One woman in eight develops breast cancer, with about 55,000 new cases a year and 11,400 deaths from the disease.
A
new era of cancer-prevention treatments was ushered in last week with
news that women can now halve their risk of developing breast tumours
thanks to a 4p-a-day tablet to be offered on the NHS.
Prescribing
watchdogs the National Institute for Health and Care Excellence
recommended that the drug, anastrozole, should be made available to
women who are over 50 and deemed to have a high risk of developing the
disease.
It is already taken by women who have had breast cancer in order to prevent it from recurring.
Younger women with similarly high risks are currently offered another medication, tamoxifen, as a preventative measure.
Both
medications act on the female sex hormone oestrogen, which is known to
trigger the development and growth of breast-cancer cells.
One
woman in eight develops breast cancer, with about 55,000 new cases a
year and 11,400 deaths from the disease. Scientists estimate that if all
women currently at high and medium risk were offered anastrozole for
five years, 39,000 could be spared breast cancer.
So, should you be on the 'wonder tablet'? Here, Britain's leading experts give their verdict…
Professor
Jack Cuzick, director of the Wolfson Institute of Preventive Medicine
in London and head of the Centre for Cancer Prevention at Queen Mary
University of London, says: 'The approach in cardiology for a long time
now has been to assess the risk of a patient having a heart attack or
stroke and, if appropriate, give drugs like statins to reduce that risk.
Professor Jack Cuzick (pictured) is the director of the Wolfson Institute of Preventive Medicine in London.
'We
can now take a similar approach with breast cancer. It's fairly easy to
find out your breast-cancer risk by using an online survey like IBIS
risk calculator, ems-trials.org/riskevaluator, which asks questions
about lifestyle and family history of diseases.
'If this flags up a concern, a GP can refer women to a NHS genetic counsellor or a breast specialist.
'Anastrozole
works by stopping oestrogen being produced in fat tissues, a process
called aromatisation. In post-menopausal women whose ovaries have
stopped producing oestrogen, this is the best way of providing
protection.
'We
already knew from studying women who had breast cancer that anastrozole
was better than tamoxifen at preventing it from coming back. It made
sense to look at this medication for prevention, too.
'Our
previous studies showed that pre-menopausal women who took tamoxifen,
which blocks the action of oestrogen in the body rather than preventing
it from being produced, for five years, gain a substantial level of
protection.
'Five
years of treatment seems to offer almost lifetime benefit and results
in minimum damage, meaning the benefits far outweigh the risk.'
Professor
Peter Schmid, of Leaders in Oncology, is a Professor of Cancer Medicine
and Lead of the Centre of Experimental Cancer Medicine at Barts Cancer
Institute.
He
says: 'The main concern about taking anastrozole or tamoxifen is that
oestrogen is integral in maintaining bone health. Before starting
therapy, women should be given a bone-density scan. If problems are
flagged up, another drug can be given to prevent osteoporosis.
Professor Peter Schmid, of Leaders in
Oncology, is a Professor of Cancer Medicine and Lead of the Centre of
Experimental Cancer Medicine at Barts Cancer Institute.
'All
women will experience some bone loss but this returns after the drug is
stopped. Otherwise, side effects are similar to menopause, which is
individual for all women.
'The
most common are hot flushes and problems with sleep, but these often
pass. A small group of patients say the side effects are too detrimental
to their quality of life to continue, a majority are willing to accept
the side effects and they are not significant enough.
'It
is important to highlight that this should only be offered to high-risk
women – those with a 30 per cent or more lifetime risk of developing
breast cancer.
'There
is also no point in giving this to women of any age – over 50 or not –
who have not yet gone through the menopause as the drug will not work on
them.'
Dr
Marilyn Glenville is Britain's leading nutritionist specialising in
women's health and author of more than a dozen books on the subject,
including the bestseller Natural Solutions For The Menopause.
She
says: 'There is a risk with drug developments like this for patients to
think a pill gives total protection. In fact, maintaining a healthy
body weight – importantly, watching out for body-fat percentage – is
extremely important.
Dr Marilyn Glenville (pictured) is Britain's leading nutritionist specialising in women's health.
'Other
proven ways to reduce risk of breast cancer: reduce alcohol intake to
no more than one unit per day, exercise 30 minutes daily, and breastfeed
children for six months. The latter is not something you can change,
but if you have done this in younger years, you are of lower risk.
'Diet
is key, intake of Vitamin D specifically. As well as being important
for bone health, it stops proliferation of breast cancer cells, a link
which has been shown in several studies.
'Also
eating enough cruciferous vegetables such as kale and broccoli, and
omega 3, through oily fish, eggs and flax seeds. Flax seeds also inhibit
oestrogen production in fat tissue.
'Anything
that's going to control excess oestrogen is going to help. These may
not be huge changes, but combined, they could make a huge difference.'

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