Tamoxifen Controversy

In response to “A Travesty at Women’s Expense,” by Samuel S. Epstein and Susan Rennie, Commentary, June 22:

Epstein and Rennie start with an extremely broad and inflammatory statement, “Thousands are to be given a chemotherapy drug as a breast cancer preventive, despite evidence of deadly side effects.” This and other extensions of the truth are so numerous in the article that it’s difficult to respond to all of them, but let me make the following points.

* Tamoxifen is not a “chemotherapy drug,” it is a hormone.

* Tamoxifen has been used extensively in this country, Japan and Europe now for the last two decades. If one looks to the international oncology literature, you are hard-put to find any reports of women dying from taking tamoxifen.

* The authors go on to insinuate that tamoxifen can produce liver cancer in human beings, when there is no medical literature to support that contention.

* As one of the cancer centers involved in the tamoxifen chemo prevention trial, I would agree with the National Cancer Institute’s claim that it has a very comprehensive informed consent, and it does not exaggerate the possible benefits, and it does not trivialize any possible side effects.

* In the authors’ summation, they take the NCI to task for not doing more in regard to cancer prevention. I believe the authors missed the whole point of the NCI’s trial: It is an experiment to test whether tamoxifen can prevent breast cancer in women who are at high risk.

We in the practicing community strongly support the NCI’s efforts to test tamoxifen as to whether it can prevent breast cancer in women who are at very high risk.

J. GALE KATTERHAGEN MD

Director, Cancer Center

Saint Joseph Medical Center, Burbank