When medical reality doesn't match the spin

[Guest guest]

> When medical reality doesn't match the spin

> http://msnbc.msn.com/id/13421277/

>

> Recent study shows the government is too eager to claim cancer success

> By Bazell

> Chief science and health correspondent, NBC News

>

> We’re making great progress against cancer, right?

>

> The National Cancer Institute desperately wants you to believe that, even if

> it means spinning the scientific facts to fit the perception.

>

> The NCI is the federal government’s lead organization in financing cancer

> research, with an annual budget of about $5 billion. Presentation of the

> results from a recent breast cancer study demonstrates the NCI’s eagerness

to

> proclaim success no matter what the data show.

>

> Called the STAR trial, the study enrolled 20,000 healthy post-menopausal

> women for five years to compare two drugs, tamoxifen and raloxifene (sold

under

> the trade name Evista), to determine which is better at reducing the risk for

> breast cancer. Scientists and journalists label such studies “preventionâ€

> trials. Unfortunately, nothing prevents breast cancer. Some drugs shift the

> odds, and the goal here was to determine which one is best.

>

> Reading a a press release issued by the NCI in April and listening to a

> telephone briefing, there was no doubt. Both drugs affected breast cancer

> incidence equally, but raloxifene has fewer side effects, according to the

> researchers.

>

> Bingo! A great result for women’s health. Raloxifene, as headlines and news

> broadcasts across the country proclaimed, was the clear winner.

>

> Since the drug is already on the market to protect against bone loss why

> shouldn’t eligible women, estimated to number 30 million, take it?

>

> Ambiguous results

> The problem? The detailed results of the study & shy; appearing in this week’

> s issue of the Journal of the American Medical Association & shy; differ

> substantially from the interpretation pushed by the press release. Both drugs

have

> side effects and the study offers little clarity about which one is best.

> Most troubling for raloxifene, it brings a higher incidence of a breast

> condition called DCIS (or ductal carcinoma in situ).

>

> Oncologists debate whether this is truly breast cancer or a pre-cancerous

> condition. But tens of thousands of women a year require surgery (often

> mastectomy) and radiation to treat DCIS so anyone would think twice before

taking a

> drug that might increase the risk.

>

> This equivocal result is especially troubling for the NCI because of the

> history of the effort to find a breast cancer “prevention†pill. In 1998

with

> great fanfare the NCI released results of a trial that compared tamoxifen to a

> placebo. Tamoxifen clearly reduced the risk of breast cancer. A government

> press release called it “an historic step toward more effective prevention

of

> breast cancer.â€

>

> But women and their doctors did not buy into the concept. Tamoxifen

> increases the risk for blood clots and uterine cancer and few healthy women

wanted to

> take a pill every day.

>

> So the NCI really wanted to prove that raloxifene could be an acceptable

> alternative. But taxpayers spent $88 million (and raloxifene manufacturer Eli

> Lilly put in another $30 Million) for the ambiguous result.

>