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Settlement in breast cancer claim over exposure to chemical DES

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Between 1940 and 1971, many pregnant women were treated with a synthetic estrogen, diethylstilbestrol -- commonly known as DES -- to prevent miscarriage and other complications.

The drug didn’t work for that purpose, but it did have biological effects on the women who took it, as well as their children.

On Wednesday, four sisters who’d been exposed to DES in the womb reached a settlement with one of the drug’s principal makers, Eli Lilly & Co., during a federal trial in Boston, the Associated Press reported. The women said that the drug had caused their breast cancers and that the company didn’t test the drug adequately. There are many similar pending claims around the country, the AP article says.

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Here are facts about DES from a website of the National Cancer Institute. Although it would be impossible to prove that these specific breast cancers were caused by exposure to the drug, studies do show that the risk of breast cancer is raised in women who were exposed during pregnancy and there’s evidence for raised risk in their daughters too.

Interestingly, even though studies in the 1950s had shown that DES did not help prevent miscarriages, doctors continued to prescribe it for that purpose. My mother was prescribed DES, even though she recalls the doctor saying to others at the time that it wasn’t effective. Maybe he thought: What harm? It was only in 1971 that scientists reported that people exposed to DES prenatally were at 40 times higher risk for a rare type of cancer of cells of the cervix and vaginal walls, known as clear cell adenocarcinoma, according to the National Cancer Institute website. (Even in DES daughters, this is still a very rare cancer.)

A possible breast cancer risk emerged later, as DES daughters grew older. The risk is a lot smaller than for the clear cell adenocarcinoma: Breast cancer rates are about twice as high in exposed daughters older than 40 compared with unexposed women of the same age, according to research, though they might climb higher as DES daughters age.

DES daughters are also more likely to have abnormalities of the cervix that aren’t themselves cancerous, and may also have fertility and pregnancy issues.

For all these reasons, women who were exposed to DES are urged to tell their doctors about the exposure so that more frequent and more thorough Pap tests and pelvic exams can be performed.

DES sons may also have some medical issues, such as an increased rate of noncancerous cysts in ducts of the testes as well as undescended testicles.

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DES grandchildren are under study too because studies in animals show that exposure to DES can cause chemical changes in the DNA that can be passed on to offspring down the generations.

“This is a victory for DES daughters,” Fran Howell, executive director of DES Action USA, said in an email in response to news of the settlement. “Sadly, Eli Lilly did not have to admit fault, but in our society a settlement is as much an admission of guilt as anything else.”

For more information on DES, you can check these Q-and-As at the website of the American Cancer Society.

And here’s a website where you can learn about the National Cancer Institute’s DES follow-up study.

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