Women at Risk Refusing Tamoxifen
Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work
APRIL 30, 2018
I will admit that I am shocked by this report from the UK that six in seven women who are at high risk for breast cancer refuse to take Tamoxifen. From my perspective in Cancer World. it is smart to do virtually anything that will keep you from becoming a resident. Meaning, it is smart to do anything to avoid a cancer diagnosis. We know that it is possible due to genetic testing to identify women with carry a gene mutation (usually BRCA1 or BRCA2) and are at high risk for developing breast cancer. We also know that there are women whose genetic tests are negative, but who have a very strong family history, and they, too, are likely to be at high risk.
So why would women turn down this medication that has been shown to reduce the risk of developing breast cancer by about 40%? The given reasons in the study are a belief that cancer is random and up to fate, a general distrust of medicines, and a worry about side effects. It is interesting that cost is not listed but this was done in the UK where there is universal health care, so I suspect a similar study done in the US would include cost concerns. From the given list, the only one that seems reasonable is the side effect issue. Yes, Tamoxifen does bring an increased risk, a tiny one, of developing endometrial cancer and of an embolism. Both risks are very, very small--especially in comparison to the breast cancer risk. Clearly it is not helpful to go around trying to scare people, but I hope that someone is talking carefully with these at-risk women about the lethal power of breast cancer. Yes, many women are treated and do fine, but far too many others die. Wouldn't it make sense to try to avoid this?
Six in 7 women at high risk of breast cancer shun tamoxifen as a preventative measure
Six in seven women with a family history of breast cancer opt out of taking tamoxifen as a preventative measure, according to a study funded by Cancer Research UK and published in Breast Cancer Research and Treatment today (Tuesday)*.
Researchers asked 258 healthy women across England who had been identified as having an increased risk of the disease whether they had agreed to take the drug to help prevent breast cancer developing, and interviewed 16 women to identify what influenced their decision to take it.
Women chose not to start taking the drug because they thought cancer was down to fate, they distrusted medication in general or they feared side effects would interfere with looking after their family.
But overall the team, based at the University of Leeds, Northwestern University, University College London and Queen Mary University of London, found women with children were more likely to take up the offer of tamoxifen.