The widespread publicity given to the success of the anti-cancer drug Tamoxifen has proved premature. I suspect researchers who release their preliminary findings into the effectiveness of new drugs for treating cancer do not realise how dangerous it is to give false hope to people who are suffering from this life-threatening condition.
There are many well-documented cases that show how patients are affected by what they learn from the media. One of the best known concerns a Mr Wright who was suffering from terminal cancer and only had weeks to live. Krebiozen was being hailed as the new wonder-drug and he talked his doctor into getting him on a panel of patients to test the drug. Within a week of his first injection, his health improved. His specialist described his tumours as shrinking "like snowballs in a hot oven".
He went into remission until doubts were expressed a few months later in the media about the effectiveness of Krebiozen. Wright's tumours returned almost immediately. His oncologist engaged in a psychological ploy which would now be considered unethical. He told Wright the original batch of the drug which he received was defective and asked if he would like to take the new, super-enhanced Krebiozen. There was no such wonder drug. All the doctor injected was sterile water, yet Wright's tumours disappeared again and he returned to a normal life. Three months later, an announcement was made in a medical journal that Krebiozen was judged to be useless. When Wright learned of this, his tumours returned and he died shortly afterwards. Earlier this year Tamoxifen was hailed as the new hope for women with breast cancer. Investigators in the US halted a study designed to find out whether this anti-oestrogen drug could prevent breast cancer in women at high risk of the disease and published their findings when, four years into the study, their research showed the incidence of breast cancer among the women on Tamoxifen was 45 per cent lower than among those on placebos.
The widespread publicity that followed raised the hopes of many women, only for them to be dashed by a recent article in the British medical journal the Lancet. Similar trials with Tamoxifen by two European research groups had exhibited very different results. In Italy, Dr Umberto Veronesi and colleagues from Milan and Bologna randomly assigned 5,408 women to take either Tamoxifen or a placebo. After 46 months of follow-up, they found "no difference in breastcancer frequency between women who were taking the drug and those taking the placebo".
In London, Dr Trevor Powles and his colleagues worked with 2,494 women with a family history of breast cancer. After 70 months of follow-up, their findings were "the overall frequency of breast cancer is the same for women on Tamoxifen or placebo".
Prof Kathleen Pritchard from Toronto points out that the difference between the findings of the European and American studies may result from the number and age of the women participating. The US study covered 13,000 women, but many of them older than in the European studies which would have made a difference to the risk factors.
While researchers acknowledge that more trials will be needed to assess the impact of Tamoxifen on cancer, Dr Richard Schilsky, director of Chicago Cancer Research Centre, is hailing another drug, Taxol, as the most significant advance in the treatment of early breast cancer. He claims it increases the chance of a cure by 26 per cent and reduces the risk of cancer recurrence by 22 per cent. It has the potential to save tens of thousands of lives when used in conjunction with standard chemotherapy. The most recent statistics from the Irish Cancer Society show that approximately 1,500 women are diagnosed with breast cancer each year. Six of every ten will go on to lead normal lives after conventional treatment. Anyone who is ill, particularly if they are about to have the powerful and toxic medical treatments for cancer, is at a low ebb physically and emotionally and particularly vulnerable to media hype about wonder-drugs that might enable them to avoid going through with unpleasant treatment. There is a very real danger that reports of wonder drugs will encourage women with breast cancer, who are not trained in assessing or interpreting research findings, to defer or even reject such treatment.
It is very difficult for the non-medical person who is suffering from cancer to read about all these so-called wonder drugs and to find, on investigation, that they have not been fully researched, are not yet available or have unpleasant side effects. Their families are also affected by false hope raised by the premature release of research findings on drugs such as Taxol and Tamoxifen.