Winning the war against breast cancer

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breast cancer AP BRCA1 and BRCA2 are widely known as breast cancer genes, and women with a mutation in one or both often decide to have their breasts removed so they do not develop that disease.

Johannesburg - New tests on old breast cancer drugs are proving that healthy women who are high-risk candidates for breast cancer can take the drugs as a preventative measure, slashing their chances of getting the disease by up to 63 percent.

Dr Carol-Ann Benn, a Joburg oncologist and founder of the Breast Health Foundation in South Africa, said the drugs Tamoxifen and Evista (Raloxifene) have been tested and found to decrease the chances of high-risk patients getting breast cancer.

“No drug will totally prevent the onset of cancer, but can decrease the chances of people getting it,” she said this morning, after new information on the drug was released in Britain.

Benn has done studies on the drug and her findings concur with the information released.

According to Britain’s Daily Mail newspaper, international trials have shown that these drugs reduce the risk of the most common kind of breast cancer by one third after five years, with the preventative effect lasting up to 20 years.

The guidelines for the drugs were released today by the UK’s National Institute for Health and Clinical Excellence, the watchdog responsible for advising the National Health Service on good practice.

Their most controversial plan is for drugs to be prescribed as preventative therapy despite not being licensed for the purpose.

Both Tamoxifen and the osteoporosis drug Raloxifene, which is used after the menopause, are licensed in the US for breast cancer prevention but are not widely prescribed, partly because of concerns about side effects.

Benn said here in South Africa, because all medication has positive and negative side effects, these had to be weighed up for each patient before they were prescribed.

Most common side effects are hot flushes, nausea, indigestion, weight gain and leg cramps.

The drugs are both selective oestrogen receptor modulators and belong to the same class, she said, but have different side effects, with some bringing on menopausal symptoms such as hot flushes.

The new tests show that using these drugs as a precaution against cancer could offer as much as 20 years of protection for high-risk women.

Even women thought to be at moderate risk of getting breast cancer within the next 10 years, due to genetic or family history, could be given this daily medication as a preventative measure.

Benn said Tamoxifen and Evista have been used to treat the illness since the 1990s, saving many lives.

They halve the chances of the disease returning. Patients take the drug for five years after diagnosis in breast cancer which is caused by the hormone oestrogen.

One in 26 women in South Africa in all age and race groups, get breast cancer, she said.

Those that are at risk are:

Those with family history: You are at higher risk if you have a close relative (on either your mother or father’s side) who have, or have had, breast cancer.

Age: Your chances of developing breast cancer increases with age, especially once you have crossed 40. Women over the age of 35 should go for regular check-ups. The younger you are when developing breast cancer, however, the greater the chance of the cancer being more aggressive than in older women.

Lifestyle: If you follow a diet high in fat, do not exercise regularly, are overweight and drink more than two glasses of alcohol a day, you are at higher risk.

Hormones: Women who went through menopause at a later stage in life, had children after the age of 40 (or no children at all) or started their menstrual cycle at a very young age, are at greater risk.

Gender: Women are at far greater risk than men. Only about one in every 100 men is at risk.

The Daily Mail reports that Chris Askew of Breakthrough Breast Cancer said the new guidance was “a historic step for the prevention of breast cancer”.

He added: “It is the first time drugs have ever been recommended for reducing breast cancer risk in the UK.

“This is exciting even though most women do not have a significant family history of the disease, it’s crucial that those who do have an array of options to help control their risk.” - The Star

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