Want to increase your chances of getting, and possibly dying from, node-positive breast cancer? Take hormone therapy.
Pharma's lucrative estrogen plus progestin combo is already known to increase the chance of getting breast cancer by 26 percent. But an article in this week's Journal of the American Medical Association (JAMA) shows hormone therapy also increases the chance of dying from breast cancer, as followups are conducted on women who took it.
In fact hormone therapy, already indicted for causing delays in breast cancer diagnosis by increasing breast density (and increasing lung cancer deaths) is now so dangerous that Peter B. Bach of the Memorial Sloan-Kettering Cancer Center, who wrote an accompanying JAMA editorial, told the New York Times that even the recommendation to take "the lowest possible doses for the shortest possible time" is now questionable. Perhaps like prescribing the fewest and lowest tar cigarettes as possible.
It is hard to image men putting up with a therapy for "outliving their testes" that kills and maims them decade after decade. Women given Premarin for their "estrogen deficiency" in the 1980s developed so much endometrial cancer, the cancer rate dropped when they quit taking the drug. Five years ago, the same thing happened with breast cancer when women quit Prempro. Who can say "iatrodemic" physician-caused epidemic? Who can say fool me twice?
Both Prempro and Premarin are made by Wyeth, now part of Pfizer.
And just as hormone therapy is repackaged for a new generation of women, so are pharma-friendly press stories that push it, such as Parade's fabled piece with Lauren Hutton extolling hormone therapy did some years ago.
In April, the New York Times magazine ran a pro-hormone piece called "The Estrogen Dilemma," by Cynthia Gorney, relying on five Wyeth-linked researchers whose conflicts of interests were not disclosed. Three -- Claudio Soares, Louann Brizendine and Thomas Clarkson -- have served on Wyeth's speaker boards.
In 2009, the Washington Post ran a pro-hormone piece lifted intact from Massachusetts General Hospital's industry-friendly magazine, where it ran next to a piece pushing hormone therapy for coronary heart disease written by Wyeth-linked doctors. Hormone therapy causes a 29 percent increase in heart attacks, according to the Women's Health Initiative.
Hormone therapy is also linked to asthma, lupus, scleroderma, non-Hodgkin's lymphoma, urinary incontinence, hearing loss, cataracts, gout, joint degeneration, dementia, stroke, blood clots, malignant melanoma, and five other kinds of cancer according to medical journal reports.
Nor does industry want to let go of the hormone gravy train.
Oblivious to the JAMA article and many others, trials are underway with NIH tax dollars, to see if pre-menopausal women given hormones will be helped instead of hurt. (Let's start smoking at 12!) In addition to the Kronos Early Estrogen Prevention Study trials at major medical centers conducted by several Wyeth-linked researchers, Wake Forest and at Mount Sinai medical school researchers are conducting hormone experiments on ovariectomized primates. (Like Premarin mares, immobilized on pee lines, their offspring killed, female primates suffer unduly from hormone therapy.)
Given over 5,000 lawsuits brought by women with hormone therapy-caused breast cancer, why is it still on the market? Why is it being tested (with tax dollars) to extend the franchise into a new generation of women? And why is it still presented to women as a "choice"? As in We Warned You.
Ten years ago, when pharma still said it didn't know about the hormone risks, Dr. Janette Sherman exposed hormone therapy's cancer links and its diagnosis-delaying breast density in a prescient book called Life's Delicate Balance: Causes and Prevention of Breast Cancer.
"The promotional literature urges we women to confer with our doctors to decide if hormone replacement is for us," writes Sherman. "Does that mean if we have an adverse outcome as a result of our decision that we will be again blamed for the outcome?"
This week in a Times interview, Dr. Bach makes the same observation. "The fallback is that doctors and patients should be deciding this on a one-to-one basis, weighing risks and benefits. How do you do that when you don't know what the risks are?" he says.
Has anything changed?
Martha Rosenberg frequently writes about the impact of the pharmaceutical, food and gun industries on public health. Her work has appeared in the Boston Globe, San Francisco Chronicle, Chicago Tribune and other outlets.