HRT—they experienced a 12% drop in breast cancer since 2003, confirming the alarming relationship. No one knows yet whether the lowered diagnosis of breast cancer will eventually increase as tumors take more time to develop. “We may have slowed their growth trajectory so that if we don't see them this year, we may see them next year or in subsequent years,” said Dr. Julie Smith of the New York University Cancer Institute.

      More research needs to address the alarming rise of breast cancer over the last 40 years, now correlated with HRT. As liability grows, physicians and drug companies will no doubt attribute breast cancer to genetic predispositions, not hormones. That's the same argument made by big Tobacco to account for how some smokers don't develop lung cancer or other ill-effects from chronic use. Unlike the tobacco industry, there's no excuse for the bizarre disconnect between endocrinologists prescribing HRT and oncologists treating estrogen-sensitive breast cancer with tamoxifen since 1977. If there's any doubt about the recent 17,000-woman NIH study, a Kaiser Foundation study reported in the journal “Clinical Oncology” an 11% decline in breast cancer in 2003, also following a cessation of HRT. With tamoxifen in use for nearly 30 years, it's hard to account for the inconsistency.

      Findings from the NIH Women's Health Study provide convincing preliminary evidence that HRT causes breast cancer. Or, as the study indicates, stopping HRT dramatically reduces the epidemiology of the disease. Over the past 40 years, countless numbers of women who otherwise would have not developed breast cancer got the disease from ingesting estrogen under doctors' orders. Few women would risk breast cancer to deal with essentially the nuisance symptoms from menopause. Since 1977, the medical profession and drug companies have known that estrogen proliferates breast cancer, routinely prescribing tamoxefin to prevent the tumor growth after surgery and chemotherapy. While significant numbers of women have stopped HRT, others continue hormones under medical direction without a clue about the risks and dangerous side effects.

About the Author

John M. Curtis writes politically neutral commentary analyzing spin in national and global news. He's editor of OnlineColumnist.com and author of Dodging The Bullet and Operation Charisma.

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