Ladies, Pick Your Cancer
Many women receiving menopausal treatments today are too young to remember the old American folk tune, There Was An Old Lady Who Swallowed A Fly even though the song could be written about them.
The old lady, swallows a spider to catch the fly--then a bird to catch the spider, then a cat to catch the bird ad infinitum--until she is a walking Noah's Ark and iatrogenic casualty.
For forty years women obligingly swallowed the "fly" of Premarin, a horse urine menopause drug manufactured by Wyeth (now Pfizer) until it was revealed to increase endometrial cancer in the 1970s.
But not to worry. Wyeth had a better drug, the notorious Prempro ("spider") which, by adding a progestin to the estrogen, reduced endometrial cancer while increasing the risk of breast, ovarian and lung cancers. Oops. Nor did the original endometrial cancer risk completely go away.
Once Prempro was found to cause cancer and greater difficulty in reading mammograms that would detect same, Selective Estrogen Receptor Modulators or SERMs surfaced (the "bird.")
SERMS like tamoxifen and Evista could help mammogram readability and prevent and/or treat breast cancer. Except they could contribute to endometrial and ovarian cancer. Anyone see where this is going?
No wonder when the news broke last week that bisphosphonate bone drugs like Fosamax and Boniva could reduce the incidence of breast cancer, women reacted with another American folkism: "Fool Me Twice, Shame on Me."
Sure the re-analysis of Women's Health Initiative data (WHI) by original author Rowan Chlebowski, MD, found women taking the bone drugs had 31 percent less invasive breast cancer after seven years. But the women on bisphosphonates in the paper presented at the Annual San Antonio Breast Cancer Symposium were also more likely to get noninvasive breast cancer called ductal carcinoma in situ (DCIS).
This is not the only example of the choice given to women of "trading" one cancer for another--some termed "good cancer"-- thanks to Wall Street wonder drugs that make women into lab animals. In fact within hours of the news, "Study Shows Merck's Fosamax May Fight Breast Cancer," appeared on Portfolio.com.