Medicine that can help prevent breast cancer - did you know that it exists?
The The National Institute for Health and Clinical Excellence (NICE) has just announced that it will start making breast cancer medications available to those who have not been diagnosed with cancer. Hopefully this announcement combined with the heightened awareness linked to Angelina Jolie will wake-up the slumbering American press. Research on medication that can potentially prevent breast cancer has been going on since the late 1990’s but most women are unaware of it. It’s time that women at higher risk of breast cancer were made aware of this potential lifesaving treatment.
The main criterion for treatment is having several close relatives who have developed breast cancer. We know that breast cancer has a strong genetic component, strong enough to prompt Angelina Jolie to undergo a double mastectomy based on her family history.
For women with a strong genetic risk of breast cancer, the treatment would involve five years of taking tamoxifen or raloxifene. Prof. Gareth Evans, one of the consults who helped develop the new guidelines for the NHS notes that the treatment spares women the emotional, psychological, physical and pharmacological trauma of post-diagnosis cancer treatment which can include surgery, radiotherapy and chemotherapy or some combination. Prof. Evans also noted that for every 4 or 5 prevented cancers, there would be one life saved.
Until Angelina Jolie’s well published double mastectomy many women didn’t know that they could be screened to evaluate their risk of developing breast cancer. For those who knew about genetic screening, it’s likely they were only aware of two options; the first option being continuous, careful monitoring and testing and the second option being that taken by Ms. Jolie. Many women remain unaware that there is a third option.
Women who have family members with breast cancer should consider being tested for mutations in the BRCA genes. If a woman was only aware of the first two options, it’s conceivable that she might prefer not to know if she carried damaged copies of the BRCA genes. However, with the third option, testing might become not just useful, but life-saving, since there is a non-surgical, non-radiation, non-chemotherapy option that can help prevent breast cancer in those with faulty BRCA genes.
BRCA (Breast Cancer) genes are genes carried on the long arm of chromosome 17. Its normal function is to repair damage that occurs in the DNA of breast cells. If the gene is defective, it fails to make the necessary repairs and the damaged DNA can lead to a cancerous transformation of the cell.
One of the characteristics of breast cancer is that it does not grow well in the absence of estrogen. As you know estrogen is a female reproductive hormone, found in some abundance, and the breast if full of estrogen receptors. The drugs tamoxifen or raloxifene act as estrogen receptor blockers in breast tissue, which prevents tumor growth. There are well defined risks in taking the drugs, however, the risks are manageable and are almost always less than the associated risk of breast cancer. Like most drug side-effects, the ones linked to tamoxifen or raloxifene will likely diminish after the drug as been taken for a few weeks.
Women need to know that there is a third option and that it is a very powerful option. Women need to know their risk of breast cancer, and if they have a family history. Women who recognize a family history should consider genetic screening; and if the screening suggests an increased risk, then they need to talk to a specialist about the options available to them and whether tamoxifen or raloxifene would be a good choice for them.
Make it a point to discuss the subject with friends and family and determine your family history.
Knowledge is power and early treatment is life.