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- <text id=92TT0075>
- <title>
- Jan. 13, 1992: Beating Breast Cancer
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1992
- Jan. 13, 1992 The Recession:How Bad Is It?
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- MEDICINE, Page 50
- Beating Breast Cancer
- </hdr><body>
- <p>Hormonal therapy is more effective for a wider range of patients
- than doctors had ever dreamed
- </p>
- <p> For women facing the trials and terrors of breast cancer, the
- worst part of the ordeal--worse even than the possibility of
- losing a breast--is the sense that the nightmare is not over
- even after the stitches heal. Breast cancer strikes 1 out of 9
- women in industrialized countries and recurs in a third of all
- patients within five years of their initial diagnosis and in
- more than half within 10 years.
- </p>
- <p> The grim statistics have led most women and their doctors
- to opt for additional treatment beyond surgery: radiation,
- chemotherapy with toxic drugs, and hormonal therapy with
- tamoxifen pills, which block the estrogens that can stimulate
- tumor growth. Though millions of research dollars and hours have
- been poured into determining which treatments work best for
- which patients, the results have often been contradictory and
- confusing.
- </p>
- <p> Now, thanks to a gigantic study published in last week's
- issue of the British medical journal Lancet, the choice of
- treatment should be clearer. Tamoxifen, alone or combined with
- other therapies, will become the treatment of choice for a
- greater number of patients than ever before.
- </p>
- <p> Led by epidemiologist Richard Peto, researchers at Oxford
- University pooled together the raw data from 133 studies
- conducted around the world on 75,000 women with operable breast
- cancer over the past four decades. Using a complex and unusual
- statistical process, they found that for women with early
- cancer, tamoxifen boosted 10-year survival rates from 71% to
- 75%. Although that kind of advance seems incremental, it
- translates into tens of thousands of lives each year.
- </p>
- <p> For women with somewhat more advanced tumors, the study
- showed, combining tamoxifen with other therapies greatly
- improved survival rates. Furthermore, tamoxifen alone, which
- produces few side effects, reduced the risk of cancer spreading
- to the other breast by 40%.
- </p>
- <p> The drug's benefits were clear in both young and old
- patients. Most surprising, tamoxifen seemed to help even those
- women whose tumors were not of the type whose growth depends on
- estrogen. "The drug probably has other mechanisms of action,"
- says Dr. Andrew Dorr of the National Cancer Institute. "It may
- be a tumor suppressor in and of itself."
- </p>
- <p> Though most patients receiving tamoxifen stop taking the
- pills after a few years, last week's report showed that the
- benefits seem to last longer than anyone had realized. "Women
- on tamoxifen for just two years had a decreased chance of dying
- 10 years later," observes Dr. I. Craig Henderson of Harvard, an
- organizer of the study.
- </p>
- <p> The Oxford study was a milestone not only in breast-cancer
- research but also in the use of a new statistical technique
- called meta-analysis, which enables researchers to pool data
- from many studies and compare otherwise incomparable results.
- The technique was recently used in a major study revealing the
- benefits of aspirin in treating heart disease. "It is emerging
- as an important tool in medicine," says Dorr, and one that can
- be deployed without the considerable costs and risks of a large
- clinical trial.
- </p>
- <p> By Christine Gorman.
- </p>
-
- </body></article>
- </text>
-
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